PARENTS’ DISCRETION

WHEN Kanye West’s mother, Donda, suddenly died of complications following cosmetic surgery last month, the media homed in on the troubling history of her doctor and the risks associated with the procedure. The hip-hop star has yet to speak out on his mother’s death, and there are many unknowns. But one question that may never be answered is this: How did Kanye West feel when his mother decided to undergo a tummy tuck and breast reduction at age 58?

Or did she even tell him beforehand?

Maybe not. With nearly 11 million cosmetic surgery procedures performed last year, it’s more likely than ever that someone in your family has had work done. It may be as subtle as the spot removal of a stepmom’s under-eye baggage. Or perhaps a parent’s sudden and suspicious jaunt to Tuscany without packing more than pajamas.

With all the emotional issues -- including a betrayal of genes and a resistance to aging -- that a nip or tuck can stir up, it’s no wonder that cosmetic surgery causes frown lines in a family. So much so that some parents are now keeping mum about their procedures.

“A lot of patients don’t even tell their adult kids about it because they’re worried that their children will think it’s vanity,” says plastic surgeon Dr. Babak Azizzadeh of Beverly Hills, who estimates that 25% of his patients want to discuss how to tell their children. “They just don’t know how to bring it up.”

The ‘other’ talk

THAT’S not shocking. It is always an awkward topic. The issue itself calls into question the most basic values that parents teach their children -- that superficiality only reigns on the schoolyard and what’s on the inside is what matters most. And what about moms who tighten up to the point of looking as attractive as their teenage daughters? No adolescent girl wants to hear, “Your mom is so hot!” Or be forced to reconsider a parent’s political ideology.

“My mom was a huge feminist who didn’t even want me to work at Elle magazine,” says Clio Manuelian, a fashion publicist who lives in Los Angeles. “Then she got a face-lift, which was very perplexing.”

For her mother, Taffy Manuelian, a psychotherapist and stand-up comedian who lives in Manhattan, the procedure made her feel sheepish enough to play down its significance.

“I taught Clio not to make evaluations based on appearance,” she says wistfully. “What can I say? I felt like a hypocrite.”

Four years later, Taffy -- a self-described “foodie” -- decided to get liposuction. This time, her daughter worried more about the health risks than the step back for women’s lib.

“I felt like it was a dangerous surgery,” says Clio. “I was so concerned that I flew home to New York to be with her and change her dressings.”

Taffy didn’t consult her New York doctor on how to allay her daughter’s anxiety. Nor did Clio get prepped on what to expect after the operation. But these days, how to discuss cosmetic surgery with kids -- from the inherent risks to the often gruesome recovery -- is becoming a hot issue.

And it’s only going to become more heated, as more aging baby boomers play Ponce de Leon. According to a 2007 study by the American Society for Aesthetic Plastic Surgery, 20% of Americans 65 or older said that they would consider cosmetic surgery. Many of their peers have already taken the plunge: 22,718, or 16.4%, of all 2006 face-lifts were performed on that age group. The next youngest age group -- 51 to 64 -- accounted for 61.5% of all face-lifts.

“I did a face-lift for a women at age 82, and she got a tweak at 89,” says Dr. Vito Quatela, president of the American Academy of Facial Plastic and Reconstructive Surgery, who concedes that the screening process is getting more restrictive as patients get older. “Her kids supported her. Usually, children in their 20s or 30s are more fearful of the medical risks.”

For patients with younger children, it’s the kids who are at risk, at least temporarily. “It’s traumatic for young kids and may be better to say, ‘Mommy’s going on vacation,’ ” Azizzadeh says. “Parents should be sure that their kids can handle it before they tell them.”

A little white lie or a convenient avoidance of the issue?

Dr. Stanley Frileck, a Brentwood plastic surgeon, vehemently advises against duplicity.

“The biggest mistake you can make is to try and fool a child,” he says and advises that patients bring their young children into the process or even the office. “Sit your 7-year-old down, and tell him that you’re having an operation and that you’re going to be swollen afterward and will need some help.”

Fibbing about having a procedure doesn’t send the best message either, says David Sarwer, associate professor of psychology at the Center for Human Appearance at the University of Pennsylvania. “It’s important to be honest about your health,” he says. “What if your daughter found a lump on her breast and didn’t tell you about it?”

A child’s worries

Teenagers bring a whole new wrinkle of complexity to the issue. “Generally, a fear of the health risks is a beard for a fear that Mom is going to change her appearance and lifestyle,” Frileck says. “It’s an intimacy issue.”

Or even a wardrobe issue, as newly lipo-ed moms raid their daughter’s closets.

Tracie Souve, a nurse in Azizzadeh’s office, promised her three kids before she had four procedures that she wouldn’t look different. That was two years ago, when her son was 15.

“He was against it the most because he thought I should age gracefully,” says Souve, who had a neck lift, cheek lift, upper eye tuck and minor rhinoplasty. “I had told them that it was important to accept who you are and how you look, of course. But I also told them my looks had started to interfere with my acceptance of myself.”

The second part of that message suddenly rang loud and clear for Souve’s daughter Jennifer Jimenez, then 20, who didn’t like her own nose.

“I saw how perfectly my mom’s nose fit her face and started staring at my own nose in pictures,” she says. She lobbied for rhinoplasty and had the surgery months later. “I don’t think I would have asked if she hadn’t done it.”

That same philosophy didn’t work for Clio Manuelian when she told her mom that she was contemplating a nose job a few years ago. “I was appalled,” Muriel Manuelian recalls, with a husky laugh.

Clio ultimately decided against rhinoplasty.

“I felt like, ‘It’s OK for me, but not for you,’” Taffy says.

“I did take her to see my doctor though, because I didn’t want it to be her secret.”

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monica.corcoran@latimes.com