Mirror, Mirror : Fashion: Southland teens are turning to plastic surgery to get new noses, thighs, chins and ears. Some doctors worry that the trend is not a healthy one.

At least one Beverly Hills High School senior went back to school with more than just a new wardrobe this fall. Her cosmetic surgeon gave her a new chin and cheekbones. Last year she sported a new nose.

Not far away at a private high school in Los Angeles, two girls talk about their cosmetic surgery. Each underwent liposuction, a surgical method of vacuuming fat out of bulging areas. One had her chin line revamped, another slimmed her thighs. “My thighs drove me crazy--they were so fat,” said the latter, who wore a Size 3 before her surgery (and still does). “Now I can wear really short skirts and not look so gross.”

Southern California cosmetic surgeons report an upsurge in the number of teen-agers who want--and get--plastic surgery. Some doctors are estimating such surgeries are up 300% since three years ago.

“The girls come in asking for Christie Brinkley’s nose, Cher’s cheeks or Kim Basinger’s lips. The boys want smaller noses, flatter ears, stronger chins,” one Los Angeles surgeon explains.

Not that every celebrity on the teens’ lists has had plastic surgery. But their features are considered the current ideal.

Across the country, teens account for about 16% of all rhinoplasties, or nose jobs, that are performed. Although nose revision is the cosmetic surgery most requested by teen-agers, chin and cheekbone augmentation, liposuction and even breast augmentation procedures are also becoming more popular among the under-20 set.

While such a trend is undoubtedly good for business, many cosmetic surgeons are concerned that this one isn’t necessarily healthy. Many believe that adolescents, influenced by advertisements that link physical beauty and social success, are often looking for more than just a new nose or larger breasts when they opt for surgery.

“The youngsters think it will increase their popularity or make them feel happier about their lives,” says Dr. Sheldon Rosenthal, chief of plastic surgery at the Medical Center of Tarzana. “When it doesn’t change their life, they’re devastated.”

In most cases, their peers don’t notice the change.

“People thought I colored my hair or got my braces off--they didn’t know I changed my nose,” says one Westside teen-ager, who like most of the young adults interviewed for this article, agreed to speak only on condition of anonymity.

“I knew when one girl got a breast job,” said a male senior from Hollywood High. “Most of my friends thought it was funny. I thought it was kind of sad.”

Too shy or embarrassed to make an appointment for a consultation, some teen-agers first seek advice from fashion and beauty magazines.

Seventeen’s beauty editor, Annmarie Iverson, says letters are on the increase. Most readers who write want facts: how much does it cost, whether their parents’ insurance will pay, how long it takes to recover and how old they should be to do it.

“Many of them regard surgery as a quick fix,” she says. “We try to encourage them to accept their own individual beauty--but that’s not always what they want to hear.”

Many teens know exactly what cosmetic changes they want and are clear about the results they expect.

Dr. Lawrence Koplin, a Beverly Hills plastic surgeon, says that although he has turned away a number of cases because the teen-agers were seeking miracles, “when the young person knows what is troubling them physically, a change can allow them to blossom when they felt inhibited by their appearance.”

It’s often up to the doctor to determine whether his or her prospective young patient is getting surgery for the right reasons.

“When patients have ill-defined goals, when they can’t tell me what they want changed and why, then I question whether they are psychologically ready for surgery,” says Dr. Timothy Miller, professor and former chief of plastic surgery at UCLA School of Medicine.

Parents play an integral part in the teen-ager’s decision to have surgery. From a practical standpoint, of course, their written permission is necessary and they’re usually paying.

But the latter isn’t always a deciding factor. If parents won’t or can’t pay for the surgery, some teen-agers get after-school jobs or dip into their college or automobile funds to come up with the necessary $2,000 to $8,000 that typically has to be paid up front.

“I would have found a way to pay for it myself--that’s how important it was to me,” says one Los Angeles teen-ager whose parents footed the bill for her $3,000 nose job and chin implant.

From an emotional point of view, parental attitudes often shape the child’s, doctors say. Some parents become overly concerned with their teen-ager’s appearance and pressure him or her into consulting with a plastic surgeon.

As Koplin points out, “On occasion I’ve had to ask a parent to wait in another room while I talk to the kid and find out if he or she really wants the operation.”

On the other hand, a parent’s support can give the teen-ager courage to proceed, as one Westside 16-year-old says. Self-conscious about a “bulbous” nose since she was 12, this teen-ager acknowledges that her father’s personal experience with rhinoplasty made him more understanding.

“He made me feel like I wasn’t just being a total princess about it,” she recalls.

Had the young girl requested a rhinoplasty at 12 when it first started bothering her, most experienced plastic surgeons would have turned her down, says Rosenthal.

“A nose job done before 15 or 16 on a girl, or 17 or 18 on a boy, can inhibit the growth of the middle third of the face,” explains the Encino-based surgeon. “Done too young, the surgery may cause the child to develop inadequate cheekbones, so further surgery may be necessitated down the line.”

Not all teens turn to cosmetic surgery for narcissistic reasons. Some are emotionally tortured by physical deformities that can be surgically corrected.

Consider the boy with breasts so fleshy that he’s embarrassed to be seen in a swimsuit or even to wear a T-shirt. Or with ears too big to cover with short hair. Or the girl whose scars from an old automobile accident still disfigure her face.

Rosenthal cites the case of a young girl whose breasts were abnormally large, so big that at times she wore her arm in a sling to support them. He removed about 10 pounds of excess tissue, “and she changed from being introverted and ashamed to feeling like a normal teen-ager. This was a case where a very specific change made a major difference in the girl’s life at a time when it’s important to feel like the rest of the girls.”

But for some surgeons, teen-agers whose surgical needs are less than essential represent a new, virtually untapped market. And they are blatant in their attempts to attract these new patients.

For instance, one Los Angeles surgeon recently issued a press release announcing that he had performed fat transplants to give a young male patient a rounder rear end.

In a less obvious marketing approach, the American Academy of Facial Plastic and Reconstructive Surgery has published a book called “The Teen Face Book, A Question and Answer Guide to Skin Care, Cosmetics and Facial Plastic Surgery.” Despite its title, the major part of the book is devoted to various surgical options.

Should teens be encouraged to surgically alter their faces and bodies? UCLA’s Miller shrugs.

“For some it’s the best choice both emotionally and physically,” he says. “For others, it’s more emphasis on physical appearance and that might not be the healthiest choice.”

Rosenthal urges parents to seek at least two opinions from plastic surgeons.

“Go with the most conservative opinion. If one doctor says to wait, wait,” he says.

Unless laws allowing it change, the onslaught of cosmetic surgery advertisements won’t stop, Rosenthal cautions, and teens will continue to be lured to the operating table.

“So parents have to make the final decision,” he says.

Although teen-agers are the trend now, the audience could soon be even younger.

One 9-year-old Beverly Hills girl turned to her mother, a physician, to complain about her “outsie” belly button. Then she shrugged and said, “But it’s OK, Mommy, I can just have plastic surgery and change it.”