Semin Plast Surg 2013; 27(01): 072-078
DOI: 10.1055/s-0033-1343999
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cosmetic and Reconstructive Breast Surgery in Adolescents: Psychological, Ethical, and Legal Considerations

Canice E. Crerand
1   Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
2   Division of Plastic Surgery, Department of Surgery, The Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Leanne Magee
1   Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
23 May 2013 (online)

Abstract

Cosmetic and reconstructive breast surgery has increased in popularity among adolescents in the United States. As more adolescents pursue these procedures, an understanding of the psychological aspects of these surgeries becomes increasingly important for the benefit of both patients and providers. The authors review the psychological aspects of cosmetic and reconstructive surgical breast procedures as they pertain to adolescents, including augmentation mammoplasty, gynecomastia correction, breast reduction, and asymmetry correction. They include a discussion of the medicolegal and ethical implications of these procedures and recommendations for clinical management.

 
  • References

  • 1 American Society of Plastic Surgeons. 2011 Plastic Surgery Report. Arlington Heights, IL: American Society of Plastic Surgeons; 2012
  • 2 Sarwer DB, Crerand CE. Body image and cosmetic medical treatments. Body Image 2004; 1 (1) 99-111
  • 3 Sarwer DB, Wadden TA, Pertschuk MJ, Whitaker LA. The psychology of cosmetic surgery: a review and reconceptualization. Clin Psychol Rev 1998; 18 (1) 1-22
  • 4 Sarwer DB, Infield AL, Crerand CE. Plastic surgery for children and adolescents. In: Thompson JK, , Smolak, eds. Body Image, Eating Disorders, and Obesity in Youth, 2nd ed. Washington, DC: American Psychological Association; 2008: 341-366
  • 5 Cash TF. Body image and plastic surgery. In: Sarwer DB, Pruzinsky T, Cash TF, Goldwyn RM, Persing JA, Whitaker LA, , eds. Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery: Clinical, Empirical and Ethical Perspectives. Philadelphia, PA: Lippincott, Williams and Wilkins; 2006: 37-59
  • 6 Sarwer DB, LaRossa D, Bartlett SP, Low DW, Bucky LP, Whitaker LA. Body image concerns of breast augmentation patients. Plast Reconstr Surg 2003; 112 (1) 83-90
  • 7 Banbury J, Yetman R, Lucas A, Papay F, Graves K, Zins JE. Prospective analysis of the outcome of subpectoral breast augmentation: sensory changes, muscle function, and body image. Plast Reconstr Surg 2004; 113 (2) 701-707 , discussion 708–711
  • 8 Sarwer DB, Gibbons LM, Magee L , et al. A prospective, multi-site investigation of patient satisfaction and psychosocial status following cosmetic surgery. Aesthet Surg J 2005; 25 (3) 263-269
  • 9 Sarwer DB, Wadden TA, Whitaker LA. An investigation of changes in body image following cosmetic surgery. Plast Reconstr Surg 2002; 109 (1) 363-369 , discussion 370–371
  • 10 Simis KJ, Verhulst FC, Koot HM. Body image, psychosocial functioning, and personality: how different are adolescents and young adults applying for plastic surgery?. J Child Psychol Psychiatry 2001; 42 (5) 669-678
  • 11 Simis KJ, Hovius SE, de Beaufort ID, Verhulst FC, Koot HM. After plastic surgery: adolescent-reported appearance ratings and appearance-related burdens in patient and general population groups. Plast Reconstr Surg 2002; 109 (1) 9-17
  • 12 U.S. Food and Drug Administration. Breast Implants. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/default.html . Accessed October 2, 2012
  • 13 American Society of Plastic Surgeons. Policy Statement: Breast Augmentation in Teenagers. Available at: http://www.plasticsurgery.org/Documents/medical-professionals/health-policy/key-issues/Policy-Statement-on-Breast-Augmentation-in-Teenagers.pdf . Accessed October 2, 2012
  • 14 Crerand CE, Infield AL, Sarwer DB. Psychological considerations in cosmetic breast augmentation. Plast Surg Nurs 2007; 27 (3) 146-154
  • 15 Sarwer DB. The psychological aspects of cosmetic breast augmentation. Plast Reconstr Surg 2007; 120 (7) (Suppl. 01) 110S-117S
