Does plastic surgery to end bullying send the wrong message? | Plastic Surgery Practice July 2014

DE Cover-New 3-2012

By Lisa Jander

“The amount of bullying weighed against the temperament of the child will often require an individual evaluation, like a close inspection on the strength of a bridge.”

Is plastic surgery ever the answer to bullying? This has been a subject of intense debate in recent years, particularly as the media has turned a spotlight on bullying and its sometimes-fatal consequences. The Centers for Disease Control and Prevention’s 2011 Youth Risk Behavior Surveillance System showed that 20% of students in grades 9 to 12 experienced bullying. Bullying is likely not any more pervasive today, but its reach has expanded due to the advent of social media, texting, and cell phones.

One of the main reasons that kids are picked on is and always has been their appearance.

There are relatively easy and practical solutions for treating acne and crooked teeth, but what about the kids who are bullied because of a big nose, protruding ears, or a small chin? Do these kids really have the emotional skill set to not only handle bullying but also make the decision to have plastic surgery?

The teen years are notoriously awkward and can be extremely challenging. Research has shown that the brain is not fully developed until the mid-twenties, yet teens are able to drive at 16, join the military at 17, vote at 18, and drink at the age of 21, long before the synapses are firing on all cylinders. So, how equipped is the adolescent brain when repeatedly confronted by abuse to be able to process the possibility of a life-altering cosmetic or reconstructive surgery? This is where a skilled plastic surgeon, concerned parent, and often a psychotherapist come in to help evaluate the severity of the physical and emotional issue.


Imagine a bridge under construction, but not yet connected. On one side is the underdeveloped prefrontal cortex, responsible for decision-making, risk management, and other executive functions, and on the other side of the bridge is the amygdala, the emotional center of the brain. Parents, along with other adult caregivers, should help fill the gap by building healthy neural connections with wisdom, beliefs, morals, habits, and goals—like laying the steel rebar that gives a bridge strength and a foundation before the concrete is poured.

Parents intentionally set in place a strong, straight mental and emotional rebar by creating a safe, happy home environment. But when their child is bullied at school, the other kids begin to destroy the good rebar (neurons) and replace it with twisted, warped inputs that skew the way a teen feels about him or herself. Now, the once-nurtured, well-adjusted teenager starts to withdraw, displaying anxiety, stress, or depression as the bad rebar continues to be reinforced. The amount of bullying weighed against the temperament of the child will often require an individual evaluation, like a close inspection on the strength of a bridge.

Reframing the thought process by replacing the bad rebar before the cement is poured is one critical step to assure that the teen has the mental and emotional wherewithal to weather the years ahead. But, does a surgical solution really solve the problem? And what will result in the memory mapping and thought process of the teen when faced with other challenges in life? The caution from a brain development perspective is that all bullying can’t be eliminated with surgery. How will that same teen handle a situation when she’s put down by a supervisor at work? The underpinning must be carefully constructed to prepare teens for all forms of adversity, not just those that can be avoided or removed.


Brains have an amazing amount of plasticity, especially during the adolescent years. Counseling, peer mediation, and even bully interventions can help empower many teens. Personality tests such as the Myers-Briggs Type Indicator assessment can determine which interventions are most likely to be effective in a given teen. Caregivers should also evaluate what has been done within the school to address the situation.

Teens can be mean. Friends can be harsh. Bosses can be cruel. Life is hard. By helping all kids learn how to face the external onslaught of life’s challenges, they will be able to better withstand challenges in the future, with or without surgery. While surgery may be the best option for teens with facial deformities, electing to undergo a surgical procedure without the necessary emotional support to build resilience would be like adding a fresh coat of paint on a bridge that instead needs concrete reinforcement.


Lisa Jander is a life and relationship coach in Del Mar, Calif, and the author of Dater’s Ed. She can be reached via [email protected].

Original citation for this article: Jander L. Setting teens up to win: Does plastic surgery to end bullying send the wrong message?. Plastic Surgery Practice. 2014;(7),20-21.