Shaping The Perfect Teen-ager

Two years ago, at age 15, Lisa Goodman had plastic surgery. "I'm kind of a little embarrassed by it because it seems really superficial to me when I really think about it," Lisa said before her operation. "And yet, I'm still doing it."

For Lisa, the embarrassment of plastic surgery was nothing compared to the shame of the bump on her nose. 48 Hours Correspondent Susan Spencer reports on a new, and to some, disturbing, trend.

"There's no question that the amount of plastic surgery we do on teen-agers has increased," says Dr. Edward Domanskis of Newport Beach, Calif., who operated on Lisa.

He is not just talking about nose jobs. In the past five years, the number of teen-agers having breast augmentation has quadrupled, and the tally for liposuction has tripled.

Hayley McCowen was 13 when she started thinking about having cosmetic breast surgery. She underwent the procedure in 1998, at 16. "Hayley was concerned about the fact that she was small, on both sides," says Dr. Domanskis. "There was some asymmetry, but fairly minimal."

To Hayley, the asymmetry was not minimal. "When I looked at myself, because I was not symmetrical, I felt that I was abnormal," she says. "I looked at myself, and I saw that I was deformed."

Over time, Kris came to share her daughter's sense that she had a deformity. "We couldn't buy a simple bra," she says. "We couldn't get an A because then it would be too tight on one side, couldn't get a B because then it would be loose."

As a high school swimmer, Hayley was especially self-conscious. "A Speedo doesn't hide anything," she says. "It reveals all."

Soon her family agreed that surgery was the only answer. At first, Hayley's father Doug thought that the prblem was not a big deal. But as he saw how important it was to his daughter, he consented.

In addition to getting her breasts evened, Hayley had them enlarged, too, from an A to a C. "No question about it, it was a cosmetic enlargement," Dr. Domanskis says. "On the smaller side, we increased her from an A to a C, and on the other side, about a B to a C also. They definitely wanted to enlarge both sides, because they wanted a cosmetic improvement."

Some experts worry that kids will see surgery as a quick fix for what may not really even be a problem.

"The definition of deformity apparently has expanded, so that many people, many parents, and certainly many teen-agers feel anything that's not perfect is a deformity," says Lilli Friedland, a psychologist.

She doesn't think these are decisions a teen-ager should be making, because the results could last for a lifetime. Friedland thinks that women should not even consider breast enlargement until their late 20s: "That decade of the 20s is so critically important to developing your sense of self-esteem. I was raised in an environment of, 'You don't worry so much about the way you look.'"

Other plastic surgeons say that teen-agers are generally too young to have such surgery. "I would not consider doing breast augmentation on anyone under the age of 18," says Dr. Harry Glassman, a Beverly Hills plastic surgeon. "I don't think that a 16- or 17-year-old, with rare exception, is emotionally prepared to make a decision such as that. They think of this as being a haircut, and it's not."

Dr. Glassman also has medical concerns: He notes that breasts can continue to develop between the ages of 16 and 18. He also points out that breast surgery can have complications: implant rupture, hardening of the breasts and pain. These effects are not common, but they do occur, he says. It is, he points out, a serious procedure.

Dr. Domanskis, who has done liposuction on girls as young as 14, says he tells his patients this but they shrug it off. "Looking good is still even better than feeling good to them," he says.

The underlying message, Glassman says, is that looks are paramount. "Teen-agers have always had difficult problems. It doesn't necessarily mean that we should employ technology in order to try to make their world perfect."

Hayley, though, is happy with the results: "Everything's...perfect now," she says, admiring her new form.