  • 16 Didie ER, Sarwer DB. Factors that influence the decision to undergo cosmetic breast augmentation surgery. J Womens Health (Larchmt) 2003; 12 (3) 241-253
  • 17 Cash TF, Duel LA, Perkins LL. Women's psychosocial outcomes of breast augmentation with silicone gel-filled implants: a 2-year prospective study. Plast Reconstr Surg 2002; 109 (6) 2112-2121 , discussion 2122–2123
  • 18 Fryzek JP, Signorello LB, Hakelius L , et al. Local complications and subsequent symptom reporting among women with cosmetic breast implants. Plast Reconstr Surg 2001; 107 (1) 214-221
  • 19 Sarwer DB, Brown GK, Evans DL. Cosmetic breast augmentation and suicide. Am J Psychiatry 2007; 164 (7) 1006-1013
  • 20 Jacobsen PH, Hölmich LR, McLaughlin JK , et al. Mortality and suicide among Danish women with cosmetic breast implants. Arch Intern Med 2004; 164 (22) 2450-2455
  • 21 Greydanus DE, Matytsina L, Gains M. Breast disorders in children and adolescents. Prim Care 2006; 33 (2) 455-502
  • 22 American Society of Plastic Surgeons. Position Paper: Gynecomastia. Arlington Heights, IL: American Society of Plastic Surgeons; 2002
  • 23 Fisher M, Fornari V. Gynecomastia as a precipitant of eating disorders in adolescent males. Int J Eat Disord 1990; 9 (1) 115-119
  • 24 Ridha H, Colville RJI, Vesely MJJ. How happy are patients with their gynaecomastia reduction surgery?. J Plast Reconstr Aesthet Surg 2009; 62 (11) 1473-1478
  • 25 Storch EA, Lewin AB, Geffken GR , et al. Psychosocial adjustment of two boys with gynecomastia. J Paediatr Child Health 2004; 40 (5-6) 331
  • 26 Kinsella Jr C, Landfair A, Rottgers SA , et al. The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg 2012; 129 (1) 1-7
  • 27 American Society of Plastic Surgeons. Report of the 2010 Plastic Surgery Statistics. Arlington Heights, IL: American Society of Plastic Surgeons; 2011
  • 28 Young VL, Watson ME. Breast reduction. In: Sarwer D, Pruzinsky T, Cash T, Goldwyn R, Persing J, Whitaker L, , eds. Psychological Aspects of Cosmetic and Reconstructive Surgery. Philadelphia, PA: Lippincott, Williams & Wilkins; 2006: 189-206
  • 29 Koltz PF, Sbitany H, Myers RP, Shaw RB, Patel N, Girotto JA. Reduction mammaplasty in the adolescent female: the URMC experience. Int J Surg 2011; 9 (3) 229-232
  • 30 Saariniemi KM, Joukamaa M, Raitasalo R, Kuokkanen HO. Breast reduction alleviates depression and anxiety and restores self-esteem: a prospective randomised clinical trial. Scand J Plast Reconstr Surg Hand Surg 2009; 43 (6) 320-324
  • 31 ACOG Committee on Adolescent Health Care. ACOG Committee Opinion No. 350, November 2006: Breast concerns in the adolescent. Obstet Gynecol 2006; 108 (5) 1329-1336
  • 32 Cerrato F, Webb ML, Rosen H , et al. The impact of macromastia on adolescents: a cross-sectional study. Pediatrics 2012; 130 (2) e339-e346
  • 33 Brown AP, Hill C, Khan K. Outcome of reduction mammaplasty—a patients' perspective. Br J Plast Surg 2000; 53 (7) 584-587
  • 34 Dabbah A, Lehman Jr JA, Parker MG, Tantri D, Wagner DS. Reduction mammaplasty: an outcome analysis. Ann Plast Surg 1995; 35 (4) 337-341
  • 35 Behmand RA, Tang DH, Smith Jr DJJ. Outcomes in breast reduction surgery. Ann Plast Surg 2000; 45 (6) 575-580
  • 36 Shakespeare V, Cole RP. Measuring patient-based outcomes in a plastic surgery service: breast reduction surgical patients. Br J Plast Surg 1997; 50 (4) 242-248
  • 37 Rogliani M, Gentile P, Labardi L, Donfrancesco A, Cervelli V. Improvement of physical and psychological symptoms after breast reduction. J Plast Reconstr Aesthet Surg 2009; 62 (12) 1647-1649
  • 38 Cruz-Korchin N, Korchin L, González-Keelan C, Climent C, Morales I. Macromastia: how much of it is fat?. Plast Reconstr Surg 2002; 109 (1) 64-68
  • 39 Wagner DS, Alfonso DR. The influence of obesity and volume of resection on success in reduction mammaplasty: an outcomes study. Plast Reconstr Surg 2005; 115 (4) 1034-1038
  • 40 Collins ED, Kerrigan CL, Kim M , et al. The effectiveness of surgical and nonsurgical interventions in relieving the symptoms of macromastia. Plast Reconstr Surg 2002; 109 (5) 1556-1566
