July 21, 2010 -- Weeks before she steps onto the set of the hit television show "Glee," 18-year-old Philippine singing sensation Charice Pempengco's appearance on a TV show of a different kind is creating a buzz -- complete with rumors about possible cosmetic procedures.
A Philippine broadcast making the rounds on YouTube appears to show Philippine dermatologist Dr. Vicki Belo treating Pempengco with a face-tightening treatment known as Thermage along with Botox injections into her jaw muscles.
When contacted by ABC News, Pempengco's publicist Liz Rosenberg said the Botox injections were "for non-cosmetic purposes." Rather, she said, the injections were performed to "alleviate the muscle pain around her jaw" from a condition similar to a temporomandibular joint (TMJ) disorder, as well as "swelling" connected to this condition.
"I can't speak for the doctor, but my understanding from the interviews she did was that she thought her jaw was swollen because she was chewing too much gum, and she wanted to diminish this swelling," Rosenberg said.
The use of Botox to treat TMJ disorders and other conditions is not unheard of. But in Southeast Asia, Botox shots and other botulinum toxin injections are used widely as a way to give the face a slimmer appearance.
By injecting botulinum toxin into the masseters -- the muscles that close the jaw -- doctors are able to cause these muscles to atrophy, or shrink, over time, making the face appear narrower.
Thermage treatments like the one in the Philippine broadcast are normally used to promote the formation of collagen and elastin in lax facial tissues, giving aging faces a lifted look. The cosmetic effects of the procedure gained renown in the United States when it was showcased on "The Oprah Winfrey Show" in 2003. Currently, Thermage has no indications that are not cosmetic in nature.
How Young Is Too Young for Cosmetic Procedures?
Dr. Stacy Silvers, an ENT and facial plastic surgeon with Beth Israel Medical Center in New York, said that if the procedures performed were indeed for cosmetic purposes, they were inappropriate.
"Why try to change the face of a young girl with a beautiful voice already planning to appear on the show?" Silvers said of the Botox injections, adding that the injections, if implemented for cosmetic rather than medically necessary purposes, could actually lead to jaw problems.
"The Thermage treatment was likely a waste of time and money and certainly did not slim the face," she said.
"It is not likely you will find physicians in the U.S. practicing this type of medicine, but patients who want something will get it, even if they have to go out of the country."
Too Much Emphasis on Beauty in Teen Girls?
There are, however, a number of cosmetic procedures currently available to teens in the United States. According to statistics compiled by the American Society of Plastic Surgeons, patients aged 13-19 accounted for a total of 11,633 Botox procedures in 2008, the most recent statistical year available. It's a drop in the bucket compared to the more than 5 million Botox procedures performed overall in the United States during that year. However, this figure did represent a 6 percent increase over the number of Botox procedures teens received in the previous year.
As for all cosmetic procedures in teens, the ASPS counted a total of 219,136 surgical and non-surgical cosmetic procedures for 2008. Unlike the statistic on teen use of Botox, this total number of procedures does not seem to be rising from year to year.
And Silvers said she does not believe the speculation about Pempengco's treatment will likely result in a surge in Botox procedures in young patients.
"I cannot imagine this incident will bring an onslaught of 18-year-olds to plastic surgeons and dermatologists for the same procedures," Silvers said.
Media Beauty Messages May Be Too Much for Teens, Tweens
But some child psychologists said they worry that if more emphasis is placed on beauty in entertainment enjoyed by children and teens, the demand for other cosmetic tweaks could rise. And for one pediatric psychiatrist, the possibility that a widely celebrated star like Pempengco could be part of a teen cosmetic trend is a disturbing one.
"I think this sends a really bad message that it doesn't really matter how talented you are and how great of an actress or singer you are, that really what matters is what you look like," said Dr. Carolyn Landis, a pediatric psychologist from UH Case Medical Center. "And that is a horrible message to send to the young fans of the show."
Landis added that she feels the entertainment industry as a whole should be careful about the messages it creates for younger girls about beauty and body image.
"My concern, and especially I'm a parent of a 10-year-old girl, is what's going to happen to even these younger and younger kids," she said. "These little ones are already worried about the way their face looks, the way their body shape is, and I'm really concerned about that generation coming up in eight years from now -- what are they going to be doing to look different and pretty?
"I really think we have to think about those kids, not just the other 18-year-olds out there."