Page 12 - SPRING 2016

Lip Augmentation in the Underage Patient -

How Young is Too Young?

Dr. Gigi Meinecke, RN, DMD, FAGD

In a world of social media, can be very costly, a bit of patience and exhaustive communication is
selfies, and Kylie Jenner, it’s well advised. Before any treatment begins, you should be absolutely
no surprise that the number of clear about what the patient wants and likewise, the patient should be
teens and very young women clear as to what can realistically be achieved. Studies demonstrate
seeking lip augmentations – a that patients with unrealistic expectations are rarely happy with out-
2
procedure, once the exclusive comes and the observation that young patients may be difficult to
domain of the over 40 crowd – satisfy has been documented. 3
has increased dramatically in
the last few years. 1 Unlike How to proceed
mature women, who shroud When a minor presents to you for cosmetic treatment and you’re sat-
their cosmetic upgrades in isfied with their treatment motivation, mental state and that the area
secrecy, teens are unabashed in question is amenable to treatment without distortion, the next step
is to get a signed parental consent. Be sure to get consent from the
and talk openly about treatments they’ve had or plan to have. We’re
definitely in a new age where both invasive and non-invasive cos- correct parent. Consent has to be signed by the parent who is legally
metic procedures are in greater use and greater acceptance. But how able to provide permission, which is not always the one paying the
bills. Since laws can vary from state to state, it’s important to know
young is too young?
the requirements where you practice.
Each time I speak on the topic of facial injectables I’m asked the ques-
And the answer is….
tion: “How old is the youngest patient you’ve ever treated?” Knowing
society and our preoccupation with self and how we look, it’s easy to see I’ve treated young teens with injectables in my practice. Most com-
how non-surgical enhancements could be subject to abuse. Treatment monly I’m treating a gummy smile with Botox®. That said, we do
age is an important consideration and in this article we’ll also explore have indulgent moms who bring their high school daughters in for lip
the factors that come into play when treating the under-aged. filler. When it comes to lip enhancements at any age, my approach is
very conservative. I believe overdone lips have the potential to
Unrealistic Expectations and Preternatural Requests become an injectable practice-killer. People can immediately identi-
Surgical and injectable manipulations of the lips have been going on fy lips that have been perverted by an unskilled practitioner. If word
since the beginning of the 20 century. No doubt we’ll have newer got out that I was creating overdone lips, my appointment book would
th
and better techniques as time progresses – but we’re in a pretty good dry-up in a flash. Moreover, so much of the personal satisfaction that
place right now with injectables that look and feel natural and are comes out of treating patients with injectables is derived from creat-
well tolerated. It’s really unfortunate that unethical motivations on ing a result that looks natural.
behalf of either the patient or practitioner can lead to lip augmenta-
tion results that move so far beyond what looks normal that a lot of And finally:
legitimate candidates who would truly benefit from lip enhancement Our society values youth and we all want to look our best.
are scared off. Another concern are patients who have a distorted per- Understanding what each age group might be looking to achieve is help-
ception of their appearance and seek treatment where none is needed. ful when evaluating patients presenting for cosmetic treatment. There’s
As practitioners we need to identify individuals who have unrealistic a decided difference between what the very young and the mature
expectations as well as those who might actually be suffering from a patient is looking for in lip volumization. Middle aged women want to
legitimate mental disorder. Knowingly treating either of these regain a youthful shape, well-defined margins and fullness to their lips
patients defines “unethical.” while the young are looking to be more beautiful. The selfie generation
is all-in when it comes to looking perfect and that’s not going away. As
What could possibly go wrong? long as the psychological and informed consent criteria are met, I per-
In what seems like a monthly occurrence, celebrities emerge into the sonally don’t think teenagers are an immediate disqualifier when realis-
public world after flagrant Hollywood makeovers. The misguided tic expectations can be agreed upon.
notion that injectable procedures have no risk is fueled by watching
these celebrity transformations. The teenage brain hasn’t matured References
enough to fully evaluate risk –and this certainly applies to possible 1. http://www.plasticsurgery.org/Documents/news-resources/statistics/2015-
adverse events associated with facial injectables. Candid discussions statistics/plastic-surgery-statsitics-full-report.pdf
regarding expected outcomes and potential side effects with both the 2. Beale S, Lisper HO, Palm B. A psychological study of patients seeking
augmentation mammaplasty. Br J Psychiatry. 1980 Feb;136:133-8.
teen and the legal guardian are absolutely necessary. Remember, no 3. Niechajev I. Lip enhancement: surgical alternatives and histologic aspects.
one “needs” cosmetic procedures and the practitioner is under no Plast Reconstr Surg. 2000 Mar;105(3):1173-83; discussion 1184-7.
obligation to treat patients asking for elective remedies.
The Medical Language-Barrier Dr. Gigi Meinecke has been active and recog-
Social media has created a platform where anyone can be a public nized in the field of facial injectables since
personality with all the “rights and responsibility to look perfect” 2004. In 2010, with the support of AGD Region
that go with it. Young patients burdened by “the need to look flaw- 5, she was instrumental in the introduction and
passing of AGD House Resolution 308 which
less” at every moment often present with unrealistic expectations. A
patient’s idea of an acceptable outcome reveals important and often supports the inclusion of facial injectables in the
dental practice. Dr. Meinecke, the principal and
overlooked information. Moreover, it’s not uncommon for a practi- founder of FACES (Facial Anatomy for
tioner to see and hear something totally different from what the Comprehensive Esthetic Seminars), provides the only training
patient is asking. Patients use industry buzzwords without fully in facial injectables to regularly integrate actual cadaver dis-
understanding their meaning. The true focus of a patient’s chief com- section (not video-taped) along with live-patient hands-on
plaint can be instantly derailed by confusion caused by incorrect ter- training. She is immediate past president of Maryland AGD.
minology used. I’ve personally fallen into the trap of misinterpreting She serves on the AGD Legislative and Governmental Affairs
a patient’s presenting concern based on the buzzwords they used. It’s Council and as a national spokesperson. She maintains a full-
only through deep exploration, and often by handing the patient a time practice in Potomac, MD.
mirror and having them point to the area in question, that ultimately
crystallizes what a patient is talking about. Since this kind of miscue
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