In the midst of the rise of the reality makeover show, recent statistics have shown that U.S. teenagers are increasingly turning to adult cosmetic procedures such as Botox injections and liposuction.

In response, the American Society for Dermatologic Surgery (ASDS) is issuing advice on when, and if, such procedures are appropriate for minors.

The numbers vary according to which medical society survey is cited, but some of the most popular cosmetic procedures among American adolescents include chemical peels, surgery to reshape the nose or ears, and breast augmentation.

According to the American Society of Plastic Surgeons, children and teens younger than 18 had nearly 332,000 cosmetic procedures last year. Although that accounts for only about 4 percent of the total nips, tucks and other aesthetic adjustments Americans had in 2003, the number represents a 48 percent increase over 2002 - owing to a surge in non-invasive procedures like Botox treatments, collagen injections and chemical peels.

In some cases, these procedures are not only safe but may also be warranted, according to Dr. Roy Geronemus, past president of the ASDS.

For example, severe acne, acne scars or excessive hair growth in girls - called hirsutism - can be “very damaging psychologically” to adolescents, he told Reuters Health.

Laser hair removal can safely treat hirsutism, and acne and scarring can be addressed with low-risk procedures like laser treatment and dermabrasion, in which the outer layer of skin is essentially “sanded” away.

Other cosmetic measures - like Botox injections or liposuction - are either inappropriate or “send the wrong message” to kids about the value of appearance and of quick fixes, according to Geronemus.

Teenagers need to know that a healthy diet and exercise are the key to weight control, he noted, and that even if a person gets liposuction, lifestyle changes are necessary to maintain the benefits. In addition, while liposuction can reshape the body, it is not a treatment for obesity.

While it may be unclear why any teenager needs treatment with the wrinkle-fighter Botox, statistics show that minors got about 5,600 Botox injections last year - up 950 percent from the year before.

According to the ASDS, Botox injections are usually not appropriate for teenagers. The one exception, Geronemus said, would be for treating hyperhidrosis - a medical condition marked by excessive sweating for which Botox is an effective therapy.

In general, experts recommend that teens and their parents move slowly when considering cosmetic procedures, making sure they know the potential risks and have realistic expectations about the outcome.

And since teenagers are almost universally self-conscious or dissatisfied with themselves in some way, understanding a teen’s reasons for wanting a procedure is vital. Wanting to look like a celebrity, for example, would not be a good basis for seeing a doctor.

It must be clear, Geronemus said, that an adolescent’s desire for a procedure is not a whim or the result of “peer pressure” to look a certain way.