  • 41 Evans GR, Ryan JJ. Reduction mammaplasty for the teenage patient: a critical analysis. Aesthetic Plast Surg 1994; 18 (3) 291-297
  • 42 Lee MC, Lehman Jr JA, Tantri MDP, Parker MG, Wagner DS. Bilateral reduction mammoplasty in an adolescent population: adolescent bilateral reduction mammoplasty. J Craniofac Surg 2003; 14 (5) 691-695
  • 43 Webb ML, Cerrato F, Rosen H, DiVasta AD, Greene AK, Labow BI. The effect of obesity on early outcomes in adolescents undergoing reduction mammaplasty. Ann Plast Surg 2012; 68 (3) 257-260
  • 44 McMahan JD, Wolfe JA, Cromer BA, Ruberg RL. Lasting success in teenage reduction mammaplasty. Ann Plast Surg 1995; 35 (3) 227-231
  • 45 Losee JE, Serletti JM, Kreipe RE, Caldwell EH. Reduction mammaplasty in patients with bulimia nervosa. Ann Plast Surg 1997; 39 (5) 443-446
  • 46 Kreipe RE, Lewand AG, Dukarm CP, Caldwell EH. Outcome for patients with bulimia and breast hypertrophy after reduction mammaplasty. Arch Pediatr Adolesc Med 1997; 151 (2) 176-180
  • 47 Losee JE, Jiang S, Long DE, Kreipe RE, Caldwell EH, Serletti JM. Macromastia as an etiologic factor in bulimia nervosa: 10-year follow up after treatment with reduction mammaplasty. Ann Plast Surg 2004; 52 (5) 452-457 , discussion 457
  • 48 van Aalst JA, Sadove AM. Treatment of pediatric breast problems. Clin Plast Surg 2005; 32 (1) 65-78 , ix
  • 49 Lin KY, Nguyen DB, Williams RM. Complete breast absence revisited. Plast Reconstr Surg 2000; 106 (1) 98-101
  • 50 Oakes MB, Quint EH, Smith YR, Cederna PS. Early, staged reconstruction in young women with severe breast asymmetry. J Pediatr Adolesc Gynecol 2009; 22 (4) 223-228
  • 51 McGrath MH, Schooler WG. Elective plastic surgical procedures in adolescence. Adolesc Med Clin 2004; 15 (3) 487-502
  • 52 Piza-Katzer H. Reduction mammaplasty in teenagers. Aesthetic Plast Surg 2005; 29 (5) 385-390
  • 53 Zuckerman D, Abraham A. Teenagers and cosmetic surgery: focus on breast augmentation and liposuction. J Adolesc Health 2008; 43 (4) 318-324
  • 54 Steinberg L. Risk taking in adolescence: new perspectives from brain and behavioral science. Curr Dir Psychol Sci 2007; 16 (2) 55-59
  • 55 Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry 2007; 20 (4) 359-364
  • 56 Laneader A, Wolpe PR. Ethical considerations in cosmetic surgery. In: Sarwer DB, Pruzinsky T, Cash TF, Goldwyn RM, Persing JA, Whitaker LA, , eds. Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery: Clinical, Empirical, and Ethical Perspectives. Philadelphia, PA: Lippincott, Williams, & Wilkins; 2006: 301-314
  • 57 Sterodimas A, Radwanski HN, Pitanguy I. Ethical issues in plastic and reconstructive surgery. Aesthetic Plast Surg 2011; 35 (2) 262-267
  • 58 DeSilva NK. Plastic surgery and the adolescent breast: preliminary patient counseling. J Pediatr Adolesc Gynecol 2010; 23 (3) 184-186
  • 59 American Society of Plastic Surgeons. Plastic Surgery for Teenagers Briefing Paper. Available at: http://www.plasticsurgery.org/News-and-Resources/Briefing-Papers/Plastic-Surgery-for-Teenagers.html . Accessed October 2, 2012
  • 60 Sarwer DB. Psychological assessment of cosmetic surgery patients. In: Sarwer DB, Pruzinsky T, Cash TF, Goldwyn RM, Whitaker LA, , eds. Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery: Clinical, Empirical, and Ethical Perspectives. Philadelphia: Lippincott, Williams & Wilkins; 2006: 267-286
  • 61 Pearl A, Weston J. Attitudes of adolescents about cosmetic surgery. Ann Plast Surg 2003; 50 (6) 628-630
  • 62 Honigman RJ, Phillips KA, Castle DJ. A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg 2004; 113 (4) 1229-1237
  • 63 Crerand CE, Magee L. Reconstructive procedures. In: Block AR, Sarwer DB, , eds. Presurgical Psychological Screening: Understanding Patients, Improving Outcomes. Washington, DC: American Psychological Association; 2012. : 173-194
  • 64 Crerand CE, Franklin ME, Sarwer DB. Body dysmorphic disorder and cosmetic surgery. Plast Reconstr Surg 2006; 118 (7) 167e-180e
  • 65 Hadley SJ, Greenberg J, Hollander E. Diagnosis and treatment of body dysmorphic disorder in adolescents. Curr Psychiatry Rep 2002; 4 (2) 108-113