Fresh Faces

The perfect nose. The perkiest breasts. For more and more teens, achieving the ideal look means scheduling time under the plastic surgeon's knife.

KRISTIN WANTED A NEW NOSE. A better nose. A resculpted, slightly smaller version of the original, with no bump on its bridge and a shorter, perkier tip. It wasn’t that she was ugly, or that her nose was so terrible: Kristin just wanted her features to be symmetrical. But doctors said she would have to wait at least a year before considering cosmetic surgery. After all, she was only 14.  

At 15, Kristin got her wish. A Boston plastic surgeon performed the long-awaited rhinoplasty during her school’s spring break. The petite, blond Newton native couldn’t be happier with the results. “It turned out exactly how I wanted it,” Kristin, now 17, says, “I feel like my face finally fits together.”

Others agreed. Most girls at her west suburban high school told her she looked pretty and praised her new look. And, influenced by a youth culture that is increasingly open to all things cosmetic, some did a little resculpting of their own. “My best friend just got her nose done last summer,” says Kristin (whose name, like those of other young patients quoted in this story, has been changed). “And my other best friend is planning on doing it as soon as she can.”

Plastic surgery is a national hot topic, thanks in no small part to television shows like ABC’s Extreme Makeover, Fox’s The Swan, MTV’s I Want a Famous Face, and a veritable bonanza of other media attention. Everywhere they look, young Americans are bombarded with promises of planned perfection. Ads for cosmetic procedures pepper magazines and newspapers, toned Hollywood actors sport wrinkle-free figures, and celebrity rags rave over young starlets with impossible combinations of tiny waists and huge breasts.

The pressure to look young and beautiful is at an all-time high, and more and more people are picking up the phone to schedule surgical enhancements. Americans spent $12.5 billion on cosmetic procedures last year, according to the American Society for Aesthetic Plastic Surgery. Since 1997, the number of both surgical and nonsurgical procedures performed annually has increased by a whopping 465 percent.

“The television shows have really captured the country’s imagination and attention,” says Dr. James May, director of plastic surgery at Massachusetts General Hospital. “The sensationalism of those programs has brought plastic surgery to the minds of young people and their parents. It’s now a dinner-table conversation.”

And the nation is changing its perspective. Whereas some Americans used to keep their tummy tucks and Botox shots a secret, they’re now showing them off with pride. Today, 60 percent of women approve of cosmetic surgery, while 82 percent say they would not be embarrassed by other people knowing that they’d had some. And these aren’t just aging narcissists: 34 percent of 18- to 24-year-olds say they would definitely consider surgery for themselves, the highest proportion of all age groups.