A quick search of your phone’s app store with the keywords “plastic surgery game” is enough to leave any parent aghast – and many medical ethics groups dismayed, too. As reports come out about games like Plastic Surgery Princess, in which users can perform plastic surgery on brightly colored cartoon characters, many are turning to app stores like iTunes and Google Play demanding the games be taken down. But are these games really dangerous, or are they helping to normalize a field of medicine that was once too taboo to discuss at the dinner table?

Dr. Bruce Chau of Berkeley, Michigan, is a plastic surgeon who believes games like Plastic Surgery Princess have no business being marketed toward children.

“Plastic surgery is definitely getting more commonplace, more acceptable,” says Chau. “But making it into a game isn’t doing anything to help champion the cause.”

Chau says that though these apps were probably not designed to provide any benefits to the plastic surgery field, games like Plastic Surgery Princess, or the now removed 2013 game Plastic Hospital Office, actually harm the reputation of the field instead of helping it.

“It basically is having the opposite effect. Parents are seeing these apps and calling them shallow, or saying they are detrimental to a child’s self-esteem. But plastic surgery is anything but those things – it can actually improve self-esteem. That’s its whole point,” says Chau.

And the field doesn’t exactly need to be normalized these days, anyway. With plastic surgery procedures reaching an all-time high in 2017 with over 17.5 million procedures (a 2 percent increase over 2016) performed in the United States alone, according to the American Society of Plastic Surgeons, the field is becoming more and more commonplace.

“I think among teens and young adults, the stigma that plastic surgery used to have among their parents and grandparents’ generations is just nonexistent,” Chau says. “You can thank social media and Hollywood for that.”

But even Chau says marketing surgery to children – especially via a game – is crossing a line.

“Plastic surgery may be elective in many cases, but it’s certainly not a game,” he says. “We don’t want kids thinking that they need to look a certain way, or that surgery is the only way to improve their self-esteem. Especially when they haven’t even finished growing.”

But not all plastic surgery apps are equal, either. Chau says many apps such as the Real Self app, and even some of the apps where users can alter their own image, can be extremely useful if used in the correct way.

“Some of these apps are designed to help you see what you can expect from plastic surgery, and others are just for fun, but they can all be positive,” he says. “They can all help the patient envision how they might look with these changes. They may decide they want to look that way, or they may not. These apps can be really helpful tools.”