About face: more and more teen girls are willing to do almost anything to look good, including going under the knife.

Ask friends of Julie, 17, to describe her, and you get words like "pretty," "athletic" and "smart." But if you'd asked Julie to describe herself a year ago, you'd only hear about her "pudgy" stomach.

"I've had a bad body image my entire life," says Julie. "Even in kindergarten, I remember playing with a friend and thinking, 'Wow! My arm is as big as her leg!' I was just always a chubby little girl. Even my very best guy friend nicknamed me 'Pork Rind' at age 9. That totally crushed me. I think that's what really started my obsession with my looks.

"I felt totally inadequate. I was completely focused on the middle area of my body as being really ugly. No matter how many sit-ups I did, my stomach was never flat. Sometimes, I'd think, 'This is so stupid. Why am I worrying about this? I have so many other things going for me!' But I couldn't stop myself. So when I was 16, I decided to have liposuction to finally put an end to my obsession."

Julie is one of thousands of teens opting for plastic surgery. In 2003, over 74,000 cosmetic surgeries were performed on kids under 18. That's an astounding 14-percent increase in just three years. And if you include all cosmetic procedures, like chemical peels, microdermabrasion and Botox (yes, teens getting Botox!), the number shoots up to 336,000--up over 50 percent in one year.

Last year, 42,515 teens got nose jobs (rhinoplasty) and 15,973 had ear pinnings (otoplasty)--the two most popular surgeries among teens. But there were also 3,841 breast implants--up more than 24 percent in a year--plus thousands like Julie having fat sucked out of them by liposuction.

Startling facts? Not when you consider that hit shows, like The Swan and Extreme Makeover, make plastic surgery look like no biggie. But, as we all know, reality TV is seldom reality. Recovery from surgery is far more painful than what you see on a one-hour show, and the operations involve life-and-death risks--with no "body-back" guarantees! So should plastic surgery, with all its potential consequences, even be an option for teenagers?

Plastic Surgery Nation

"Plastic surgery is available more than ever to the average person, and that's a big motivating factor," explains Dr. Paul Glat, a plastic surgeon practicing in Philadelphia.