More than 87,000 invasive surgical procedures were performed on teenagers for cosmetic reasons in 2007. Ten thousand 18–19-year-olds had breast augmentation. And Botox was used 11,000 times on teenagers (though because that counts injection sites, the number of patients was smaller). A few years ago I could get gasps from a crowd by reading a Wall Street Journal story about "Botox parties" hosted by 33-year-olds. Guess I'll have to revise that anecdote. Many of these procedures are no doubt a real source of mercy. I had a friend in high school with gynecomastia, and the corrective surgery made a marked difference in his self-esteem. Yet the fact that I have to resort to that wretched twentieth-century word "self-esteem" to explain the benefit of his surgery is telling, and troubling.