BBC News Online: Health

Law call on teen breast ops

He is calling for a law on consent to safeguard children and the doctors assessing them for cosmetic surgery.

Dr Michael Wilkes, chairman of the British Medical Association's ethics committee, said the lack of a law meant doctors were forced to make a decision based on their own interpretation of each case that came before them.

Dr Wilkes also said teenagers should not have cosmetic breast surgery unless there were good clinical reasons.

"It should absolutely not be because they don't like the size."

He added: "Clearly someone of 15 who wants their breasts altered has some underlying issues about what they're ideal shape is."

He told BBC News Online that the shortage of official guidance for doctors left them and patients in a state of confusion.

"There is not a statutory law of consent. That's the problem."

Children under 16 can currently give consent for medical treatment, including surgery.

It is down to the individual doctor to take clinical and psychological consequences into consideration.

Teenage op

On Thursday, the case of Jenna Franklin hit the headlines.

Her mother Kay had said she would buy Jenna, now 15, a breast enlargement operation for her 16th birthday in August, to prevent her having "hang-ups" about her body.

But after their chosen surgeon refused to operate until Jenna was at least 18, Mrs Franklin backed down.

She said she would not be a responsible parent if she did not heed the advice.

Jenna earlier told BBC News: "You've got to have breasts to be successful. Every other person you see on television has had implants

"I used to pray my boobs would grow. Then I just thought, what's the point when I can have implants when I want?"

"I just want to be happy with my body and I think having my breasts enlarged will give me more self-confidence."

Jenna, whose parents run a cosmetic surgery business, said she wanted to have the operation since the age of 12.

Some operations necessary

Dr Wilkes said he would not rule out cosmetic breast operations on girls of 16 or less because some did have clinical needs.

Women can have asymmetry of the breasts, where one is significantly bigger than the other.

There could also be cases where young women needed surgery to cover up scars or disfigurement.

Dr Wilkes said: "Every case must be considered on its merits."

But he added cosmetic breast surgery should be the exception rather than the rule in teenage girls.

"A full history must be taken. It's especially important in cosmetic surgery, to be aware about the clinical issues, but also the psychological and body image issues too."

The BMA has just issued guidance to doctors on consent in children for all kinds of treatment.

Dr Wilkes said : "It's quite clear that every young person may have the chance to make decisions about their health care.

"But for many young people, especially young women, you have to be extremely cautious about doing plastic surgery with anyone under the age of 16."

Full consultation needed

Cosmetic surgeons, he said, must always talk to the patient, of whatever age about why they want the operation, and even try to dissuade them from going through with surgery if they felt it was inappropriate.

He said anyone who did not could face the GMC.

Children can legally give consent to have treatment, or surgery without telling their parents.

It is up to the doctor to decide if the child is old enough to make his or her own decisions.

But where parents are involved, they do have the right to refuse treatment on behalf of their children.