"Parents buy this as a gift because the child has everything else," said Dr. Diana Zuckerman, president of the National Research Center for Women and Families. "It should be considered with the same seriousness as any other surgery, not with the same seriousness as buying a graduation dress."
Zuckerman added there's a difference between getting a nose job, for instance, and wanting breast implants as a teen. Liposuction and breast augmentation, she warned, can have more immediate and dangerous complications, including allergic reactions. She also said it's important to remember that the U.S. Food and Drug Administration has not approved the marketing and use of silicone gel-filled breast implants for women under 22.
Nowadays, it's not uncommon to come from a family with a history of cosmetic surgeries like the Kushners. By now, grandparents, parents and kids alike have all had work done.
But sometimes it's the parents who urge their kids to go under the knife.
"I saw someone today, and I am sure she came to the office because her mother wanted the child to be seen," said Erhardt. "I feel fairly confident that she wasn't as interested in the procedure as much as her mother was."
Long Island, N.Y., surgeon Dr. Peter L. Schwartz said he's also been seeing more cases in which parents are encouraging their daughters to get breast implants. After going through a consultation, he decides whether they are ready to have the surgery based on their maturity level and how long they've been considering it.
"Sometimes, I tell them they're too young," he said.
Then he sends them home and asks them to think about it for a while.
Erhardt agreed, adding, "The interest needs to be self-motivated."
Patients under 18, for example, need parental consent before getting breast augmentation. Adolescent psychologist Lisa Boesky said it's important for parents to take part in the decision-making process. But they must do it for the right reasons.
"Parents today want to please their kids," she said. "They don't want to say no. It's easier to pay for plastic surgery than to take them to talk therapy."
Boesky said it's important to understand the difference between corrective and elective surgery.
"Parents considering this for their teens want to look at if there's something that's damaging," she said. "For example, a nose is out of whack, or men who were born with breasts. Elective surgery among teens is often more a symptom of a bigger issue that needs to be addressed. So even after the surgery, the teen sometimes doesn't feel good about themselves."
Also important to keep in mind is a patient's maturity and readiness for change. Experts say that some young people looking to have cosmetic surgery may suffer from body dysmorphic disorder, a preoccupation with a perceived defect in one's appearance.
"Individuals who suffer from body dysmorphic disorder -- who turn to cosmetic surgery -- almost uniformly report no improvement of their bodies after surgery," said Dr. David Sarwer, associate professor of psychology at the Center for Human Appearance at the University of Pennsylvania School of Medicine. "They then become preoccupied with another aspect of their appearance."
But for some patients, like Robin, the surgery has made all the difference in terms of her confidence. Her friends say that she looked good before, but looks even better now.
"It's easy for people to say to look on what's on the inside, not the outside," said Antell. "That's being naive. We all judge books by the cover. I'm not saying its right, and I'm not saying it's wrong. I'm saying it's reality."
But most doctors agree that all cosmetic surgery needs to be considered seriously.
"It's not a substitute for a personality disorder or social difficulties," said D'Amico.