Increasing numbers of teens are having elective cosmetic surgeries to address body image issues, without fully considering the physical and psychological risks involved. Part two of our three-part series on Body Dysmorphic Disorder (BDD).
Our last post focused on Body Dysmorphic Disorder (BDD), body image issues, and cosmetic surgery in the entertainment industry. While I can appreciate that movie stars and models to some extent depend on their appearance for their livelihoods, I worry about the message that stars’ cosmetic surgeries send to the public, particularly young women who see these stars as role models. One recent news story focused on the increasing numbers of teens seeking cosmetic surgeries. The article noted three problematic issues specifically related to this growing trend of teens looking to surgically enhance their bodies:
- Teens’ bodies are still changing and growing, so having surgeries before their bodies have fully grown is ill-advised;
- Teens seeking cosmetic surgeries may be suffering from depression and would be better advised to address their feelings about themselves in a non-surgical manner
- Teens often don’t understand the significant risks involved in having any surgery, including the risk of disfigurement and death.
On this last note, readers should be reminded that people can and do die as a result of complications from what are considered “routine” cosmetic surgeries. Many will remember the publicity generated by the November 2007 death of Kanye West’s mother from complications related to having a tummy tuck and breast augmentation. In fact, many people die each year following cosmetic procedures. One recent study found the mortality rate for those undergoing liposuction was approximately one death for every 5000 patients, while approximately one out of every 350 patients undergoing this supposedly “routine” procedure experienced “significant complications”.
These findings were corroborated by a second study, while a third study suggested that, due to under-reporting, a more realistic mortality rate would be one death in every 1000 liposuction procedures. And the rates for abdominoplasty (tummy tuck) and facelifts are far worse.
Society has age-limits for access to certain things such as driving cars and drinking alcohol for the simple reason that teens are unlikely to have the maturity needed to handle the responsibilities inherent in these behaviors. Should we not at least consider setting age-based limitations on elective cosmetic surgery?
A less dramatic, but equally compelling argument against teens having cosmetic surgery can be found in a recent article in Elle magazine. The author, Sabrina Weiss, recounts her growing regret with having had a nose job just after her graduation from high school. While initially pleased with the results of the procedure, Weiss over time came to feel she had lost a part of herself. Upon encountering a picture of her father in his youth, she sees how much her nose job had robbed her of a connection to her father:
“Despite everything the surgery did for me—and it did a lot—I wish I could undo it. At 31, I’ve come to appreciate the things I inherited from my father: his humor, his love of ketchup and Mondrian paintings. When he is gone, how will I reconcile my decision to erase something we once shared? I stared at the image, tears running down my cheeks.”
I’m confident that there are many teen girls who have no such regret about their decision to alter their natural appearance. But Weiss’ story points to a question often not asked – are teenagers emotionally mature enough to make informed decisions about surgery that will permanently change their appearance? In discussing the Elle article with CNN, Weiss notes that her own thought process at the time was that of a typically immature teenager:
“Looking back, if anyone had questioned my reasons for doing this, they would’ve seen it was irrational and a fantasy that having this surgery was going to somehow transform my entire life…my fantasy was that I’d have this surgery and I would turn into the person that would easily be able to connect with others and have this social ease.”
Unfortunately, Weiss notes that she can’t recall anybody questioning her motivation when she was preparing for her nose job. What she does remember are the negative thoughts and feelings she had about her natural, pre-op nose. She is painfully clear about how much her negative self-image at the time was related to her distorted thinking about her nose:
“I felt it was a defect. It was a central obsession in my self-hatred. … I felt like it was all anyone saw when they looked at me.”
Her thoughts about her nose present an almost textbook example of the thought processes we see every day when treating clients with Body Dysmorphic Disorder (BDD) – the over-valuing of a minor defect, the obsessionality, the self-hatred, the belief that others are focused on the alleged defect, and the belief that surgery will magically solve the problem. It is difficult enough for a mature adult to contend with such negative body image issues, and unfortunately, teens are even less able to do so. As Weiss notes:
“As a teenager, you’re so myopic, you don’t think about the long-term consequences of what you do…it’s on the shoulder of parents and guardians to ask a lot of questions of their teenagers to get to the root of why they’re asking for this kind of surgery, to get them thinking about reasons below the surface for wanting this surgery.”
I am not advocating that teens be barred from having cosmetic procedure, nor that all cosmetic surgeries are evidence of Body Dysmorphic Disorder. Rather, I am suggesting that teens, and their parents, think long and hard about their motivations in electing to undergo such procedures, and the potential risk of experiencing significant negative consequences.
For those interested in more information on the research linking cosmetic surgery and Body Dysmorphic Disorder (BDD), here are some suggested readings:
•Tom Corboy, MFT, is the director of the OCD Center of Los Angeles, a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), and related conditions. In addition to individual therapy, the center offers six weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment. To contact the OCD Center of Los Angeles, click here.