OCT 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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64 OCTOBER 2018 | MedEsthetics NEWSMAKERS | By Inga Hansen In July 2017, Allergan CEO Brent Saunders authored a blog post on the company's website in which he shared his discomfort with the growing number of minors undergo- ing cosmetic enhancement. In the post, he encouraged the medical aesthetics industry to start a dialogue on this topic in an effort to fi nd consensus and provide guidelines for the treatment of minors. Just over a year later, Rod J. Rohrich, MD, and Min-Jeong Cho, MD, of the Dallas Plastic Surgery Institute, published the results of a literature review on adolescents and medical cosmetic procedures in the September issue of Plastic and Reconstructive Surgery. In the paper, they offered guidelines covering the most popular surgical procedures among this age group, including: Rhinoplasty: It is recommended that surgery not be performed until nasal growth is completed—typically age 15 to 16 in females and age 16 to 18 in males. In some situations, such as a child with a cleft lip, a rhinoplasty may be performed at a younger age. Breast reduction: To alleviate back and neck pain, a breast reduction is commonly performed on teen girls; however, it is important to ensure that surgery is performed after the patient has completed breast development, which typically occurs between 12 and 19 years old. Otoplasty: Surgery to correct ear deformities can be per formed as young as age 5, when the ear is almost fully grown. Liposuction: Unless performed as part of a breast reduction surgery, it is not recommended that a teenager undergo liposuction. Breast augmentation: Candidates with uncommon chest deformities or congenital breast asymmetry are generally the only cases in which a plastic surgeon should deem breast augmentation appropriate for a teenager. In regard to nonsurgical interventions, the authors note that their search of the OVID database for botulinum toxin type A and hyaluronic acid in adolescents revealed no retrospective or prospective studies on their use in patients under age 18. "We have a very simple policy in my offi ce: We perform no cosmetic procedures for anyone under the age of 18. They get turned away on the phone or at the consultation," says plastic surgeon Anthony Youn, MD, of Youn Plastic Surgery in Troy, Michigan. "I do occasionally perform breast reductions and otoplasties on people under 18 depending on the situation and severity." Dermatologist Lorrie Klein, MD, founder of OC Dermatology in Laguna Niguel, California, specializes in laser treatments and nonsurgical cosmetic procedures. She has seen an increase in younger patients coming in for cosmetic treatments and is comfortable treating patients as young as 16 provided they are there of their own volition and have realistic expectations. She notes that these patients typically come in seeking lip augmentation with their mothers who are patients of the practice. "After age 16, your body is essentially fully developed, so my concerns are more psychological than physical," she says. "If the patient wants huge lips that will look unnatural or has a celebrity obsession, I will not treat them." She addresses questions about preventive use of botulinum toxins in teens just as she does with patients over 18. "If someone who has no wrinkles comes in and wants to get Botox to prevent them in the future, I say, 'Maybe you'll never get one. There's nothing there so let's wait and see. If you start getting a wrinkle, then we'll treat you,'" she says. "You have to see something signifi cant in the area either with movement or when they're not mov- ing to warrant treatment, and that is true at any age." Inga Hansen is the executive editor of MedEsthetics. With new guidelines published last month, physicians share how they address teen requests for cosmetic procedures. TEENS AND COSMETIC PROCEDURES © GETTY IMAGES

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