Ethics and Teenage Plastic Surgery: Is it Morally Acceptable?

I. Introduction
A. Background and history of teenage plastic surgery in the Philippines
1. What causes them to perform plastic surgeries?
2. How do parents feel about it?
3. How do Filipinos view plastic surgery in the Philippines?
4. Is it common?
B. Morals and teenage plastic surgery
1. Is it morally acceptable to perform such surgery on minors?
II. Body (use theories to support answers)
A. Plastic Surgery on Self Esteem
1. Does it make you virtuous when you alter your appearance as a person?
2. Will the procedure itself, the plastic surgery, boost your confidence as an
individual?
3. If you are the person being operated upon, does it really help you to attain
happiness?
4. Does it really make you improve your moral compass?
5. Does it really make you morally upright when a person undergoes a
procedure?
B. Plastic Surgery as a Business
1. Is it ethical or morally acceptable that surgeons make business/money out
of these procedures?
2. How does the procedure go about with regards to consent with the
teenager?
3. How much do surgeons make from performing such surgeries?
4. What are the common cosmetic surgeries performed on teenagers?
C. Main Theory

III. Conclusion
1. Reconcile A, B, C
2. Overall idea
3. What is the group’s stand, is it morally accepted or not?
Abstract

This paper provides an analysis of teenage plastic surgery being morally acceptable

wherein the purpose of this essay is to explain the prevalence of plastic surgery in

teenagers by providing supporting evidence. For this procedure, the topic got divided into

four parts: (1) Background and history of teenage plastic surgery in the Philippines, (2)

Morals and teenage plastic surgery, (3) Plastic Surgery on Self Esteem, and (4) Plastic

Surgery as a Business. The first topic is about the background and history of teenage plastic

surgery in the Philippines, which determines the cause why people undergo plastic surgery

and whether it is common or not, which is prevalent and wants to increase their

confidence. Next is morals and teenage plastic surgery, which tackles whether performing

such surgery on minors is morally acceptable. Moreover, the third topic is the plastic

surgery on self confidence that uncovers how this boosts the confidence of an individual

and attains happiness. Lastly, plastic surgery as a business was considered to determine

whether the business money acquired by the surgeons is morally acceptable. In this regard,

given the stand, knowing the significance between these Ethics and plastic surgery can

result in a better understanding of their importance in an individual.

Keywords: confidence, ethics, plastic surgery, teenager

Introduction

“As I get older - and wiser of course - I appreciate natural beauty in a different way.”

- Kaitlyn Bristowe

Plastic surgery has equipped various individuals from different walks of life to

improve their lifestyle for distinct reasons. Medical Travel Czech (2015) explained that the

first medical literature extends back to ancient Rome, Greece, and perhaps Egypt. Plastic

Surgery can be defined as the practice of restoring or repairing body parts through tissue

transfer, either for medical or cosmetic purposes. The practice is more widely known at

present for its cosmetic and aesthetic implications over being a previous form of

reconstructive surgery. Reconstructive Surgery is a method used to address deformities in

the body such as physical birth defects; cleft lips and palates and ear deformities, whereas

Cosmetic Operations, on the other hand, alter a specified portion of the body with where the

individual wishes to be changed. Changes include enlarging or reducing the breasts,

contouring the nose, and removing fat pockets from specific parts of the body.

In the American Society of Plastic Surgeons’s (n.d.) article, it was stated that there is

a difference in motive when interviewing teens and adults on their desire for plastic

surgery: teens consider plastic surgery as a way to fit in and look appealing to friends and

peers. Adults, on the other hand, frequently regard plastic surgery as a method to stand out

from the crowd. Apart from plausible reasons such as for medical reasons; to repair a

physical flaw or to change an area of their body that causes them discomfort. Having said

that, common reasoning and purpose of the practice focus on the desire for a cosmetic

modification because one is unhappy with their visible appearances. Teenagers who

undergo cosmetic procedures such as otoplasty (surgical to pin back protruding ears) or
dermabrasion (a process that can help smooth or cover severe acne scars) often feel more

confident in their outward appearance afterwards. Motivations revolve around the need to

increase self-confidence as this equips an individual to have a lifestyle free of negative

connotations about themselves. The confidence gives an individual a more positive outlook

in life that follows into their mental and social well-being. Clinical Psychological Science

(2013) stated that plastic surgery targets boosting happiness, sense of pleasure, and

self-esteem. It’s been proven that those who underwent surgery were less anxious and

grew to have a positive attitude about their bodies as a whole.

