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Committee Opinion No. 686 Summary: Breast and Labial Surgery in Adolescents

doi: 10.1097/AOG.0000000000001857
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The obstetrician–gynecologist may receive requests from adolescents and their families for advice, surgery, or referral for conditions of the breast or vulva to improve appearance and function. Appropriate counseling and guidance of adolescents with these concerns require a comprehensive and thoughtful approach, special knowledge of normal physical and psychosocial growth and development, and assessment of the physical maturity and emotional readiness of the patient. Individuals should be screened for body dysmorphic disorder. If the obstetrician–gynecologist suspects an adolescent has body dysmorphic disorder, referral to a mental health professional is appropriate. As with other surgical procedures, credentialing for cosmetic procedures should be based on education, training, experience, and demonstrated competence.

For a comprehensive overview of these recommendations, the full-text version of this Committee Opinion is available athttp://dx.doi.org/10.1097/AOG.0000000000001862.

Committee on Adolescent Health Care:The North American Society for Pediatric and Adolescent Gynecology endorses this document. This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Adolescent Health Care in collaboration with committee member Julie L. Strickland, MD.

This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.

INTERIM UPDATE: This Committee Opinion is updated to clarify medical indications and reflect legal considerations of performing genital surgery on females younger than 18 years.

Copyright January 2017 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

Requests for authorization to make photocopies should be directed to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400.

The American College of Obstetricians and Gynecologists 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920

Official Citation: Breast and labial surgery in adolescents. Committee Opinion No. 686. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017:129:e17–9.

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Recommendations

The American College of Obstetricians and Gynecologists makes the following recommendations regarding breast and labial surgery in adolescents:

  • The obstetrician–gynecologist caring for adolescents should have good working knowledge of nonsurgical alternatives for comfort and appearance as well as knowledge of indications and timing of surgical intervention and referral.
  • When adolescents seek medical treatment, the first step is often education and reassurance regarding normal variation in anatomy, growth, and development.
  • Appropriate patient counseling and assessment of the adolescent’s physical maturity and emotional readiness are necessary before surgical management or referral.
  • Individuals should be screened for body dysmorphic disorder. If an obstetrician–gynecologist suspects an adolescent has body dysmorphic disorder, referral to a mental health professional is appropriate.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.