Barbie wrapped in a Manchester United footie scarf—pinned, scarred and misshapen, like a memento left behind by a vengeful sorceress going at a voodoo doll—is your Exhibit A. It shares space with things you would deem to be part of the normal, reassuring ecosystem atop an urban teenage girl’s chest of drawers: a Harry Potter collection, a high-end Bose Bluetooth speaker set and bobble heads of Beyonce and Kim Kardashian. What gives? What brought this turn to the macabre in this regulation picture of girlish innocence, with its coy aspirations to ideals of beauty?
Well, the grotesque doll is a reminder of the months of depression this girl went through early this year—pockmarked by bouts of hysterical rage that she vented on the toy. Why? Because she was trolled and body-shamed for her small breasts. She was asked if she was from ‘Man-chester’—a cryptic taunt that swiftly opened the sluice-gates for a torrent of plain in-the-face filth. She pulled away from her Facebook, Instagram and Twitter feeds, and from people, too. She seldom stepped out of her parents’ cushy duplex in a tony south Delhi neighbourhood. Her home became her self-imposed penitentiary, her asylum.
And she was just 15.
The next turn in the script was as predictable as it was filled with intimations of danger and tragedy. Worried sick about her not-so-ample bosom, she found herself in a doctor’s office discussing surgery. It was a risky move, but she reclaimed her place in the spotlight. She is a C-cup now; her selfies are all wow, topped with bug-eyed emojis, and how she loves the sideways glances of looky-loos on the street. She has got her pound of flesh—er…silicon.
Her story is not uncommon. Like the plastic in her chest, her sense of beauty is synthetic, unreal—dictated and designed by Bollywood, Hollywood, romcoms, reality television, social media and, above all else, Aishwarya Rai’s nose or Angelina Jolie’s lips or the bootylicious figures of Beyonce and Kim Kardashian. This is emblematic of a growing trend where Indian teenagers and pubescent youngsters—bullied, body-shamed or simply unsatisfied with their inherited looks—are putting their noses, lips, chins, eyes, breasts and bellies under the surgeon’s knife as if it’s a coming-of-age ceremony.
So, is cosmetic surgery the new vanity must-have for Indian teenagers obsessed with selfies and incurably afraid of body-shaming? Experts respond in the affirmative. “The trend of cosmetic surgery for kids has increased over the past few years because of social media, peer pressure and an inherent desire to look good,” says Mumbai-based plastic surgeon Viral Desai. Children are pushing the limits of human endeavour to change their appearance, beyond the limitations of grooming, using make-up and adding appurtenances—earrings, tattoos and so on.
There is no definitive data on the number of Indian teenagers going for cosmetic surgery, but demand has grown exponentially, if figures reeled out by a cross-section of surgeons from across the country are taken into account. Dr Bimal Mody of P.D. Hinduja Hospital in Mumbai says that, a few years ago, he would see two to three teenage patients every month. Now he gets that many children each week. According to New Delhi-based Dr Shishir Agrawal, senior consultant plastic surgeon at Sri Balaji Action Medical Institute, it is increasing at a rate of 10 to 15 per cent a year. Dr Kiran Lohia, who specialises in aesthetic medicine and laser surgery in New Delhi, says about 50 per cent of her patients are kids, while Dr Priyadarshan K. of Fortis Hospital in Bangalore puts the figure at 40 per cent. “A 30 per cent increase in cosmetic surgery for children under 18 over the past decade has been reported,” says Dr Sameer Karkhanis, a cosmetic surgeon in Mumbai.
Bullying is perhaps the primary cause of the spurt in aesthetic procedures. For teen girls, being called ‘flat’ or ‘fat’ by friends or family contributes to developing negative image stereotypes and social devaluation. Shivangi, a teenager from Mumbai who was relentlessly body-shamed, had to go to great lengths to get the reassurance she needed. “My breasts never grew. I used to be extremely self-conscious about the way I looked. I overheard my classmates calling me a ‘manly girl’. That got me to explore options on breast enlargement. I thought about it, talked to my parents, who are supportive, and went ahead with the surgery. Now I feel confident about my body,” she says. In most cases such as hers, according to Dr Karkhanis, parents seek surgery to help end the ridicule their kids are subjected to because of “physical abnormalities”.
The strong need to bolster one’s self-image is affecting boys as well. Rajan, a 15-year-old from New Delhi, became a recluse when his ‘breasts’ began growing abnormally about three years ago, a common condition among adolescent boys. Called pubertal gynaecomastia—man boobs or moobs—it usually resolves itself. “My friends teased me; pinched me. My self-esteem was shattered. My parents asked me to join a gym or play some sport. ‘But how the hell am I going to run on the treadmill with the wobbly bits?’ I asked myself. Then I saw a video on YouTube for chest reduction,” he says.