In HealthyChildren’s report (2015), one’s health and well-being rest with the

parents considering that they are minors. As with any other surgery, parental authorization

is required in order to proceed. Plastic surgery has been more popular among teenage

females in recent years with most being influenced by social media. Perfect appearances

greatly impact viewers to develop bleak perceptions toward their outward looks. Some

parents, as well as doctors, also consider that teenagers may lack the maturity to recognize

the dangers and hazards of such medical therapies. Guinness (2018) expounded that

almost 230,000 individuals aged 13 to 19 received cosmetic operations last 2017.

Teenagers accounted for 4% of all cosmetic surgery procedures performed that year. To

add, in a Boston University study published in JAMA Facial Plastic Surgery, social media was

noted to have the strongest influence on the growing number of people seeking plastic

surgery. People strive to obtain a filtered version of themselves due to the developed beauty

standards of society that emphasize symmetrical facial features, pointed noses, and

prominent cheekbones. It can be said that the necessity of understanding a teens

reasons for surgery is to secure for themselves a suitable and pleasing appearance.
 Regardless, plastic surgery performed on teenagers has been on the rise in recent

years. It remains a taboo subject for some who remain to have conservative judgements

about the procedure and this is applicable to the Philippines. Given that it is a traditional

and religious country, Filipino parents feel the need to protect the child’s physical

appearance and refuse to go against nature's will despite the races’ high regard for natural

beauty. In the eyes of God, according to church teachings, the values of kindness and

simplicity in life overpower physical appearance. As stated by specialists, an economical

reason as to why plastic surgery remains unacceptable in Philippine society is for social

reasons such as the rising case of poverty in the country; the goal of putting food on the

table outweighs the pursuit of beauty. However, it contradicts given that Filipinos adore

beauty products such as whitening soaps and glutathione (Devesa, 2017).

Main Theory

The researchers believe that happiness obtained from plastic surgery is only

temporary. As part of the principles of Stoicism, there are situations and circumstances

which one has no control over and should not attempt to force their authority over it.

Instead, one should make a distinction between one’s capabilities considering suffering

from the consequences will be part of the choice (Weaver, 2019). Knowing this, the

researchers suggest that teenagers shouldn’t feel the need to perform drastic changes on

themselves to achieve pleasure and happiness. It’s a natural reality they can control but

only to an ethical extent through how they behave and present themselves instead. At the

end of the day, what people look towards would always be one's personal values over

physical appearances as recommended by church teachings in the Philippines. This can be

supported by the Epicurean Theory on one’s mindset on how exactly pleasure should be

attained since state of mind can always be altered depending upon their way of state of

mind.

Plastic Surgery on Virtues & Self Esteem

Modifications made to one's body make them feel better about themselves, but can

that change their personalities? Aguillo (2015) indicated that plastic surgery affects one's

sole personality based on the kind of bad experiences they encountered due to their

physical appearances. This leads them to the desire to undergo plastic surgery knowing it

will help them feel more confident about themselves and this interrelates to being virtuous.

The Katian’s goodwill believes that one should always be kind to fellow men as these people

come from different walks of life. lt chooses to fulfill its moral responsibility voluntarily, and

that responsibility is exclusively imposed by rationality that is solely driven by reason.

Therefore, a person behaving appropriately and properly is a result of virtue and happiness

(Oxford University Press, n.d.).

Condron (2018) mentioned that the media is increasing the promotion of the new

standards of cosmetics, and individuals are joining the beauty industry, trusting their

psychological comfort to the surgeons. Keeping this in mind, people should be aware that

despite plastic surgery providing people a sense of fulfillment, too much of this can impair

their self-confidence. The evidence on whether plastic surgery improves self-esteem is

inconsistent because some studies have linked dissatisfaction with cosmetic surgical

operations to suicide due to the unrealistic expectations from the patients (Dittman, 2005).

