Rebecca's Policy Paper

Age Requirement for Youths Considering Undergoing
Cosmetics Surgery in State of Iowa

Cosmetics surgery has increasingly become a crutch for teens looking to improve minute defects or mold to societal expectations. Unrealistic, photo shopped images of what is in style are shoved in teens faces by a money hungry media. The youth of America are turning to a cosmetic cure before they are physically, intellectually, or emotionally prepared. Preventing individuals under the age of twenty-one from undergoing cosmetic altercations would ensure that a more responsible, informed, and safe decision is made.
Cosmetic surgery is not the one hour television special that the media portrays. Youths are less likely to understand the dangers and risks that exist; any surgery is accompanied by hazards “including infections, scarring, poor results, and even death” (Fanning, 2001). Teens are “being operated on at the most tumultuous time in their bodies” and they “may not recognize the permanence of what they’re doing” (Current Events Staff, 2005). Physical altercation that is not reconstructive is a serious choice that must be made for mature reasons. A good candidate must have realistic goals, be emotionally stable, and not have risky behaviors (Springen, 2004). More often than not those under the age of twenty one do not meet these requirements. A child’s desire to look like a celebrity or become more popular is not considered a mature reason. These surgeries are also performed when adolescents are not fully developed or emotionally and physically accustom to their bodies (Austin, 2000). The brain is still developing and the change of puberty makes this time frame not especially idealistic for surgery. Permanently changing one’s body this early is warned by medical experts as something that may be regretted in the future (Fanning, 2001).
Augmentation mammoplasty or breast implants in young girls is often the result of feeling self-conscious of small breast development. But for many girls, their bodies are still growing well past high school. The average female freshman gains 5.49 pounds within the first year of college (Economos, 2008). This weight gain caused many girls’ breasts to increase in at least one cup size and change their desire for surgical implants (Rados, 2004). In addition to many girls not realizing that they are still growing, many do not realize the potential dangers of the procedure. The FDA has banned silicone implants for those 18 and under (Fanning, 2001). Often a patient will “have at least one serious complication within the first three years” and implants typically last only ten years (Zuckerman, 2005). And compared to other cosmetic procedures, a breast implant patient is four times as likely to commit suicide (Zuckerman, 2005). This would be a volatile situation for a teenage already suffering depression or self image deficiencies.
Rhinoplasty or a nose job is another procedure that is unnecessarily made in the rash decisions of youth. There are multiple dangers that accompany this surgery especially if the nose is still growing. Most noses continue developing into the late teens (Kids Health Staff, 2006). This means that a nose that was too large or disfigured at a young age may naturally become proportionate over time (Kids Health Staff, 2006). Liposuction and Tummy tucks are demeaning the values of exercise and eating healthy. Giving these adolescent patients a cosmetic cure without, teaching them healthy habits will only lead them down the same path later in life. Liposuction is also associated with eating disorders, which already is an epidemic in the youth (Zuckerman, 2005). In 2004, eight patient deaths in Florida caused a three-month stop of liposuction and tummy tuck combined procedures (Shute, 2004). The many dangers and complications of these surgeries have lead some plastic surgeons to “believe it is wrong for teens to undergo liposuction” (Fanning, 2001).
The number of youth being operated on for solely cosmetics purposes is increasing at a dangerous rate. A poll taken in 2005 found that of 2,000 girls a shocking 42 percent have already considered having plastic surgery (Current Events Staff, 2005). The average age of these girls was only fifteen years old. Also in 2005, there were 335,000 reported cosmetic procedures on just those under 18. This is up nearly 30,000 cases since just 2000. Cosmetic procedures have been performed on children even at the age of six years old (Prevention Staff, 2005).
This young of patient suggests that parental pressure also plays a major influence. The dramatic age range for such radical procedures is in need of change. A study found in March 2005 that body image improved in patients with cosmetic surgery, but also improved in the control group without surgery. Adolescents from ages 11-18 had the highest image satisfaction at 18 in both sexes (Zuckerman, 2005). This suggests that anyone’s body image will improve with time, regardless of surgery. This fact and the above evidence promote instating an age requirement to undergo cosmetic procedures. The policy is defined below.
Bill: This policy is designed to solve the issue defined above. It proposes that, in the state of Iowa, an individual must be 21 years of age to undergo plastic surgery for purely cosmetic intentions. The procedures that this bill will encompass are augmentation mammoplasty, rhinoplasty, liposuction, tummy tucks, facial implants, and face lifts.
Pre-Surgery Program: Six months prior to the date one desires to have cosmetic surgery, one must complete a consultation with a physician to discuss the procedure and outcomes desired. The physician can provide the patient with further sources or previous patients to learn more details. The earliest consultations are allowed is six months before the patient’s twenty first birthday. This six month time frame provides a waiting period and time to complete further research into the procedure. After the initial consultation, the patient must complete an online questionnaire designed to inform about procedure details, clinics, and risks. A patient that does not meet this requirement will be denied the surgery. This will be similar to pre-loan entrance requirements. The purpose of this is to better prepare those who eventually elect to undergo cosmetic surgery and assist in fully comprehending what they have agreed to.
Exception Clause: Persons under the age of twenty-one with deformities will be allowed reconstructive surgery. This law considers a deformity that would meet the exception, as a bodily malformation, distortion, or disfigurement. Acceptable procedures to correct malformations and disfigurements are cleft palates, otoplasy: pinning back ears, critical burns, dermbrasion- severe acne, and breast reduction- due to pain or strong discomfort. A teen deciding that his nose is too pointy or to large is not considered a deformity because his body is still developing. Smaller than average breasts is not considered a malformation because a girl at this age has not finished growing. A child suffering from extreme obesity, which is considered a body mass index of thirty or higher, will not fall under this exception because of the serious dangers that accompany liposuction especially in youth (Mayo Clinic). However if this child loses excessive weight by natural and healthy means, the procedure of post-bariatric is not regulated by this law. This is because a child that undergoes extreme weight loss by non-cosmetic means should be able to have the excess skin removed for health purposes. In a case like this, a pre-surgery program would have to be completed first as well.
Enforcement: Clinics and hospitals will be routinely inspected to ensure that all institutions are in accordance with this policy. The Iowa State Health Department will conduct these inspections and will publish their findings on the online website (that has the pre-surgery questionnaire). This website will allow citizens to search local clinics and view compliancy and history of the physicians and clinics. Treatment centers found to be providing surgery to those underage will go through a three step disciplinary system. The first violation will result in a fine and public write up on an online database. This fine will consist of 100 times the profit of the surgery performed illegally. The second violation will result in a three month suspended license and another fine of 100 times the procedure along with an additional write up online. The third and final violation will result in the physician’s license being pulled to practice in the state. This information will also be documented and post for public viewing online.
Clinics Requirements and Incentives: Clinics will be required to document the age of the patients they treat and report statistics by age group. Age information allows for further research into the surgery habits of the population. This paperwork also helps to keep a clinic aware of the age of the patients and provides a safety net for them if the patient lies about his or her age. Clinics will be able to apply for grants to cover surgery costs and upgrade equipment when performing cosmetic surgeries on those children under the exception clause with deformities. More aid will be available particularly to clinics serving low income patients.
Funding: The State Health Department Inspectors will be funded with money from 25 percent increased fines on littering and pollution on businesses and individuals. This increased income will fund the inspections and the informational website upkeep. Money collected from clinic fines will go towards the grants offered to clinics caring for those patients under the exception clause.
This policy will affect many cosmetic surgeon, clinics, and hospitals. Many will be upset with the restriction of potential patients. While adolescent surgeries were nowhere near their largest customer group, it is the fastest growing. Once this law is fully in place the benefits will outweigh any issues. Many of these teenage potential patients will opt to have the procedure eventually anyway. They will just be making this decision at a more appropriate time in their lives. This age requirement benefits the physicians as well because surgeries on fully developed patients mean better results and a decrease in complaints and lawsuits. Additionally, the online website provides free and positive publicity for compliant clinics and physicians.
The young public will also be affected. Many will feel like the state should have little to no control over what they decide to do with their own bodies. Yet the research and facts are indisputable that point to cosmetic surgery dangers and problems in adolescents. This policy is protecting the future generations during a time where uncertainty rules their bodies, minds, and emotions. This age requirement ensures that an individual has developed fully physically, has attained a positive body image, and can now make and mature and successful decision.

