A major U.S. plastic surgery organization has released new guidance about gender-related surgery for patients under 19. In a February 3, 2026 update, the American Society of Plastic Surgeons (ASPS) said surgeons should delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.
This guidance is specifically about gender-affirming surgeries for patients under 19—it does not address typical adult cosmetic procedures such as facelifts, neck lifts, or blepharoplasty.
This update has drawn attention because ASPS is a large professional group, and its guidance often shapes safety standards. It also arrives at a time when many hospitals already require patients to be adults before undergoing irreversible gender-related surgeries.
Quick Summary
ASPS recommended delaying gender-related breast/chest, genital, and facial surgery until age 19. ASPS also said:
- There is insufficient evidence showing a favorable risk–benefit balance for these surgeries in children and adolescents.
- Evidence on mental health outcomes is low certainty, and ASPS cited concerns about possible long-term harms and the irreversible nature of surgery in a developing population.
What is ASPS and Why Does This News Matter?
Founded in 1931, ASPS is one of the largest plastic surgery organizations in the United States. It represents more than 11,000 physician members in cosmetic and reconstructive plastic surgery. When ASPS releases guidance, it matters because it can influence:
- How surgeons think about patient safety
- How hospitals set policies
- How patients and families understand risks and timelines
What Is Top Surgery?
Top surgery is a common term for gender-related breast or chest surgery. For transmasculine individuals, it often refers to chest reconstruction. In a transfeminine context, it can refer to breast augmentation.
Why ASPS is Recommending a Delay Until 19
American Society of Plastic Surgeons says these surgeries are permanent, and for people under 19, the group does not believe there is enough strong, long-term research to clearly show that the benefits outweigh the risks. They also point out that teens are still growing and changing, both physically and emotionally, which can make long-term outcomes harder to predict. Because of that, ASPS recommends waiting until age 19 so decisions can be made with more maturity, more stable development, and clearer information.
Is This a Law?
No. This is professional guidance, not a new law. Reuters also described it as a recommendation by the professional group.
ASPS additionally said it opposes criminal or punitive approaches to regulating medical care and supports professional self-regulation, while advising members to stay aware of state laws.
Does This Affect Adult Gender-Affirming Surgery?
The ASPS recommendation described here is about patients under 19. It does not affect adult care. For adults, decisions about gender-affirming surgery are typically made through consultation, informed consent, and a full discussion of risks, benefits, and alternatives. The key point in this news update is that ASPS is urging extra caution for minors due to the evidence concerns it lists.
What This News Does Not Mean
News headlines can be confusing, so here are simple clarifications:
- This is not a ban on adult care. The ASPS recommendation focuses on people under 19.
- This does not change how common adult plastic surgery works. Adults still make decisions with informed consent, medical screening, and clear discussions of risk and recovery.
- This also does not apply to routine cosmetic procedures for adults, like eyelid surgery, facelifts, or breast surgery performed for cosmetic goals.
What This Means for Seattle Plastic Surgery Patients
This recent update from the ASPS reinforces the core principles we have always stood by for every patient: a commitment to evidence-based practices, meticulous patient screening, and a foundation built on clear, honest communication.
For adults considering plastic surgery in the Seattle area, this news serves as a powerful reminder that choosing a qualified surgeon is the most critical step in your journey. Our commitment to ethical care, safety, and informed consent applies across every cosmetic and reconstructive procedure we offer.
Many of our patients come to us to enhance their confidence and align their appearance with how they feel inside. Here’s how our patient-first philosophy applies to some of the procedures you may be researching:
Facial Rejuvenation and Contouring
Our approach is to create elegant, natural-looking results that refresh your appearance without making you look “done.” We achieve this through a deep understanding of facial anatomy and a personalized plan for each patient.
- Facelift & Neck Lift: For comprehensive rejuvenation, a facelift in Seattle can address sagging in the mid-to-lower face, while a neck lift targets the jawline and neck. Patients often seek the best neck lift surgeon in Seattle to achieve a crisp, defined profile and restore youthful contours.
- Eyelid Surgery: An eyelid lift in our Seattle practice, medically known as blepharoplasty, is a procedure for creating a more rested and alert appearance by addressing drooping lids or under-eye bags. People often search for “best blepharoplasty surgeon Seattle” when looking for this treatment.
- Facial Balancing: Patients may look for “best chin reduction surgeon” when they want to improve facial balance. These procedures are designed to create a more harmonious and balanced facial structure, ensuring all your features work together beautifully.
Breast Surgery and Body Contouring
We understand that breast surgery is a deeply personal decision. Our goal is to help you achieve a silhouette that feels natural, beautiful, and authentic to you.
- Breast Enhancement: Whether you are considering breast augmentation in Washington to increase volume or a breast lift with implants (also known as an augmentation mastopexy) to restore both shape and fullness, our team will guide you toward the best option for your goals.
- Seattle Breast Reduction: For patients seeking relief from the physical and emotional discomfort of overly large breasts, breast reduction surgery in Seattle is a transformative procedure that improves both comfort and proportion.
- Male Chest Contouring: We provide discreet and effective gynecomastia surgery in Seattle. This male breast reduction procedure helps patients achieve a firmer, more traditionally masculine chest contour.
Gender Affirmation Surgery
We are proud to provide a supportive and affirming environment for our transgender and gender-diverse patients.
- Facial Feminization: For adults exploring gender affirmation, we offer compassionate consultations for Seattle facial feminization surgery (FFS). This is a highly customized set of procedures designed to soften facial features and create a harmony that aligns with your identity.
This news does not change the fact that adult cosmetic and reconstructive surgery is still widely performed. What it highlights is the importance of choosing a team and making decisions based on clear information and realistic goals.
A Simple Way to Think About Guidance vs Care
A news headline can make it sound like everything changed overnight. In reality, medical care is shaped by many things: research, training standards, ethics, and local laws.
If you have any questions and want to talk about these in detail, you can reach out to our surgeons for a consultation by calling 206-324-1120.
FAQs
What did ASPS advise in February 2026?
ASPS recommended that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.
Why did ASPS make this recommendation?
ASPS cited low certainty evidence, uncertainty about long-term outcomes, and concerns about irreversible surgery in a developmentally vulnerable population.
Does this news affect adult cosmetic surgery like blepharoplasty or facelift procedures?
The ASPS statement is about gender-related surgery for patients under 19. Adult cosmetic procedures such as blepharoplasty Seattle and facelift Seattle continue to be performed based on standard medical screening and informed consent.
Where can I learn about procedures offered by Seattle Plastic Surgery?
Seattle Plastic Surgery publishes educational pages on common procedures, including blepharoplasty, chin surgery, neck lift, breast augmentation, breast augmentation with lift, breast reduction, gynecomastia, facelift, and facial feminization.
Dr. Craig Jonov is a board-certified cosmetic surgeon based in Lynnwood, serving the Seattle area. With extensive training in facial, breast, and body procedures, he combines surgical expertise with artistic precision to achieve natural-looking results. Dr. Jonov also specializes in advanced injectable treatments and non-surgical rejuvenation techniques. Recognized for his commitment to safety and innovation, he is an active member of leading cosmetic surgery organizations and is dedicated to providing personalized care tailored to each patient’s goals.
