You may not think of cosmetic surgery as critically important to a child’s well-being, but often it is.

For a boy with protruding ears or a teenage girl with abnormally large or different-sized breasts, cosmetic surgery can be a life changer, said Dr. Ananth Murthy, director of plastic and reconstructive surgery at Akron Children’s Hospital.

“Cosmetic surgery for kids is different from cosmetic surgery for adults,” Dr. Murthy said. “Most insecurities that kids face are about their appearance and body shape. There’s a huge amount of stigma related to these issues that can have a profound effect on self-image and confidence.”

Sure, Dr. Murthy encounters teens who aren’t stigmatized. Some girls just want a Scarlett Johansson nose. But the vast majority of cosmetic procedures are for kids who just want to look normal.

Cosmetic surgery for kids most often involves fixing misshaped noses, ears and breasts. That includes breast deformations that may be congenital or caused by disease. It also includes breast-reduction surgery for boys with a condition called gynecomastia. These procedures are considered cosmetic and often aren’t covered by insurance. But Dr. Murthy said they are necessary for quality of life.

He has operated on girls who don’t want to go to school and who suffer back and neck pain because of oversized breasts.

“It’s a big deal. We did a reduction on a girl, and it changed her whole life. She was more confident and sociable. She got more involved with sports and exercise.”

Children with prominent ears suffer from teasing. The psychological impact can be severe and lasting.

“Other kids give him names, like ‘Dumbo-ears.’ It’s about a one-hour operation to correct it. Parents routinely tell me their child’s whole personality is different afterward,” Dr. Murthy said.

Most teens who want a rhinoplasty – a nose job – don’t want it for vanity reasons, but because of deformities from injuries that affect appearance and in some cases cause breathing difficulty.