This is where Aristotle’s Golden Mean takes place wherein Aristotle’s Happiness and
Enjoyment welcomes actions that bring forth the individual a sense of happiness or

enjoyment once fulfilling it, and any action that brings agony is not welcome. The lack of

pleasure from the results of the procedure leads to something that is beyond our control;

therefore, these people tend to undergo plastic surgery again until they feel satisfied. In

Maslow’s (n.d.) hierarchy of needs, lower wants are more localized, tangible, and finite,

whereas higher needs' satisfaction is limitless. Higher need satisfaction makes people

happier which can accomplish higher need gratification therefore diverting it to the

possibility of developing an addiction to wanting to perform more plastic surgeries.

Plastic Surgery on Self Esteem & Moral Compass

Abdel-Khalek (2016) in his book entitled In Self-Esteem talked about the

psychological explanation behind self-esteem in the first chapter. Self-esteem was

illustrated as an admirable and approbatory perception of oneself because of its connection

to how one understands ‘social relationships’ and capabilities. It encourages one to make

an appropriate or tentative judgment that has a domino effect on how they are to respond

to their concluded perception which can also be known as ‘emotional reaction’ according to

Abdel-Khalek. Keeping this in mind, how exactly do one’s self-esteem and moral compass

interrelate? Ruyter et al. (2020) explain a young adolescent's biological being in their

research entitled What do you mean by ethical compass? Bachelor students’ ideas about

being a moral professional. Adolescents are said to derive decisions without logical

reasoning and simply base their choices according to what is appealing to them. He added

that this mindset encourages them to make unethical decisions, therefore, having poor

direction. Ciranka & van de Bos (2019) supports this in their article entitled Social Influence

in Adolescent Decision-Making: A Formal Framework where he maps out the behavioral

changes in an adolescent as they are exposed to external influences. He divided the focus of

his study and how these relate to adolescents' decisiveness when it comes to social

influence (Social Motivation, Reward Sensitivity, Distraction). The core prime stage of

influence in the human developmental stages is during the ‘mid-adolescent’ stage. Having

said that, adolescents simply learn from the actions of others and then systemize their

preferences. Ciranka added in his research that adolescents were more vulnerable to

familiar experiences than ones that had unfamiliar implications or ones they have not been

exposed to. How then are they able to outgrow this behavior of making impulsive decisions

without direction? It was scientifically suggested that if these young adolescents habitually

immerse themselves in engaging and productive learning environments that challenge their

logical skills, it would enlighten them with better wisdom in life.

Having listed down the newfound information, the researchers formulated that in

the context of one's self-esteem and better direction, having plastic surgery does not

improve their moral compass. A moral compass is intended to be the reference for decision

making and it seems that the adolescent stage is an age frame for exploration. In other

words, this is an experimental stage for them where they try and see new interests that

they might be able to develop through experience. Investing in plastic surgery at a young

age is a long-term investment and sometimes results are not always as expected.

Perception and satisfaction with oneself change depending on their current season

in life. In the expectancy that the individual’s confidence becomes weary even after having

undergone plastic surgery, it might encourage them to alter different features of themselves

considering that plastic surgery equips one with temporary satisfaction. There is also a

possibility of addiction that can negatively impact their health since they are still
biologically developing. Having said that, it is common and within human nature to

frequently want to change something about themselves when used to a routine. However,

the researchers recommend that one not base his or her happiness on the brief satisfaction

they receive from changing their physical appearance.

Plastic Surgery on Self Esteem & Being Morally Upright

Coopersmith (1990) explained that moral uprightness is determined by one's

personality and actions and should be guided by moral principles that are compatible with

the kind of environment they have. A morally upright individual incorporates all qualities in

order to form a strong positive personality. This is extremely beneficial for achieving one's

objective and maintaining mental peace. Acting morally fosters a good feeling of self, which

improves the chance of future moral behavior. Self-esteem has been highlighted as a

significant aspect in a person's effective interpersonal actions. Moral uprightness and

growth should be vigorously promoted since this is what makes people great; one must

have respect and discipline.

