When 18-year-old Filipino singer Charice Pempengco said she’d used Botox injections “to look fresh on camera” for her appearance on the hit TV series Glee, the news went viral.

As people responded online, more headlines followed. The singer’s publicist explained that Pempengco had used the cosmetic procedure to treat a flare-up of TMJ, a painful jaw disorder.

Soon the talk turned to the fact that young people—some of them kids of color—are now seeking cosmetic improvements through surgery and other body-enhancing procedures. The latest estimates show that 2 percent of teenagers have undergone cosmetic procedures. While this number isn’t staggering, nips and tucks among this age group have increased.

In fact, between 2002 and 2006, the number of cosmetics procedures performed among this age group nearly doubled to 244,124, according to the American Society of Plastic Surgeons. Cosmetic surgeries also increased from 2007 to 2008, according to the American Society for Aesthetic Plastic Surgery, although the data don’t reveal the number of African-American teens in this group.

For one doctor, Cheryl M. Burgess, MD, a board-certified dermatologist in Washington, DC, cosmetic procedures also include “image-enhancing” beauty treatments such as the hair weaves and eyelash extensions young girls get done in local salons.

Burgess says she’s seen numerous patients 18 and older (18-year-olds don’t need parental consent) seduced into seeking increasingly more invasive and complicated procedures in their quest to achieve physical perfection.

“Probably the No. 1 thing I see as a dermatologist is [people of color] wanting to lighten their skin,” Burgess says. “I recently saw a young woman in her early 20s who wanted a butt implant. Breast implants are also common, along with rhinoplasties [nose surgery].”

In general, among blacks, cosmetic procedures increased 5 percent in 2009. The most commonly requested procedures included liposuction, nose-reshaping, breast reduction, chemical peels, Botox treatments and those using injectable fillers such as hyaluronic acids and collagen.

Pure and simple, it’s a self-esteem issue, Burgess believes. What’s driving some young people of color to reconstruct their appearance is their desire to match the media’s definition of what beauty is at the moment.

“The latest fad is being exotic looking,” Burgess says. “By exotic, I don’t mean [that black people want to look] Caucasian. The fad is to want a mixed-race look, such as [a mix of] Filipino and Indian and Caucasian. If you watch a lot of music videos and television shows, typically [you’ll see] a beautiful young woman of color with long flowing hair. But the woman won’t necessarily be African American. As a result, people are trying not to look as black or as white. They want to look more exotic.”

Indeed, a study published in Plastic and Reconstructive Surgery  showed that reality television and the media do play a huge role in first-time patients’ decision to have cosmetic alterations, specifically plastic surgery.

Of the 42 patients whom researchers examined for the study, 57 percent were considered “high-intensity” TV viewers of plastic surgery shows (regularly watching at least one ongoing program). These viewers reported that they felt compelled by television and the media to undergo plastic surgery and believed they were more knowledgeable about cosmetic surgery.

In addition, when compared with “low-intensity” watchers of programs about cosmetic surgery, those who regularly watched these TV shows felt they were more realistic. (One out of four participants reported television directly influenced their decision to seek plastic surgery, and nearly one third said they were extremely or moderately swayed in this direction.)

Interestingly, 70 percent of the high-intensity viewers were African American.

But besides the role plastic surgery reality shows play in persuading some viewers to alter their appearance, another reason why young people desire cosmetic changes is so they can fit in or become popular with their peers. The problem is that these goals might not be possible through cosmetic procedures.

It’s important for young people to consider the long-term physical effects of cosmetic surgery. In the short-term, the recovery periods for some procedures can be intense and painful.

“I tell patients that our bodies are constantly in transition; that’s why we age,” Burgess says. “And I advise them not to do anything they’ll regret.”

Young women who have had breast implants don’t talk about the hypertrophic or keloid scars they sometimes develop from cosmetic surgery, Burgess continues. To further enlighten patients, Burgess also tells them about Michael Jackson’s facial implants and how as he aged they no longer fit his face. “I remind them not to get permanent cosmetic work done that can’t be altered or revised later in life,” Burgess says.

Reputable plastic surgeons discuss these concerns with their clients in efforts to determine whether patients are physically and emotionally ready for cosmetic surgery.

Patients who want to undergo procedures in order to be accepted by their friends, family or romantic partners should be a red flag to a plastic surgeon. Doctors should also ensure that patients are knowledgeable about what will and won’t happen before, during and after a cosmetic procedure.

In addition, doctors should watch for signs that patients don’t exhibit an obsessive desire to constantly change their body. This could point to underlying emotional or psychological problems such as body dysmorphic disorder (BDD).

BDD, a.k.a. “imagined ugliness,” is a chronic condition rooted in someone’s obsessive focus on a minor or imagined flaw in his or her appearance. This creates very real feelings of shame and distress.

People with BDD often undergo numerous cosmetic procedures to fix their “imperfections,” but they’re never satisfied with the changes. Other BDD symptoms include feeling extremely self-conscious, avoiding social situations and wearing excessive makeup or clothing to camouflage perceived flaws.

If left untreated, BDD does not disappear. The disorder requires treatment. The good news is with the help of a mental health professional, people can determine the cause of the disorder and overcome its symptoms, often caused by low self-esteem and stress from the pressure of trying to live up to society’s current beauty standards.

But help to overcome the problem can also come from home. Young people’s parents and their communities can actively cultivate teens’ self-esteem and self-love.

How? By supporting the idea that beauty doesn’t mean perfection and that beautiful people are of all different shapes, sizes and looks.