Amanda of Pandagon points to a disturbing ABC News story about teens getting plastic surgery in a bid to escape bullying or, and/or to recover from the psychological scars of bullying.

We meet Erica, who was mercilessly teased about her nose, became so distraught that she started skipping school. She even tried to force the rhinoplasty issue by slamming her nose against a door. At this point, her parents gave in and agreed to let her have a nose job at the age of 15. She's now a senior in high school, and much happier at school. Her mother tells ABC that the nose job was a good decision because it "brought her back [Erica's] self-esteem."

The second subject, 19-year-old Michelle, who "upgraded" her A-cup breasts to D-cups in order to make herself feel better after years of teasing. ABC interviews Michelle just days after the surgery, so it's too soon to know whether the initial high will translate into long-term satisfaction.

ABC dutifully interviews a child psychiatrist who stresses that getting surgery to defeat bullying is an extreme and probably ineffective strategy. The shrink is cast in the TV news role of token skeptic. In quack medicine segments, the skeptic gets 30 seconds to say, "I'm sure the stars of your show sincerely believe enemas cured their cancer, but..." before the camera cuts back to a beautiful, telegenic former patient yammering about high colonics while whipping up a wheat grass smoothie in her beautifully appointed kitchen. For a lot of people, seeing is believing.

A plastic surgeon who operates on teenagers gets equal time on ABC to say that, yes, ideally you'd deal with the bullying first, but sometimes his patients are "mature" enough to go under the knife without waiting for the social problems to resolve. He doesn't explain what he means by "mature," but I'm 99% positive that it's not what I think it means. 

The take home message of this segment, as told through the stories of the teens, is that plastic surgery is a serious (if controversial) option for dealing with bullying. Of course, this is one of those annoying "small but growing trend" pieces where announcer concedes at the outset that only a small, unspecified, percentage of the 90,000 teenagers who get plastic surgery every year do so in response to bullying.

Anecdotes speak louder than data, especially on TV. The segment didn't make any effort to assess whether bullied teens actually benefit, either socially or psychologically from surgery.

As Amanda points out in her post, trying to appease bullies with surgery flies in the face of common sense. Dramatic gestures of submission just reinforce bullying behavior.

Besides which, bullying is about the social pecking order, not about specific physical features. The ABC segment notes, without irony, that breast enlargements and breast reductions are among the most common cosmetic surgeries performed on teens.

Judging by their "before" pictures, Erica and Michelle looked utterly normal. They weren't being ridiculed for physical deformities, or even an unusual features. That's not surprising. Bullies are really good at honing in on their victims' insecurities, whether these fears are based in fact or not. 

How many people have exactly one point of insecurity that can be fixed by surgery? Chances are, if it weren't the nose or the breasts, the bullies would have found something else--including the surgery itself.

According to the American Society of Plastic Surgeons, the world's largest plastic surgery specialty association, good candidates for cosmetic surgery have realistic expectations and generally solid self-esteem. Severely bullied teens seem unlikely to meet either of these criteria.

According to the society's Physician's Guide website:

It is important to learn not only what the patient expects from the surgery itself, but also what effects he/she anticipates the altered appearance will have on his or her life in general. A good surgical candidate has:

-Realistic expectations of the surgery itself
-Realistic expectations of the effect surgery will have on quality of life/lifestyle/relationships
-A good self-image, but a concern about a bothersome feature or a moderately diminished self-image due to the cosmetic defect

Everything we're told about Erica suggests that she did not meet any of those criteria. Expecting surgery to fix a bullying problem is intrinsically unrealistic.

The Guide continues:

Also, although it is reasonable to hope for an improved self-image, a person whose ego is in crisis is not a good surgical candidate.

A patient who is so distraught that she's slamming her nose into a door is not a good candidate for surgery.

ABC News let its viewers down by not explaining that their star subject would not have been considered a viable candidate according to the ethics of mainstream plastic surgery. The segment opens the door for unscrupulous plastic surgeons to exploit desperate kids and their families.

[Photo credit: Jungleboy, Creative Commons.]