Like most teenagers living a life hooked to WiFi, the Internet made it easy and quick for him to find the right doctor. Rajan found a cosmetic surgeon, who suggested liposuction, and his parents played along. “I am an outdoorsy person again. Even my friends are astonished to see the transformation. I regained my lost confidence and self-esteem,” he says. Research links the rise in gynaecomastia among young boys to their food habits and sedentary lifestyle. “Those are basically fatty tissues. There are teenage boys who come to me asking for six-pack abs. I tell them to wait until they are 18,” says Dr Agrawal, who conducts at least six gynaecomastia surgeries a month.
Doctors don’t recommend surgeries for children younger than 18 as they have not grown fully—physically and psychologically. “According to Indian law, parents’ consent is must for a surgery for anyone under 18,” says Dr Mohan Thomas of Cosmetic Surgery and Skin Institute, Mumbai. The procedures come with the disclaimer: RESULTS MAY VARY. First, patients face medical risks as they do in any surgical procedure. Second, a surgically-enhanced cute nose could turn crooked in months, or a couple of years, because a child goes through various stages of biological changes until adulthood. It all depends ultimately on how a person has worn his or her face over the years: smiley people earn crow’s feet; the brow of a person who has often been angry is knotted into a permanent scowl.
Going under the knife for superficial reasons such as a cuter nose is a no-no. “Cosmetic rhinoplasty (nose job) should be considered only after 18, because nose cartilages and bones continue to grow along with the body. Similarly, healthy eating habits and exercise can reduce body fat, which a child’s body can easily metabolise. Therefore, liposuction is not advised at all,” says Dr Thomas, adding, “Children sometimes need a little fat. That recommended bit becomes excess for many couch potatoes hooked to fast food.”
Sometimes, correctional surgery has vastly improved the quality of life of teenagers. The surgeon’s scalpel has helped alleviate the nagging backache that girls with abnormally large breasts experience, or those children born with cleft lips. But others go under the knife again and again to cope with some inner sense of being imperfect. The problem is that the results are not always desirable; who hasn’t heard about Michael Jackson’s nose falling off?
But many youngsters perilously overlook the consequences. Mumbai homemaker Mrs Kamath’s daughter went ahead with a procedure for fuller lips, despite her parents advising against it—and came home with bruised, swollen and uneven lips. And a scar, too. “She was adamant, as her best friend had had this treatment and told her it was as simple as a flu shot. We gave in to her wishes as she wanted it as a gift for her 16th birthday. The cosmetic surgeon said it was as easy as a lunchtime beauty procedure, but the results were disappointing and scary. She now wants corrective surgery,” her mother says.
And as with most things, there’s a dark side to beauty. The perils of cosmetic surgery were illustrated by the death of Donda West, mother of rapper Kanye West, at a Los Angeles-area hospital in 2007 after a botched operation. British model Chloe Khan told a magazine last year how she couldn’t sit down for six weeks after a Brazilian Butt Lift—the same aesthetic procedure that dubious doctors such as celebrity surgeon ‘Dr Bumbum’, real name Denis Furtado, are said to specialise in. Furtado now stands accused of murdering a patient— a 46-year-old bank manager and mother-of-two—at his home in Rio de Janeiro this year. The ultimate sacrifice aside, there are thousands of people living with scars and bruises from plastic surgery gone horribly wrong.
It isn’t cheap to be beautiful either. Most children that surgeons see in India have indulgent parents with money to pay for the nip and tuck that may cost between Rs 50,000 and Rs 80,000 for a nose job alone. But the trend is catching on with children from all sections of society, including those from lower-income families, says dermatologist Dr A. Selvam of Chennai, who is getting more and more children asking for scar and mole removal. And this popularity often means that people without the money to pay for a procedure end up getting one from back-alley quacks.
The most sought-after treatments among Indian teenagers are procedures for fuller, plumper lips, nose jobs or rhinoplasty, jawline corrections and eyebrow lifts. Reshaping of abnormally large breasts and abdominal liposuction are also increasingly frequent. And flawless, blemish-free skin is in high demand. “Some complain about their broad nose, others about their elongated nose. They all want a nose with a sharp tip. Many bring images of a type they want. Aishwarya Rai’s nose is the latest craze among girls,” says Dr Agrawal.
Fellow surgeon Dr Desai agrees that selfies have made lip augmentations and nose jobs the most popular cosmetic procedures among children. “There are kids asking for Angelina Jolie’s luscious lips, Russell Crow’s jawline and Cristiano Ronaldo’s sharp features. They want the perfect pout on selfies, which can be done easily with fillers and fat injection.” Dermatologist Dr Lohia encounters many teen patients looking for fillers to make their nose straighter and without humps, and for the lips and under-eyes because no one wants eye circles on photos. Laser hair removal is another new normal for teenagers.
More often than not, the reasons go beyond bullying or a compulsive craving for a cuter nose, flatter tummy and bigger breasts. “From a psychological point of view, adults seek to stand out in a crowd; teenagers want to fit in among their peers,” explains psychiatrist Dr Ambrish Dharmadhikari of Mumbai. “For children, maintaining social media profiles is a full-time, stressful job because they have to get more ‘likes’ than their peers to be ahead in the game.” It’s being argued that if it’s all about selfies, why don’t they simply use an app to airbrush a self-portrait, rather than opting for cosmetic surgery? Well, any attempt to touch up an image digitally draws more contempt from peer groups, as everyone knows how that person actually looks. “Flattering filters aren’t enough, and going under the knife seems an easy way out,” Dr Priyadarshan says.
