It’s normal to be proud of your kids. It’s normal to want to document the milestones in their lives. But the evolution of back-to-school time from a childhood progression into a personal media event has had a decidedly abnormal effect on many young girls.

When it comes to more drastic changes in kids’ appearances, the stats are grim. According to RealSelf, a consumer review site for cosmetic procedures, consultations for non-surgical treatments like lip fillers and Botox among teens and young adults have skyrocketed. Their data shows that interest in these types of medical interventions are up 11 percent from last year among the baby-faced cohort.  

Dr. David Shafer, a cosmetic surgeon in New York who contributes to RealSelf by answering questions from the community, told Observer he’s seen “an upswing in exaggerated lips, butts and breasts.” But he leaves a lot of money on the table by turning away girls seeking Kylie Jenner’s pillow-like pout and other alterations. “I don’t do cosmetic procedures on minors,” Dr. Shafer says. “There are cases where the procedure is reconstructive in nature, such as pinning back prominent ears which I will do. But that’s a reasonable request.”

Less reasonable are the moms bringing their daughters in for labiaplasty and other genital reconstruction surgeries. Both Dr. Shafer and fellow RealSelf contributor Dr. Lara Devgan report an increase in young women pursuing such extreme operations on their reproductive zones. Dr. Devgan says this has become a back-to-school option because, for both students and teachers, “it makes sense to heal during summer vacation.”

“It’s been an incredibly busy summer, starting in June,” she told Observer. “I typically book surgeries several months in advance, but there are always people who call in mid-August and want to recover by Labor Day. I do everything I can to accommodate them.”

Unlike Dr. Shafer, Dr. Devgan does operate on minors. “There are young patients for whom the right answer will be not to have surgery, but there are also those who would be excellent candidates.”

Dr. Anthony Youn disgrees. “I don’t condone cosmetic surgery on minors, so it’s a no-go there,” says the doctor, also a RealSelf contributor. While he does operate on young adults, Dr. Youn doesn’t think it’s always a good idea. “I discourage many people under the age of 23 from getting work done unless absolutely desired and even needed, since the face and body can continue to change, even in the late teens and early twenties.”