From Kim Kardashian to Jersey Shore‘s JWoww, young reality TV stars are no strangers to plastic surgery. But are these glamorous starlets sending the not-so-subtle message to their young female fans that you need a boob job or Botox to be beautiful and feel better about yourself?

According to a briefing paper from the American Society of Plastic Surgeons (ASPS), teenagers often have plastic surgery to improve physical characteristics they feel are awkward to look similar to their peers. Adults, on the other hand, tend to have plastic surgery to stand out from others.

In his New York City rhinoplasty practice, Robert A. Guida, MD, FACS, works with teens trying to fit in. “Oftentimes a teen will say, ‘I’d like my nose to look like a celebrity’s nose, like [Gossip Girl‘s] Leighton Meester,” says the double-board-certified plastic surgeon, who uses computer imaging to show his clients how a certain celebrity’s nose would look on their face. “I always try to counsel my patients that they should look for an effect that helps them achieve their goals while still looking natural and real.”

The American Society of Plastic Surgeons reports that in 2010, nearly 219,000 cosmetic plastic surgery procedures were performed on people ages 13-19. But what is the recommended age for a young person to consider plastic surgery?

Dr. Guida says his youngest female rhinoplasty patient was 13. “If there is a facial issue that is causing a true social impact on a teen, then I advocate helping them change that,” explains Guida. “However, until a teen is through puberty his or her face will change – sometimes a great deal. I believe it’s always best to wait until they’ve passed those growth years before a plastic surgery procedure.”

Gregory P. Mueller, MD, FACS, a board-certified plastic surgeon in Beverly Hills, California, agrees that celebrities influence women of all ages to get plastic surgery. But young women, he says, may be more impressionable. “Teenage girls succumb to the pressure of being beautiful and thin, and when they see these celebs have surgery, they seek it out more than before,” explains Dr. Mueller. “Hopefully they go to a good doctor for a natural look. You have to know when to say when. I tell patients you have to remember where you started.”

A glaring example of a young reality star who went too far is former The Hills star Heidi Montag, who at age 23 underwent 10 cosmetic procedures in one day. “People look up to those folks,” says Mueller. “A young person could be influenced by that.”

Mueller’s youngest nose-reshaping patient was 18. “Any younger than 18 is hard for me to swallow. Patients need to be old enough to understand what they’re doing,” he says. “[My patient] was a beautiful young lady, but her nose was genetically large. She was being called names at school and it affected her psychological state.”

Although Mueller believes that when it’s done tastefully, cosmetic procedures like rhinoplasty and breast augmentation can help boost a teen’s self-esteem, research published in the academic journal, Body Image, found that there was no conclusive data to prove that cosmetic surgery makes people happier.

“What has been documented is that it makes repeat costumers,” says Charlotte Markey, an associate professor of psychology at Rutgers-Camden who conducted the research.

Reality TV played a major role in Markey’s study. The psychologist and her husband Patrick of Villanova University surveyed nearly 200 participants (men and women) with an average age of 20 on their immediate responses to an “extreme makeover” program or a home improvement show – incorporated specifically to conceal the focus of the study.

As Markey suspected, women were more likely to want cosmetic surgery than men, and viewers of the cosmetic surgery show were more inclined to consider the procedure for themselves than those who had not watched the show.

“There is a cultural context to never be satisfied with our physical selves. It’s the rare person who is either completely oblivious or has developed such a strong counter message to not be affected,” Markey notes in her study. “We need to teach children to be critical of the messages we’re receiving and tell them positive things now to foster self-esteem.”

Teens who do seek plastic surgery (with the consent of their parents) should make sure their plastic surgeon is certified by the American Board of Plastic Surgery (ABPS). All