Being a teenager is not easy in an age of rapacious consumption of internet content and narcissistic social media that thrive on self-promotion. Studies show that teenagers who engage in social media report greater desire to have plastic surgery, comparing their appearance unfavourably to a model’s looks, which in all probability are enhanced through cosmetic surgery or digital media. The definition of beauty has acquired a shape-shifting quality, propelling American showbusiness folk like the Kardashians to iconic status. “Essentially, the world of the Kardashians has made cosmetic surgery accessible and has reduced the fear associated with it,” says dermatologist Dr Lohia. Dr Priyadarshan adds, “Teenage girls come to me with requests for breast augmentations, obviously a result of the Kardashian trend.”
Teens request Ronaldo’s abs and Aishwarya’s nose. Kim is another big influence.
The internet is full of stories, pictures and videos of celebrities exposing their pert derrieres or blowing a pouty kiss after a visit to the plastic surgeon. These are irresistible stimulants. And feeding the frenzy are apps such as Girls Plastic Surgery Doctor that are essentially simulators. “There are many shows on cosmetic surgeries, educating teens about available options. They portray biased facts. Teenagers try to match the unrealistic expectations of beauty standards portrayed on the screen,” Dr Dharmadhikari says. Yet, most doctors called these kids well-informed about the technicalities of surgical procedures as they read up a lot of material before visiting a surgeon.
But isn’t this urge to alter the way we look a little off? Why do so many of us succumb to the ceaseless pressure to achieve the entertainment industry’s unattainable beauty standards? Evaluating this thing called beauty from a historical perspective may help us understand its hallucinogenic power over humans across different time periods. Long before the Kardashians warped people’s perceptions of their own bodies, Helen of Troy was the toast of Greece, fawned upon not for her intellect but for her physical perfection. Why and what did the ancient Greeks find so intoxicating about her beauty? Probably, Plato had an answer: the width of an ideal face should be two-thirds its length, and the nose should be no longer than the distance between the eyes, he wrote. But his golden proportions, or fundamental symmetry that people found attractive, don’t hold up in the face of cross-cultural prejudices because, as Darwin deduced, there is much variance in appearance and preference across human groups.
Not long ago, Chinese men preferred women with small feet; achieved by making little girls wear tiny wooden shoes which they were not allowed to take off through their life. The result: disfigured, crooked and painful feet. The Kayans of Myanmar greatly appreciate giraffe-like necks; some of their women have necks that are more than a foot long, unnaturally stretched in the clasp of brass rings. Men in one African tribal group liked, or still like, women who insert large discs in their lips. Ankles were all the rage in Shakespearean England. The prejudices of the Victorian age found reflection in the work of great authors. Charles Dickens’s slimy Uriah Heep had “hardly any eyebrows, and no eyelashes, and eyes of a red-brown”. Thomas Hardy’s wholesome Tess of the d’Urbervilles had “a mobile peony mouth and large innocent eyes”. Are people with no eyelashes less trustworthy or those with large eyes more pure? There is no scientific evidence to prove that.
What is beauty, after all? Dr Desai explains: “Society determines its own standard of beauty, and it is becoming increasingly difficult to figure out what constitutes a normal appearance. The desire to meet these standards is questionable, and even crosses the line to psychopathology.” The good news is that no one is attractive to everyone else—even movie stars are not Universally admired. Someone who may appear plain to most people will surely and sincerely appear attractive to somebody else. It is at this point that beauty is in the eye of the beholder, surgery or no surgery.
- Parents’ consent is a must if the patient is under 18
- The doctor must be satisfied with the patient’s capacity to consent, and whether he or she supports the procedure
- Teenage patients must be referred to a psychologist, psychiatrist or general practitioner before surgery to identify any significant psychological problems
- Major procedures can happen only three months after consent
- Complications from anaesthesia
- Shock (usually from not getting enough fluid during surgery)
- Fluid accumulation (pockets of fluid forming under the skin)
- Fat embolism (when tiny pieces of fat break away and block blood flow)
- Burns from instruments
- Uneven fat removal
- Tissue death (necrosis) and scars (haematoma)
What Parents Say
“Every kid has strength that should be honed, appreciated and encouraged. Looks are the last thing your kid should worry about.”
Swati Bhattachariya, Mother of two and top executive in New Delhi
“My daughter’s front tooth looks like Bugs Bunny’s. Even after braces, there was a gap. We said enough is enough. It is okay to be a little imperfect. ”
Susmita Barman, Mother and content writer in Mumbai
What Parents Can Do
“A chat on what makes one beautiful would help children. Parents can use real-life examples to broaden horizons beyond social media.”
Dr Ambrish Dharmadhikari, Psychiatrist, Mumbai
“Kids should be made to understand that they are unique. The biggest blunder a parent can make is to let their teenage kids go under the knife.”
Dr Seema Hingorrany, Clinical psychologist, Mumbai