When Nadia Isle returns to school she won't just be toting a new bag, or uniform. The high school pupil is preparing to return to classes with a new-look nose, chin and ears after undergoing plastic surgery, aged 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 feel beautiful, I feel better about myself," she declared, 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."
Nadia's story, revealed on CNN, prompted a debate over whether a surgeon's scalpel is an effective or ethical weapon against bullying.
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 be learning 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.
While the pursuit of Hollywood-style looks may be the driver in some cases, in others it is low self-esteem. For some, this can prove psychologically crippling.
Nadia was treated to $40,000 (pounds 25,000) of surgery by the Little Baby Face Foundation, a New York non-profit organisation that offers procedures free for indigent children with facial birth defects.
Nadia, who lives in a trailer with her single mother and brother, who has cerebral palsy, tried to conceal her misery over the bullying because she did not want to add to her mother's challenges. She had her ears pinned back and nose and chin reshaped.
"Did I cure everything in her life? Was I the only thing she needed? Of course not," Dr Thomas Romo, founder of the foundation, told The Sunday Telegraph. "But I did my part."
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," he said.
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, with telling results.
Some patients 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.
Anthony Diaz, 8, had his ears pinned back last month. "He's a very friendly kid, he gets along with others, and his ears didn't bother him before," Maureen Maniscalco, his mother, said.
"As he got older, children in his class called him names and it would get him upset because he thinks everyone should be friends.
"I can see a lot of parents questioning why I'd put my child under the knife, sometimes a child just has to grow thick skin and deal with life, but seeing how it's helped, I know it was the right decision."
In Britain, a survey of plastic surgeons last year showed no evidence of a climbing trend in this age group, and a quarter saw two or fewer teenagers per year.
Whereas patients in the US can present themselves for plastic surgery and, in some cases, private insurance might cover the bill, in Britain GPs form a front line that perhaps screens out more cases.
Lorrie Sanchez, of Utterly Global, a bullying prevention organisation, said: "Bullying isn't about differences in looks … It's not 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.