Today, Jamie is a happy mother and wife. Ten years ago, she was a young girl dragged down by a low self-esteem.
"I
had always had self-esteem issues throughout most of my childhood and
teenage years, and most of it was because I was flat-chested," said
Jamie, who asked that we not use her full name. "I never felt
comfortable in anything that I was wearing."After seeing a
plastic surgeon who specialized in younger patients on the news when she
was 16, Jaime approached her mother about having her breasts enlarged.They went to see Dr. Frederick Lukash, who told them he didn't think high school was the right time to perform the surgery."He
said it probably wasn't the best time because it wouldn't help my
self-esteem to be the target of, 'Wow, did you just have your boobs
done?'" said Jamie.After consulting with Lukash for over a year,
Jaime had her breasts enlarged in the summer between high school and
college, when she was 17."I was barely an A (cup) before my
surgery, and now I am at a B, so my surgery wasn't to give me a DD
exotic-dancer body or visions that I had seen on TV. It was just to feel
comfortable in my skin," said Jaime."It just completely changed
my life. I went to college just feeling good about myself, and I didn't
have all the self-esteem issues. I made friends more easily. I met my
husband. I was just happy with myself."
National Debate Over Breasts
The
issue of young girls having breast augmentation became a national
debate recently when Stephanie Kuleba, an 18-year-old high school
cheerleader in Florida, went in for breast augmentation surgery on March
22 and died.According to her family, Kuleba was getting the surgery to fix asymmetrical breasts and inverted nipples.The
story made headlines across the country. For example, on its Web site,
Fox News reported, "But now, 18-year-old Stephanie Kuleba is dead, and
her friends, relatives and family attorney are pointing to breast
surgery as the reason."But it is believed that Kuleba did not die
because of the type of surgery. Instead, she apparently died from
malignant hyperthermia, a rare genetic disorder brought on by
anesthesia.Lukash, who said he has performed many breast
augmentations on girls under the age of 18 for a number of reasons,
questioned why so much attention has been focused on the fact that
Kuleba was having breast surgery and very little on malignant
hyperthermia, a disorder that occurs in every 5,000 to 50,000 patients
who are given anesthesia, according to the
Genetics Home Reference."Because
we hear the word 'teenager' and 'implant,' now the story has gone from
teenagers and implants to, 'Is cosmetic surgery unnecessary in kids?'"
said Lukash. "The whole story starts to snowball beyond what the
original story was. That happens all the time."
Augmentation Of Minors Rare
The
American Society of Plastic Surgeons reported that 47.4 percent of
breast augmentation procedures on women under 18 in 2007 were cosmetic,
but that only 2 percent of the nearly 400,000 breast augmentations
performed were on patients under 18.
(Note: An earlier version of this story mistakenly said 20 percent were on minors.)In its
position paper about teenage breast augmentation,
the ASPS pointed out a number of possible health risks that are
involved with breast implants, including bleeding, infection, changes in
nipple or breast sensation, capsular contracture, implant leakage and
wrinkling of the skin over the implant that may require secondary
procedures.The paper also pointed out that all surgery carries risks associated with anesthesia.The
FDA and the ASPS are against the practice of patients under the age of
18 receiving breast implants for purely cosmetic reasons."(Breast
augmentation) is not performed (on underage girls) unless there is an
overriding situation, if it has been deemed a reconstructive case," said
Lukash, a member of the ASPS group that wrote its position paper on the
subject. "Asymmetrical breasts, sagging breasts getting uplifted plus
augmented. There are certain protocols that allow you to do it at an
earlier time."
Deeper Emotional Issues
Lukash said
he will also perform breast augmentation on an under-18 girl if there
are some extenuating psychological issues, which he said he only
encounters every few years. That was the case with Jaime."I had
been working with counselors. I definitely had deep issues," said Jaime.
"(Lukash) definitely knew that I was having emotional and esteem
issues. It was more than just wanting to enhance my body."Once the surgery was done, Jaime said it did more than just improve her body image."It
was a ripple effect," said Jamie. "Once I felt better about my body, I
could kind of not focus on that and harp on it as much. It was now, 'OK,
I can improve every other area of my life.'"But even with
Jaime's psychological issues, Lukash still took a cautious, slow
approach with her, which he said he does with all his patients who are
under 18."I say to them, 'I agree with you, but I don't think
that the middle of high school is the time to do it where all your
friends are going to notice a change. Why don't we do it during that
transitional period?' And nine times out of 10 that satisfies them,"
said Lukash.Lukash said he thinks bad plastic surgeons who don't
know how to say "no" to patients contribute to the negative reputation
plastic surgery sometimes gets in the media."The media is only
interested in two things: miracles and disasters," said Lukash. "They're
not interested in covering mainstream, under-the-bell-curve plastic
surgery. Someone's got an altered body image, they come in, they get it
done, they're happy, they go on with their life. What kind of a story is
that?"Jaime said Lukash's cautious approach was frustrating when she was 16, but she now thinks it was the right decision."Make
sure it is something that you really want," said Jaime when asked what
advice she would have for young girls seeking breast augmentation. "Make
sure that you do your research and that you go to the best doctor
possible, somebody like Dr. Lukash who is going to care about you and
not just want to do the surgery to do the surgery."
