The question of whether or not to perform plastic or cosmetic surgery procedures on teenagers — and even young adults — has always been somewhat contentious. Is it ethical to treat someone who is so young and impressionable? Should anti-ageing procedures be offered to people of this young age? Are some ethical concerns admissible for a teenager who is being bullied (e.g. for the size of their ears or nose)?

In a recent editorial I wrote for the European edition of PRIME, I discussed a UK newspaper’s investigation, which found that a number of cosmetic surgery practitioners were willing to administer injections of botulinum toxin to girls as young as 16 years — with the patients arguing that they were concerned about worry lines when they were older, and one doctor saying it was the easiest money he makes. This certainly isn’t ethical by anyone’s standards, and I hope our readers agree!

However, when it comes to cosmetic surgery because a child or teenager is being bullied, the boundaries are a little less clear and throws the debate wide open. In 2010, ASAPS noted that otoplasty is the most popular surgical procedure for US teens, and is often recommended for children as they near full ear development, at the age 5 or 6 years to avoid potential teasing from classmates. Other common procedures include rhinoplasty, breast asymmetry correction surgery, breast reduction and augmentation, acne treatments, and treatment for gynaecomastia.

Recently, a 15-year-old girl from South Carolina was given a free rhinoplasty by the charity Little Baby Face Foundation. This was because she had been bullied by her peers and became withdrawn and scared to go out in public. The charity aims to transform the lives of children born with facial deformities through corrective surgery.

While the charity has been subject to both criticism and praise, I’m finding it difficult to know where to stand on this matter. Bullying is certainly not something that should ever be condoned, and it makes me sad that so many young people feel that surgery is the only option available to escape the torment, at a time of one’s life that should be the happiest and most care free.

Unfortunately, part of human nature will always mean that there are bullies who will try to make you feel like a lesser person — no matter your age — and if someone can restore lost self-esteem and be given a new lease of life, then perhaps we shouldn’t be so quick to criticise.

Whatever the reason for pursuing a cosmetic treatment, when it comes to patients under 18 years of age, the decision to go ahead should be well-informed and ethically sound.