When someone discusses having plastic surgery, they are labeled as "fake" or

"plastic." Its practice is frowned upon for the following reasons: (1) “It is self-harm" people

would say that those who get plastic surgery do not appreciate how they appear therefore

wanting to change themselves to feel better. It’s often compared to situations such as when

someone who is depressed cuts themself to "feel better." (2) "It is lying and/or deceiving"

because as someone has plastic surgery, they deceive people about their appearance. (3) "It

is horrible that an entire business preys on people's fears in order to sell them unneeded

operations." With that being said, getting plastic surgery is not necessarily about how
you appear because it serves more as a rebrand, and the researchers believe that it is

not immoral. One presents themselves precisely as who they are today, including what

makes them happy and how they see themselves. Nevertheless, there are other sources to

‘rebrand’ for exploring teenagers over performing a plastic surgery with little modifications

about themselves. The prevalence of plastic surgery at this time shows how important

appearances are for these teenagers and in our society. One's appearance influences

many areas of life, from personal connections to career prospects.

Plastic Surgery on Being an Ethically Acceptable Business

In many situations, surgeons are aware of the individual's mental preoccupation or

inability to accept their physical appearance when consulting for plastic surgery. Common

physical traits that teenagers may seek to correct include nose, breast, acne, and scars.

When a physical problem is resolved, it often boosts self-esteem and confidence. Plastic

surgery for teenagers generally has different reasons and aims than for adults. They

frequently have plastic surgery to fix physical qualities they perceive to be unpleasant. If

this matter is left unaddressed, it may affect their self-worth. Plastic surgery is commonly

used by teenagers to blend in with social beauty standards.

Based on Salary Expert’s (2022) estimated salary, the suggested net salary for a

plastic surgeon in the Philippines is ₱2,059,923, or an hourly pay of ₱990. Furthermore,

they receive an average incentive of ₱154,082 whereas an entry-level plastic surgeon (1-3

years work experience) makes ₱1,373,865. A senior level plastic surgeon (8+ years work

experience) makes ₱2,787,890 on average.

 Plastic surgery is not forbidden in any country however, parental consent is a must

for patients since it is their responsibility to help their children to make a decision

beneficial to them. In some cases, obtaining written informed consent is insufficient to offer

proper medical protection. In particular, enhancing the doctor-patient connection by better

understanding the patient's feelings and expectations becomes a deciding element when

identifying the optimal treatment plan for the issue at hand, which may also involve

nonsurgical eligibility (Morselli et.al., 2019). Parents' responsibility is to assess the

physical and mental development of the adolescent and consider particular instances that

require careful consideration under the supervision of a board-certified plastic surgeon.

Before receiving plastic surgery, specific development and physical maturity must be met.

Plastic surgery is appropriate for teenagers who can articulate a specific problem and set

realistic expectations for their outcome. For instance, if the structure of their nose obstructs

their breathing airway, they are recommended to undergo surgery. But, if they believe that

having a straight nose will make them more popular, then this goal is unrealistic, thus they

are not suitable for the surgery. A matured thinking teenager should also be aware of the

potential for things to go wrong and be prepared to accept the consequences. They must

demonstrate maturity and understand the process, danger, and outcomes. Further, a parent

should never recommend plastic surgery to their child. If a teen does not seek surgery,

there will be no patient consent, even if there is parental approval. As this can be

considered unethical if they were pressured into taking the surgery.

Common Cosmetic Surgeries Performed on Teenagers

The most common plastic surgery performed on teens include (1) Breast

augmentation or breast implants (HealthyChildren, n.d.). Aesthetic breast augmentation for

patients under the age of 18 is considered an off-label usage by the Food and Drug

Administration (FDA). (2) Rhinoplasty is the most popular surgical procedure requested by

teens to improve breathing pathways, straighten the bridge, eliminate an unattractive

hump, and contour the tip. This can be done when they reach the age of 15 - 16 years old in

girls and a year later in boys, when the nose has finished 90% of its development. (3)

Breast Reduction is performed on women with an excessively large breast, which can cause

ongoing back and shoulder strain as well as limit daily physical activity. Breast reduction is

typically postponed until the breasts have fully developed. Further, excessive breast growth,

known as gynecomastia, can be a serious issue for certain guys. With these circumstances,

excess tissue removal can be performed. (4) Acne and Acne Scar Treatment. (5)

Liposuction.

