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The question

My thirteen-year-old won't stop talking about a nose job. She does have a big nose - and she's very persuasive. Am I crazy to allow this?

The answer

Allow her to talk about her body image: she trusts and confides in you, and you should take pride in that.

Self image at age 13 is very important. Ask her more about what specifically concerns her: has she been bullied or teased? Is she concerned her friends will date one day and she will never find a nice guy to go out with? The key thing is to see what exactly bothers her about her nose.

Spend time to convince her that her nose is simply the way she was made, and that her self worth has nothing to do with her nose.

The surgeon will most likely not perform any procedures on a patient that young. In the U.S., 40,000 rhinoplasty procedures were done in patients under 19 years in 2008.

It should not be done until the nose has reached its adult size which normally occurs about age 15 or 16 in girls. The risks are bleeding, swelling, numbness, or scars at the base of the nose.

I am all for kids to get the facts about the future options, but your daughter is far too young for such a procedure right now. That way they can think things over and plan accordingly.

My advice would be for you to support your teen by being a good listener and helping her understand that although surgery may be the ultimate solution, it is not feasible at age 13.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com.

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