Brittani Niccole's father, a plastic surgeon, gave her breast implants when she was 18. (Courtesy Niccole Family.)

A California plastic surgeon is keeping it in the family by performing multiple cosmetic procedures on his own young daughters.

Dr. Michael Niccole, founder of the CosmetiCare Plastic Surgery Center in Newport Beach, Calif., gave his daughter Brittani, now 23, breast implants when she was 18. Brittani also had a rhinoplasty. Niccole performed surgery on his daughter Charm, now also 23, when she was 10 to turn her "outtie" belly button into an "innie."

Dr. Niccole said he has performed surgery on other family members as well and felt comfortable operating on his daughters, both of whom are adopted.

"Who would give them the time - that extra little look during surgery more than I would?" the surgeon said.

Brittani told "20/20? she wanted breast augmentation surgery to "build my self esteem."

"I didn't have large breasts when I was younger, and all my friends did…I felt very self conscious about it," she said.

Both Brittani and Charm also receive regular injections of Botox to prevent wrinkles and undergo other cosmetic procedures.

Though critics say women Brittani and Charms' age have no business undergoing cosmetic procedures, Dr. Niccole defends his work on his daughters as "maintenance."

"I'm not changing their looks in any means. They want maintenance," he said. "They don't want to get old. They want to stay young."

Watch the full story on "The Cutting Edge," a "20/20? special, online here.