Girls, interrupted

If MTV's My Super Sweet 16 - the reality show where teens with too much money and too little parenting spend the equivalent of a small nation's GDP on a birthday party - has shown us anything, it's a nose job as a teenage gift isn't nearly as shocking as it once was. Young women are even being so bold as to request boob jobs as graduation presents, perhaps spurred by speculation that former teen queens Lindsay Lohan and Britney Spears underwent breast augmentation before they were 20 years old. "It's very common," says Dr. Fleming. "There's nothing inappropriate about that, as long as the patient is emotionally and physically mature."

According to The American Society for Aesthetic Plastic Surgery, 1.8 percent of all cosmetic procedures performed in 2007 were done on patients under the age of 18, with the most popular being laser hair removal, microdermabrasion and otoplasty (cosmetic ear surgery). In general, the most requested surgeries include rhinoplasty and, surprisingly, breast reduction. Dr. Levine agrees to perform surgery on mature teens when medically reconstructive work is necessary. However, the average teenager is not a candidate for cosmetic surgery.

"If they're under the voting or drinking age, I just won't do it," Dr. Mulholland says of teens who come to him for face- or body-contouring procedures in order to "achieve a look they were not genetically endowed with." In his experience, the young patients who seek his services suffer from an "unhealthy preoccupation with institutionalized ideals of beauty." They are, he says, teens with anxiety issues best dealt with by a therapist, leaving him to ask: "At what point does an anxiety end and cosmetic surgery begin?"

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