SAN ANTONIO — In 2016, San Antonio area teenager David Molak, was literally "cyber-bullied" to death.
After months of being tormented and harassed by his peers, he committed suicide.
The following year, his parents worked with legislators to help pass a state law criminalizing bullying.
Some parents are taking other steps to protect their kids; paying for permanent cosmetic procedures in hopes of keeping their kids from being made fun of.
The pressure to be perfect is high and the bar keeps getting higher as celebrities set the standard for growing teens at the most vulnerable time in their lives.
"The Kardashians and celebrities have sort of pushed cosmetic surgery to be more acceptable, maybe to an extreme now that they have maybe an unrealistic goal of what they want," said San Antonio Plastic Surgeon, Dr. Kenneth Yu.
Yu is seeing an increase in the number of parents paying for their kids to have permanent life-changing procedures.
"It's because they're not happy with the way their nose looks, they're self-conscious and as you know today's self-image is really crucial in today's age of social media," Yu said.
In many cases, the decision is driven by the kids.
"We have a lot of kids who call us and say I want a nose job or rhinoplasty, and we say well how old are you? And find out they're like 13, 14," Yu said.
Often, the kids are bullied by their peers in school.
"I hear kids or maybe older kids come in and complain that their friends or their classmates say you've got a witch's nose or you've got a hump, what's wrong with you," Yu said.
Rhinoplasty and otoplasty or ear pinning are the most sought-after procedures for kids and teens, some parents opting to have ear surgeries at a young age to prevent teasing before it even starts.
Tracy Kempenich's son was born with prominent ears.
She and her husband not only noticed it, but also weighed whether or not they should have them surgically altered.
"It's just something that I didn't think was necessary because I just thought he was so cute the way he was," Kempenich said.
The boy's father had a different perspective.
"My mother-in-law and husband did definitely want to have it done because my father-in-law had ears like that growing up and he was teased all the time," Kempenich said.
Despite the risks involved with surgery and anesthesia, in the end Kempenich was on board.
"There was the possibility of my son being teased so it wasn't hard to convince me," Kempenich explained.
In his case the doctor said it might improve his hearing, but it was primarily a decision about aesthetics that would likely impact the rest of his life.
"If you're doing it to be the best parent to your child and it's something that the medical professionals agree with, then I would say why not," said Kempenich.
This mom has never had any regrets and her son never knew life any differently.
Dr. Yu says some surgeries can't be done before a particular age. Surgeons have to consider the age and stages of development as well before deciding whether a procedure should be done.
"We would like to think that all of us are strong enough to ignore it, but it's hard," Yu said. "We get self-conscious and it bothers us."
Dr. Yu says the before and after is remarkable with his young patients who've endured years of taunting; not just the newly shaped nose or less conspicuous ears, but also the eye contact, the smile, and the confident demeanor.