The unkindest cut of all

IT'S the must-have item among teenage girls, along with an iPod Nano and the Kate Moss at Topshop collection. But you can't buy it on the high street and it'll cost a lot more than a month's pocket money. The desperately coveted procedure? Breast augmentation.

The number of British teenagers having breast surgery has increased by more than 150 per cent in the past year according to disturbing new figures unveiled at the weekend. Statistics from three of Britain's largest cosmetic surgery chains showed that almost 600 teenagers had the surgery last year, by far the highest figure ever recorded.

In fact, such is the demand among young women for plastic surgery that there is even a new clinic, Make Yourself Amazing, aimed solely at 18 to 35-year-olds. It has signed up reality TV stars including 21-year-old Naomi Millbank-Smith, who appeared on the Channel 4 show Shipwrecked last year, to provide glowing testimonials about the benefits of breast augmentation.

"I have always considered breast enlargement, but after appearing on Shipwrecked I finally convinced myself to go through with it," Millbank-Smith burbles, accompanied by pictures of her in a variety of bikini tops that leave little to the imagination.

"Being filmed for five months in a bikini is enough to make anyone think long and hard about their figure and I found myself becoming envious of the curves other girls had."

It's not hard to see how teens are being influenced into changing their shape when the celebrities they admire are doing so.

Shami Choudhry of plastic surgery chain Transform says: "Young women read in magazines about personalities like Chantelle (Houghton, 24, winner of 2006's Celebrity Big Brother, who recently went from a 32B to a 32E "to boost my self-confidence"], who have had breast augmentations and have a great influence on teenagers.

"Eighteen and 19-year-olds are big consumers of weekly celebrity chat titles. Every edition contains something about cosmetic surgery, and women who read these magazines often buy two or three of them a week."

And although such procedures are still expensive, with a breast augmentation costing around 4,000-5,000, many clinics now offer attractive payment packages, meaning a surgical operation can be paid off over many months, or even years, making it even more accessible to younger women.

Anita Naik, agony aunt and author of a number of books on teenagers, including one on the issue of self-esteem, says that she recently received a letter from a 17-year-old who had received a breast augmentation operation for her 17th birthday.

"It's seen as far more acceptable now," Naik says. "It's a trend. A lot of young women don't see any problem with it, though it's clearly a result of esteem issues. If a girl wants a breast enlargement in the first place, the chances are she's not happy with her body image. She'll have one either to give herself more confidence, to give herself more sex appeal, or because she thinks it will make her famous."

Teenagers under the age of 16 cannot have plastic surgery without parental consent, and most British cosmetic surgery clinics do not operate on women under the age of 18. One cosmetic group, SurgiCare, turns away 18- and 19-year-olds and advises them to come back when they are 20.

Mark Bury, its chief executive, said: "In some cases these women have not finished developing. Even if they have, surgery may be a knee-jerk reaction or a result of peer pressure."

But not all cosmetic surgery chains employ the same tactics. The Hospital Group, which has 14 clinics across Britain, carried out 203 breast augmentations on 18- and 19-year-olds last year, more than doubling the number performed in 2006. The Harley Medical Group, meanwhile, which has 19 clinics nationwide, performed breast implant operations on 180 18 and 19-year-olds last year, compared with just 90 the previous year.

Christine Williamson of Silicone Support UK, which wants a total ban on silicone implants, has said in the past that she would like to see the age limit for surgery raised to 18.

And she says: "Breast implants should carry a warning saying that they can have serious implications for your health. Some of them only last for a few months, before they fold up in your body. Lots of girls go to have implants and know nothing about the possible complications. Surgeons do not have to tell them legally."

The British Association of Aesthetic Plastic Surgeons (BAAPS) advises caution to teenagers who are contemplating plastic surgery, and urges them to speak to their doctor before considering a procedure.

Adam Searle, consultant plastic surgeon and president of BAAPS, says: "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.

"However, the complex mix of adolescence, self-esteem, peer pressure and surgical treatments carries potential for problems.

"With the media pressures on teenagers to look good there may be an increase in requests for plastic surgery in the future."

Naik says that those media pressures push teenagers to one of two extremes: "The magazines advocate either that you have to be exceptionally skinny, like Kate Moss or Nicole Ritchie, or have this overly curvaceous body like a glamour model. They're both extremes, there's no in-between for normal-sized girls."

And there are other, serious risks too. Having surgery at 18 means the patient is likely to need repeat surgery to replace the implants in later life – with the possibility of something going wrong remaining every time they go under the knife.

So with all the potential risks out there, whatever happened to the time-honoured method of investing in a decent push-up bra and some stuffing?

"There's an ethos now of doing absolutely all that you can to be as attractive as you possibly can," says Naik. "Whenever I go into schools or meet young women, they're always complaining about their looks and what they want to change. These days, tissue paper down your top just doesn't cut it."

It's a worrying state of affairs for a generation of young women trying to come to terms with their own body image in a culture that is constantly hurling images of perfection at them.

And even if the age limit for breast augmentation procedures were to be raised in Britain, the likelihood is it wouldn't stop those determined to change their appearance.

"The chances are they'll just go and get the same procedure done abroad," says Naik. "It's not going to stop them.

"The sad truth is that nowadays, you very rarely hear a young girl say now that she's happy the way she is."