Plump body, puffy cheeks and puberty - when is it 'too early' for liposuction?

My 16-year-old daughter is unhappy with her plump body and puffy cheeks. I’m convinced it’s just baby fat that she’ll soon lose, but she wants to do undergo facial liposuction to get a V-shaped face. What’s your opinion?
Although it’s labelled “baby fat”, some people maintain those pinch-able pouches until their early teens. However, at 16, it’s not very likely that the cause of your daughter’s cheeks is “just baby fat”.
Even for babies, the “just baby fat” excuse is a poor reason to ignore excess fat. Babies might look cute with chubby cheeks and chunky thighs, but obesity at any age is unhealthy.
Researchers have found that obesity begins to threaten the health of the heart as early as age two, and even at such a young age, a child needs at least a half-hour of exercise a day, just like us adults.
Understandably, now that your daughter is a teenager, she feels more conscious about the way she looks, and feeling big is not a good feeling. You should, however, talk to her about a realistic goal – teenagers are more susceptible to being influenced by the media.
She shouldn’t aim to look like a Korean pop star but to look the best in her own way, and, considering her age, for health’s sake rather than beauty.
There are many technologies to help contour the face and the body, but for a teenager, the best way is to watch what she eats and exercise more. At 16, chances are her metabolism is still in prime condition, and any excess fat should be burned off easily (or, at least, easier than when she’s 36). A healthy lifestyle also means she’ll be able to keep a healthy weight later in life.
While technologies today are safe and reliable, it is advised to wait until she’s at least in her late teens.
Some doctors perform facial liposuction on teens once past puberty, but at such a young age, and at age 16, their bodies and faces are still undergoing a lot of changes naturally.
Facial liposuction, for a 16-year-old, might not be necessary. Even if she manages to lose weight and still has a round face, other non-invasive technologies might be better.
More to the point, the cause of her round face might not even be fat – it could be her masseter muscles – the muscles attaching the jaw to the cheekbone.
If that’s the case, most doctors would consider injecting botulinum to weaken these muscles, slimming the face into a V-shape. US teenagers as young as 13 are getting the injections and reportedly doctors there carry out more than 12,000 procedures on teenagers each year. While the US Federal Drug Administration has approved its use for anyone over 11, it can be dangerous if not regulated properly. This trend has a potential for complications from unskilled injectors who operate illegally at cheaper rates.
What you can do is to take her to a reliable medical cosmetic clinic that can provide honest information and not just try to sell as many treatments as possible. A skilled doctor should be able to work out with her a plan for a weight-loss programme that will make her healthier, happier and more confident about her appearance.
As unfair as this sounds, teenagers usually believe outsiders more than their parents, and talking about food consumption with a teenager is quite sensitive, so it’s probably better to let the doctor to do the talking.
Meanwhile, as a parent, you can teach her that she shouldn’t believe everything she sees in the magazines or on TV. Not everyone looks like an actress or a glamour model in real life, and even the “perfect” women we see in the media probably don’t look like that in real life either.

Thanisorn Thamlikitkul MD is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and certified in dermatological laser surgery. Send your questions for her to |[email protected]