Can plastic surgery help beat bullies? Jacqui Goddard reports from Miami.
When Nadia Isle returns to school she won't just be toting a new bag or uniform. The American high school pupil will return to classes with a new-look nose, chin and ears after plastic surgery, at 14.
The teenager from Georgia, who has been haunted by taunts of ''Dumbo'' and ''Elephant Ears'' since the age of six, had the surgical treatment in an attempt to curtail the abuse and end her misery.
"I used to be very talkative when I was a little kid and now I'm just shy and would rather not talk to anyone now. I'm anti-social," Nadia told CNN before going under the knife, revealing she'd first asked her mother for an operation to pin back her ears as a 10-year-old.
"[The teasing] happened so many times that it all blends together...It's been very depressing."
Screw you. You don't have to do it on your child, but don't tell someone else they can't help a kid feel better about themselves.
After her operations, Nadia, who will also undergo counselling, said she had no regrets. She said parents needed to tell their children they were beautiful "every single day."
''[Now] I feel beautiful, I feel better about myself,'' she said before returning to face her classroom tormentors. ''It's going to be nervous at first, but I think I can pull through and that they'll realise what they've done and that they'll stop.''
Figures from the American Society of Plastic Surgeons show a more than fivefold rise in the number of teenage clients in the past 15 years, with procedures from breast enlargements and reductions to hair removal, nose reshaping and pinning back ears.
Many doctors argue that rather than surgery, youngsters such as Nadia should learn to ignore the taunts of their peers.
Dr Malcolm Roth, president of the American Society of Plastic Surgeons, said that while plastic surgery could change lives in extreme cases, in many instances such procedures were not ''appropriate for a teenager''.
''Yes, we have to respond to peer ridicule and torment and abuse, but the response isn't necessarily going to be surgery,'' he said. ''Sometimes adolescence is just tough.''
Last year, 230,000 teenagers had cosmetic procedures, according to the society. Otoplasty - the pinning back of ears - and repairs to cleft lips were the most common.
Nadia was treated to $40,000 worth of surgery by the Little Baby Face Foundation, a New York non-profit organisation that offers procedures free for needy children with facial birth defects.
Nadia, who had her ears pinned back and nose and chin reshaped, lives in a trailer with her single mother and brother, who has cerebral palsy. She tried to conceal her misery over the bullying because she did not want to add to her mother's challenges.
''Did I cure everything in her life? Was I the only thing she needed? Of course not,'' said Dr Thomas Romo, founder of the foundation. ''But I did my part.''
During an on-camera interview, Dr Romo can be heard telling Nadia: ''I love thin chins but I dont want them as pointy as [your] chin." He also tells the teen her nose is crooked.
To people who might decry such surgery, his message is blunt: ''Screw you. You don't have to do it on your child, but don't tell someone else they can't help a kid feel better about themselves. I'm happy that I can provide this.''
Dr Frederick Lukash, author of The Safe and Sane Guide to Teenage Plastic Surgery, has treated children as young as eight for facial deformities. He asks them to draw themselves before and after surgery.
Some draw themselves pre-surgery with exaggerated body parts, a background of clouds and rain, and children jeering. After surgery, their images are bright, with frequent use of the sun and images of friends.
Lorrie Sanchez, of Utterly Global, a bullying prevention organisation, said: ''Bullying isn't … going to stop because someone gets their nose straightened or their ears pinned back.''
Dr Richard Gallagher, associate professor of child psychiatry at New York University Medical School, said the growth in teenage cosmetic surgery was disturbing.
''The US has become a country of great diversity but this trend almost goes against it, saying everyone needs to look like a certain type of model,'' he said.
- THE TELEGRAPH, LONDON