Liposuction for Preteens: Too Young or Much Ado About Nothing?

Nov. 6, 2006— -- Brooke Bates of Austin, Texas, weighed a shocking 220 pounds when she sought liposuction from an Austin plastic surgeon. Even more shocking -- Brooke was only 12 years old.

According to the American Society of Plastic Surgeons, more than 3,000 people under age 18 underwent liposuction last year. But many doctors questioned whether serious cosmetic surgery like liposuction is wise for someone as young as Brooke. Here is what some experts had to say about Brooke's story:

Susan Downey, M.D.
Clinical associate professor of plastic surgery, Keck School of Medicine, University of Southern California
"Liposuction is intended to treat small areas of fat that are unresponsive to weight loss, not as a method of weight reduction. I would be very concerned about such a large volume of fat being removed in one stage -- it could be life threatening. Liposuction is not the answer to the obesity problem for either children or adults."

Suzan Obagi, M.D.
Director, the Cosmetic Surgery and Skin Health Center, University of Pittsburgh Medical Center
"I think this case is a dangerous precedent. Most surgeons who perform cosmetic surgery have ethical standards about treating minors for many reasons, including an overzealous parent, misguided body image questions, and the potential for missing underlying psychiatric issues common among teenagers such as depression and body morphic disorder. She certainly appears better and is happy to have had the procedure. However, as those of us who perform liposuction know, patients with bad eating habits will oftentimes eat themselves into a fatter body again."

Dee Anna Glaser, M.D.
Director of cosmetic and laser surgery, Saint Louis University School of Medicine
"This physician's use of liposuction to treat a morbidly obese teen was outside the standard of care in all aspects. There are guidelines for liposuction procedures and, again, this procedure violated all the principles established for safety. Guidelines have been published by the American Society for Dermatologic Surgery, American Society of Cosmetic Surgery and Plastic surgery. The most prudent care would be to address the eating disorder. There are also other weight-loss surgical procedures now such as the lap band, which can be removed."

Elizabeth Kerner, M.D.
Plastic surgeon, private practice
"This is irresponsible and potentially dangerous. A 12-year-old has no intellectual means of truly weighing the risks and benefits of such a large procedure.

"Personally, I think this sends absolutely the wrong message to teens -- you don't have to take responsibility for your decisions, we can bail you out with a quick fix."

Brent Moelleken. M.D.
Assistant clinical professor, UCLA, division of plastic surgery, and private practice, Beverly Hills, Calif.
"Removal of more than 11 pounds at one setting can be dangerous and generally requires hospitalization; it is the metabolic equivalent of a major car accident. Also, not all fat is accessible with liposuction. The fat inside the abdomen in particular is associated with diabetes and heart disease and remains behind when large volumes are removed on the outside of the body. In general, it is a very bad message to convey to teenagers that this is a method to lose weight."

Ronald Friedman, M.D.
Director, West Plano Plastic Surgery Center, Parkland Memorial Hospital, Dallas
"In my practice, I rarely perform liposuction on any patient under the age of 18. I would not even consider a tummy tuck on a patient under the age of 18. I am concerned that children and young teenagers are not emotionally prepared to make a decision of this magnitude. Any surgical scar is irreversible, and tummy tuck scars are very large. I do not perform liposuction on patients who are actively gaining weight. Although liposuction permanently removes fat cells, overeating can certainly cause the remaining fat cells to enlarge, negating the beneficial effects of the procedure."

Garry Brody, M.D.
Former president, American Society of Reconstructive Plastic Surgeons
"This girl had significant health problems -- she was an extreme case requiring extreme measures. True, no one knows what effect this may have on puberty and development, but we will never know without trying. From what we do know, my guess is that the long-term benefits of health and social development will outweigh the risk."