Plastic surgery is surgery that focuses on fixing body parts that have been lost, been hurt, or have not grown the way they should.
Usually, living tissue is used to make repairs, meaning that skin or muscle from another part of your child’s body is used to fix the part that is missing, deformed, or injured. Sometimes implants are used.
For children, there are specialists called pediatric [pee-dee-AT-rik] plastic surgeons. (Pediatric means they are trained in working with kids.) The two main kinds of plastic surgery for children are reconstructive surgery and cosmetic surgery.
Reconstructive surgery is used to fix a physical problem that keeps your child from functioning. Cosmetic surgery is used to improve how your child looks. Some procedures in kids both fix a physical problem and change how your child looks. The things a plastic surgeon can treat in children include:
- Some birth defects
- Injuries to the face and body
For your child to have a cosmetic surgery, they need to be over 18 or have your consent as a parent. Common cosmetic surgeries include:
- Breast augmentation (with breast implants)
- Breast reduction
- Rhinoplasty [RIE-no-plas-tee] (to reshape the nose)
- Liposuction [LIE-poh-suk-shun] (to remove fat)
- Tummy tuck (to remove fat and excess skin)
- Otoplasty [OH-tuh-plas-tee] (ear surgery)
Plastic surgery is done on children of all ages. Surgery to fix a cleft palate might be done on an infant. Otoplasty (to pin back ears) can be done on young children. It is best to do it as your child’s ears are almost done developing, around four to six years old, but it can be done on teens too.
Rhinoplasty is the most common surgery in teens. It can be done when the nose is almost done growing. Breast surgeries can be done when the breasts have stopped growing. Getting implants to make breasts bigger is not approved by the FDA for patients younger than 18.
Pediatricians recommend that you don’t bring up the subject of your teen having a cosmetic procedure done. It’s important that your teen have a specific and realistic goal before they would be considered a good candidate for cosmetic surgery.
Plastic surgery can help your child if they have a condition or injury that can’t be treated with medicine or other treatments alone. Plastic surgery to fix birth defects, injuries, and other problems can help a child feel better about their looks and help give them confidence.
Examples of birth defects that can be helped with reconstructive surgery include:
- Cleft palate
- Misshapen skull
- Ears that stick out or are missing
- Misshapen breasts
- Webbed fingers and webbed toes
Cosmetic surgery can sometimes benefit your child. For example, removing breast tissue (a breast reduction surgery) can help with these problems:
- Back and shoulder pain caused by very large breasts in some girls
- Breasts that develop on boys and don’t go away even after losing weight
To learn more about whether a procedure will help your child, talk to a pediatric plastic surgeon.
Young children don’t always know how to explain what’s wrong. They may have a hard time when they are examined by a doctor. It’s best to find a pediatric plastic surgeon because they usually:
- Are trained plastic surgeons
- Have trained to work on children
- Devote at least half of their time to caring for kids
- Have offices designed with kids in mind
- Have equipment that is child-sized
To avoid complications with anesthesia, be sure to follow all instructions from the doctor about eating and drinking in the hours before surgery. The doctors and nurses will tell you when to stop feeding your child before their surgery. If your child eats or drinks within a short time before surgery, the surgery will have to be delayed or cancelled.
Children of all ages have questions and fears. These fears are often worse than what actually happens during surgery. You can help your child by knowing what to expect when they have surgery. Some questions you can ask your child’s doctor include:
- Will my child need antibiotics before or after surgery?
- When does my child need to stop eating or drinking?
- What exactly will the surgeon do?
- How long will it take?
- When can I see my child after the surgery is done?
- Will my child have side effects from the anesthesia?
- How long will they need to stay in the hospital?
- What activities should my child avoid after the surgery?
- How long will it take to heal?
First, you will meet with a plastic surgeon who can show you and your child pictures of other kids. Some of the pictures will show what those children looked like before they had the procedure your child needs, and some pictures will have been taken after the surgery.
On the day of the surgery, a nurse will prepare your child for the procedure. The plastic surgeon may use a marker to draw on your child. The marks will help them see where to operate.
A special doctor called an anesthesiologist [ann-ess-tee-zee-AHL-oh-jist] will give your child anesthesia], a medicine that makes them sleep. Younger children may breathe the medicine through a mask, but sometimes it’s safer to put the medicine directly into your child’s vein through an IV. An IV is a tiny, flexible tube. Your child will go to sleep quickly, and then the operation will start.
Plastic surgery often uses pieces of skin from another area of the body. These pieces are grafted to the area where the skin might have been hurt or lost.
Sometimes a flap surgery is done. In this procedure, a piece of skin and the blood vessels are removed from a healthy area and reconnected to the blood supply in the new area. The blood flow can help the skin heal faster after surgery.
Sometimes the plastic surgery procedure will require more than one operation. A tissue expander might be placed that makes the skin grow. Then the surgeon can use the new skin to finish the procedure.
Sometimes, you will know right away if your child’s surgery worked. Other times it might take longer to know if the surgery was a success. This depends on what body part the surgery was done. It also depends on how long it takes for the swelling to go down in that area.
Your child’s plastic surgeon will want to see your child again after the surgery to check for things such as:
- How the area is healing
- How the area looks after the swelling goes down
If there is a problem with the surgery, another surgery will need to be done.
Most follow-up care can be provided by your child’s primary care provider. They will want to follow your child to ensure they continue to grow and function the way they should.
There are some risks that are shared for all kinds of surgery, including plastic surgery. These include:
- Infection. Because surgery involves cutting the body, there is always a risk of infection at the site where the surgeon makes the cut. Infection risks are low but you should talk to your child’s doctor if you think your child might have an infection from surgery.
- Damage. Some surgery can cause damage to the part of the body that the surgeon is operating on.
- Doesn’t help. Sometimes, surgery won’t help your child with their symptoms or the condition for which they are having surgery.
Plastic surgery has added risks if it’s done before your child’s growing body is ready. For example, a surgery to change the shape of a nose cannot be done until the nose is 90 percent finished growing.
Breast implants are not approved by the FDA in children under the age of 18, and the surgery can make your child lose feeling in the breast and nipple. Breast reduction surgery should not be done until the breasts are done growing.
Sometimes kids want cosmetic surgery to improve their looks. This is not always a good idea. Most people are self-conscious about their bodies. Teens who have had cosmetic surgery are more likely to have emotional problems. They find the waiting time for healing to be hard, and can find it hard to adapt to how they look after surgery.
Kids need the “okay” from their parents or legal guardian in order to have cosmetic surgery done before they are 18. It is up to you to help them make the right choice. Cosmetic surgery probably won’t change your child’s life, and the hard parts of surgery still apply:
- Anesthesia [ann-ess-TEE-see-uh]
- Risk of infection
- Wound healing
- Not being happy with the result