Too young to go under the knife

By Salma Khalik Senior Health Correspondent, The Straits Times, 30 Aug 2014

THERE are some things that youth should not be exposed to, too early in life - smoking, drinking and cosmetic procedures are among them.

And just as there are laws to prevent those who are under 18 years old from buying alcoholic drinks and cigarettes, so too should there be a ban on children and teenagers under 18 going for cosmetic treatments.

The popularity of cosmetic procedures among youth has shot up in the United States, and possibly here.

Statistics from the American Society of Plastic Surgeons show that 230,000 cosmetic procedures were performed on patients under 18 years of age in the United States in 2011 - up from just 14,000 in 1996.

This led a team headed by Dr Ng Jia Hui of Singapore General Hospital (SGH) to look into how popular cosmetic treatments are among youth here.

They surveyed 1,164 junior college and 241 medical school students and found that one in three junior college students and one in four medical students approve of their peers going for such treatment.

Only 14 admitted to having had such procedures. The three favourite areas for treatment were the nose, eyes and skin.

Also, one in nine JC students and one in six medical students "were keen on body contouring of areas such as the thighs, buttocks and abdomen", the team said in an article in the August edition of the Singapore Medical Journal.

The team of three doctors and a dentist added: "A large percentage of the JC students did not have any knowledge of the risks associated with cosmetic procedures.

"Even among the medical students, 35.7 per cent of the students were unaware of any risks."

And among those who said they were aware of the risks, not all knew what the real risks were.

The team cited an American study that found the sources of information on cosmetic procedures for many young people are television shows and teen magazines - hence the lack of awareness on the risks that come with the procedures.

In Singapore, at least two people have died as a direct result of having gone for cosmetic procedures. There are also many horror stories of procedures gone wrong, resulting in the patients looking worse than they did before their operations.

Not all botched jobs can be successfully repaired.

Referring to previous research on the subject, the article said: "The general public has an inflated perception of the benefits of plastic surgery and exhibits a tendency to minimise the sense of risk of plastic surgery."

The authors cautioned that the problem may be "more severe" among adolescents "who have been observed to be more inclined than adults to seek instant gratification".

But a Dutch study quoted by the authors found adolescents become less unhappy with their body image as they get older - regardless of whether they tried to improve it or not.

Those who undergo cosmetic procedures may later regret doing so, or at least find it unnecessary.

The authors said adolescents "are a particularly vulnerable group" and suggested having a national database to track all cosmetic procedures done here.

While this might be a good idea, it would be far better to prevent youth - whose bodies are still growing and undergoing major physical and hormonal changes - from trying to remodel their faces or bodies to suit the whim of the moment.

Perhaps schools should raise this topic as a subject for discussion, so students are, at the very least, aware that there are real dangers to unnecessary medical procedures. And cosmetic treatments are just that.

The Ministry of Health (MOH) should also look into protecting teenagers.

While the vast majority of doctors are ethical and professional, there are, unfortunately, a few bad apples.

The medical profession, in the form of the Singapore Medical Council, tries to keep the profession clean. The number of doctors censured and penalised for negligent and unprofessional acts proves this.

This year alone, nine doctors have already been hauled up before disciplinary tribunals and found guilty of behaviour inappropriate for a doctor.

However, it would be far better to prevent a cosmetic medical mishap from happening than to punish the doctor after it has occurred.

An age barrier would prevent susceptible teenagers from experimenting with possibly dangerous procedures.

A ban on cosmetic treatments for youth will also be something most parents would welcome.

A third of youth here say plastic surgery OK
We've had such treatment, say 1% of 1,400 students aged 16 to 21 polled
By Salma Khalik And Kash Cheong, The Straits Times, 30 Aug 2014

ONE in three youth here think it is perfectly all right to go for cosmetic procedures at their age - with 14 out of the 1,400 surveyed admitting that they have already undergone such treatment.

Cosmetic treatment purely to improve looks, and not for medical reasons, has become very popular in countries like the United States and South Korea, where aesthetic treatment is thriving.

A team of doctors and a dentist decided to find out if it was the same here and studied more than 1,400 responses from medical and junior college students aged 16 to 21.

The results were published in the Singapore Medical Journal.

Only 1 per cent said they have had cosmetic procedures done, mainly to the face, but the team implied that the figure could be higher, saying: "A major limitation of the present study is its dependence on honest responses."

Although more than a third approved of youth going for cosmetic treatments, almost two in three said they would be embarrassed if people who are not family or close friends found out that they had done so.

The team, headed by Dr Ng Jia Hui of Singapore General Hospital (SGH), was disturbed by the lack of knowledge of the dangers involved in cosmetic treatment.

Among JC students, 52 per cent were not aware of any risks while 36 per cent of medical students too thought cosmetic procedures were harmless.

So far, at least two people are known to have died here as a result of cosmetic treatment.

The team said: "It is even more alarming that a large number of JC students who claimed to be aware of the risks associated with cosmetic procedures listed three risks which were incorrect."

They said this was a matter of concern as self-perceived knowledge plays "a central role in influencing the choices of potential cosmetic patients".

Singapore Association of Plastic Surgeons president Karen Sng said plastic surgeons should discourage young patients, as every surgery carries risk.

"In general, I would not recommend cosmetic treatment for the young," she said.

But she added that it depends on the treatment they want, and their age. If it was a higher risk treatment such as liposuction, she would not consent. However, the most common treatment teens here seek is for double eyelids.

She said she would only agree if they are in their late teens and have the consent of a parent who is fully aware of the risks involved.

Ms Ann Tan (not her real name) had cosmetic procedures done earlier this year. The 19-year-old got Botox jabs on her jaw and also had chin fillers injected to make her face look longer.

Botox, one of the brands of botulinum toxin, relaxes muscles, while fillers, which are chemicals such as hyaluronic acid or collagen that naturally occur in the body, plump out the skin.

"I thought my face looked fat and round. I wanted a slimmer-looking face," said Ms Tan, whose procedures cost about $1,600.

The doctor at EHA Clinic, Dr Elias Tam, briefed her and her parents about the risks of the procedures, which include swelling and allergic reaction.

Her father also signed a consent form allowing her to undergo the procedures.

Dr Tam said: "We are very strict. We want to ensure patients and guardians know exactly what they are getting into."

Ms Tan was not particularly worried about the risks because she knew of friends who had undergone plastic surgery and had told her the procedures were safe.

She said: "A lot of people are doing cosmetic procedures these days, so I think it's okay."