Times Staff Writer

Last week, Reuters reported that a consumer group, Public Citizen, is lobbying U.S. authorities to strengthen the health warning on Botox and its kin, Myobloc. They want to see a "black box" warning -- similar to the health caveat plastered on cigarettes -- adhered to containers of the substances.

What is most surprising, however, is that the group studied 180 reports submitted to the FDA and noted that in the 16 deaths caused by Botox, four of those fatalities occurred in patients under 18.

Who would inject a teen with Botox? Adolescence may be tough, but it certainly can't permanently furrow a brow. Still, plastic surgeons say teenagers get Botox for several reasons. Kids with cerebral palsy get it to weaken spastic muscles. Others use Botox to control excessive sweating. And, hard as it is to imagine, there is also a group that worries about crow's feet and the "11" lines between the brows. When they're not much older than 11 themselves.

"I don't believe that we have a stated position on age limitation when it comes to Botox," says plastic surgeon Walter Erhardt, a former president of the American Society of Plastic Surgeons. According to the organization's 2006 statistics, 22,795 Botox injections were given to teenagers. (The ASPS tallies injections, rather than patients.)

A call to Beverly Hills Physicians revealed that a patient would have to be 18 in order to get any sort of lip filler or Botox treatment. Over at Rodeo Drive Plastic Surgery, they wouldn't treat anyone under 21. But at Cosmetique Med Spa in Culver City, a doctor said he would "see" a 17-year-old who was concerned about lines around her lips. He said it was up to a parent to consent to her treatment.

"I wouldn't treat a junior or senior in high school who was worried about getting crow's feet," says Dr. David E. Banks, author of "Beautiful Skin: Every Woman's Guide to Looking Her Best at Any Age." "I would have a long conversation with the parents about self-esteem."

Surely, resourceful teens in L.A. could figure out how to get Botox without a nod from a parent. Dr. Erhardt notes that medi-spas in malls may not require consent.

Even more disturbing: Plastic surgery among teens, according to the American Society of Plastic Surgeons, is on the rise too. In 1994, 10,000 procedures were performed on adolescents. In 2006, it was 244,000.


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