HUNDREDS of Scottish youngsters have had NHS-funded cosmetic surgery - including breast enlargement - some of them in a desperate bid to escape being bullied at school.
Scotland on Sunday can reveal that at least 40 girls under 18 have had operations on the NHS to enlarge or reduce their breast size in the past five years. Another 21 youngsters have had surgery on their noses while more than 520 children have had prominent ears pinned back.
Health officials insist cosmetic operations are only carried out on children suffering from severe psychological problems due to their appearance, but senior surgeons have revealed that some of the youngsters were referred for surgery after suffering taunts at the hands of bullies.
The figures have alarmed doctors and children's groups who claim teenagers should not be having such surgery at an age when their bodies are still growing. They fear many teenagers are under undue pressure to look a certain way due to the fashion for surgically enhanced celebrities such as glamour model Jordan.
The statistics, obtained under the Freedom of Information Act, reveal that in Glasgow four 13 to 15-year-olds underwent surgery to reduce their breast size as did one youngster in the 16 to 17-year-old group. Nine people of the same age had breast enlargements while three had breast lifts, which cost around 3,000 each.
Surgeons in Aberdeen also carried out one breast enlargement, one breast reduction, one breast lift and inserted a breast prosthesis. There was one breast reduction in the Highlands.
NHS Lothian, which has Scotland's second-largest plastic surgery unit at St John's Hospital in Livingston, said it had paid for a dozen cosmetic operations on under-18s in 2005 alone. These include five breast operations. The previous year they carried out six cosmetic operations on youngsters.
NHS Lothian also admitted it had carried out seven nose reductions while there were 10 similar operations in Argyll and Clyde and 11 in the Highlands.
John McGregor, a consultant plastic surgeon for 26 years before he retired this year from St John's Hospital, said: "The few breast enlargements I was involved in during my career were usually youngsters who were suffering from a severe asymmetry or were suffering an element of bullying at school.
"We saw a few girls aged 14 and 15 who had big bumps on their noses and had reductions because they were having difficulty studying for exams due to bullying. I am a little bit surprised that these type of cases are having operations while so young when they are likely to still be developing.
"I would urge caution to parents about going down this route until their children are older. This is a time that is difficult for children and it might not be absolutely right."
Ken Stewart, a cosmetic surgeon at BUPA Murrayfield and St Johns Hospital, added: "Not one of these operations will have been done for flippant cosmetic reasons. Breast augmentation is not carried out routinely unless a psychological assessment has recommended it or they are affected by a disease affecting breast development."
By far the most common cosmetic operation carried out on children was pinnaplasty, where prominent ears are reshaped and pinned back.
There were 63 such operations in Dumfries and Galloway, 28 in Argyll and Clyde and 427 in Glasgow. The youngest child to get an operation on their ears was aged less than five years old at Yorkhill hospital in Glasgow.
Adam Searle, President of the British Association of Aesthetic Plastic Surgeons, warned against carrying out cosmetic operations on children when they are too young.
He said that in many cases characteristics such as small or asymmetric breasts will become less noticeable as the youngsters' bodies develop.
He said: "There are obvious situations in which plastic surgery may assist a teenager with obvious deformity, for example marked asymmetry of their breast or correction of a substantial nasal deformity.
"The complex mix of adolescence, self esteem, peer pressure and surgical treatments, however, carries potential for problems."
He added that the popularity of TV programmes such as Nip/Tuck and Cosmetic Surgery Live had led to many teenagers considering cosmetic surgery as a viable option. Surveys by teen magazines such as Bliss have revealed that a third of teenagers have considered cosmetic surgery.
Searle added: "With the media pressures on teenagers to look good there may be an increase in requests for plastic surgery in the future."
Strict guidelines mean that teenagers under the age of 16 may not have cosmetic surgery without parental consent. The expensive operations can only be carried out on the NHS after a patient has been referred by a psychologist.
Andrew Mellor, manager of the Anti-Bullying Network, expressed concern at children seeking cosmetic surgery after being bullied.
He said: "We know that children with disabilities or disfigurements can be subjected to verbal taunts and bullying. Surgery is obviously an extreme solution but could be considered by those who are particularly vulnerable. The work we are doing in schools is to make people take responsibility for their own actions and words and be aware of the consequences they can have."
A Scottish Executive spokeswoman said: "Where someone's cosmetic appearance is causing them severe and intractable psychological distress then clinicians can decide it is right for the NHS to support surgery to reduce that distress."