Teenage girls have long struggled with their looks, battling pimples and enduring braces.
But instead of turning to makeup to cover up imperfections, more teens than ever before are getting Botox injections -- a procedure usually restricted to their mothers and grandmothers to slow down the aging process.
Pempengco is not alone. Teens ages 13 to 19 had nearly 12,000 Botox injections last year, according to the American Society of Plastic Surgeons, and some of them got multiple doses. It's a 2 percent increase over 2008.
New York City plastic surgeon Yan Trokel said he has seen more and more teenagers come in for consultations. Nicole Sanders, an 18-year-old from Manhattan, came to Trokel for the injections, but was turned away.
"Really, at this age you shouldn't really be thinking about Botox," Trokel told Sanders. "You don't really have any lines."
Why are teenagers seeking such drastic treatments?
"I wanted to prevent getting wrinkles. A lot of my friends do it and they see great results," said Sanders.
Peer pressure has long caused teens to turn to cosmetic enhancements -- nose jobs have become a more drastic and common procedure over the last two decades. But Botox, the muscle-relaxing and wrinkle-removing injection first approved by the FDA for cosmetic use in 2002, has taken off, and become even more popular because of the price. For $100, it's one of the more affordable and less invasive cosmetic enhancement procedures on the market today.
While it's perfectly legal for a 12-year-old to get a shot of Botox for medical reasons, most doctors believe that teens do not need Botox for cosmetic reasons and urge other doctors to stop giving the injections to young girls.
"We don't know what the long-term impact would be of giving something like Botox over someone's life," said ABC's senior health and medical editor, Dr. Richard Besser. "When you're starting as a teenager, does it mean you're going to be using this product for the next 40, 50 years?"
Five years ago Brooke Sittman, then 18, had a deep line running across her forehead that bothered her. She opted for Botox.
"People would always be concerned that I was upset or frustrated because I had this deep line in my forehead," Sittman said. "It always looked like I had some sort of pensive state and that wasn't always necessarily the case."
Dr. Doris Day, the Manhattan dermatologist who gave Sittman Botox, said her situation was an exception.
"She had a very specific issue in terms of the way her forehead moved and a crease that was very deep and was becoming present at rest at a very young age," Day said.
Day said Botox can be useful for medical purposes, helping those who suffer from nerve damage or twitching around the eye.
While most experts agree that teenagers are too young for Botox, some say it has helped some teens' self-esteem and self-worth.
"In Brooke the difference was pretty remarkable," Day said. "It's really quite profound how much of a difference it can make when you do the right thing for the right person in the right way."