Conclusion

The plausible risk that the teenage patient gets themselves into can still be

unpredicted with the several possible outcomes a plastic surgery can derive. Having said

that, the practice will always be shrouded by the desire to look appealing and pleasant.

Many teenagers feel self-conscious and insecure about their image, notably as their

physique changes rapidly. Apart from that, one of the most prevalent reasons people

undergo plastic surgery is to boost their self-esteem. They will benefit from the increased

self-confidence that this surgery will provide. Those who had surgery were less anxious

and had a more favorable outlook on their bodies in general. People who are pleased with

the results have a noticeable increase in how they engage with others, which boosts their

self-esteem because they are no longer insecure. Not to mention that this can often result in
an increased desire to try new things and embrace new possibilities. Allowing teenagers

to undergo surgery is morally acceptable if the motivation is sound. From here, one

must be able to fully understand why these patients are desiring these operations.

Individuals might have negative experiences that prompted them to seek plastic surgery; as

a result, a person can become more virtuous after enhancing their appearances.

Plastic surgery can change a person's personality by making them feel better about

themselves. However, it can be presumed that a person can make changes to their

personality depending on the results of the procedure. The issue at hand has both benefits

and disadvantages. Altering an existing flaw in someone's physique may enable a person in

regaining confidence and self-esteem. On the contrary, other issues to consider include

dissatisfaction, for the reason that the outcome of the procedure is not always anticipated,

and the individual may end up with such a look or body that he or she dislikes. Youth who

can express a specific concern and understand the limitations of their outcome are eligible

for cosmetic procedures. A matured thinking adolescent must also be aware of the

possibility of mishaps and be willing to accept the repercussions. They must exhibit

maturity and understand the procedure, the risks, and the outcomes.

Young individuals should frequently engage themselves in interesting and

productive learning settings that challenge their reasoning skills, as this will provide them

with better life wisdom. The study concluded that undergoing plastic surgery does not

improve one's moral compass in terms of self-esteem and better direction. A moral

compass is supposed to be a guide for making decisions, and it appears that the adolescent

stage is a suitable period of exploration. In the event that an individual's confidence wanes

even after undergoing plastic surgery, it may motivate them to change various aspects of
their appearance, as plastic surgery only provides temporary satisfaction. The personality

and actions of an individual determine their moral uprightness. A morally upright person

integrates all of the characteristics to produce a strong, positive personality. The concept

behind the perspective on self-esteem is that one's personality views ethical standards

seriously, hence one feels good or bad based on one's moral acts. Self-esteem has been

identified as an important part of good interpersonal behavior. This is highly beneficial for

reaching one's goal and preserving mental tranquility. One's sense of personal and social

identity is intricately related to one's facial appearance. That being said, having plastic

surgery does not imply that you are lying about your physical features because that is

your new appearance, and it is not immoral. Acting morally promotes a positive sense of

self, which increases the likelihood of future moral behavior.

Plastic surgery is currently generally known for its cosmetic or aesthetic benefits

than for its earlier reconstructive use. Teenagers frequently use plastic surgery to conform

to social beauty standards. The most common plastic surgery performed on teens includes

Breast augmentation or breast implants, Rhinoplasty, Breast Reduction, Acne and Acne Scar

Treatment, and Liposuction. Plastic surgery is not prohibited in any country; however,

parental consent is required as parents must assist their children under the age of 18 in

making decisions that are in their best interests. It is the obligation of the parents to assess

the adolescent's physical and mental development and to consider certain situations that

demand thorough consideration under the guidance of a board-certified plastic surgeon.

Prior to undergoing plastic surgery, certain development and physical maturity must be

met.
 There is one definition that implies that cosmetic procedures are "surgery of the

norm," with the purpose of making a person happy by changing one normality into the

other (A brief philosophy of Cosmetic Surgery, 2015). Epicurus (an ancient Greek

philosopher) taught that achieving this elusive state of happiness is an important goal in

life. These individuals are able to obtain happiness by opting to have plastic surgeries

performed on them. If the surgery will improve their overall self-worth, then it should be

appropriate for them to have the operation performed. Happiness obtained by plastic

surgery, however, is just momentary. Hence, youth must understand that they cannot

constantly alter their physical features.

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