Works Cited
Austin, A. (2000). More Teens Opt for Plastic Surgery. Christian Science Monitor, 92(162), 14.
Current Events Staff. (2005). So You Want A Famous Face? Current Events, 104(18), 3-3.
Economos, C. & Hildebrandt, M. & Hyatt, R. (2008). College Freshman Stress and Weight Change: Differences by Gender. American Journal of Health Behavior, 32(1), 16-25.
Fanning, K. (2001). Perfectly Plastic? Scholastic Choices, 16(6), 20.
Kids Heath Staff. (2006). Plastic Surgery. Retrieved February 2, 2008, from
Mayo Clinic. (2007). Obesity: When to Seek Medical Advice. Retrieved February 8, 2008, from help?section=section_03
Pole, N. & Johnston, P. & Gallagher, B. (2006). You Asked Us. Prevention, 58(7), 29-31.
Prevention Staff. (2005). Pretty Plastic Children. Prevention, 57(2), 36-36.
Rados, C. (2004). Making an Informed Decision About Breast Implants.
FDA Consumer, 38(5), 6-6.
Shute, N. (2004). Makeover Nation. U.S. News and World Report, 136(19), 52-63.
Springen, Karen. (2004). Kids Under the Knife. Newsweek, 144(18), 59-60.
Zuckerman, D. (2005).Teenagers and Cosmetic Surgery. Virtual Monitor. Retrieved February 2, 2008, from

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