Because of a discussion with wild_irises recently and a similar discussion on a mailing list I read, I've been thinking about all the different opinions I have on various forms of appearance modification, especially surgical. Here's some of what I wrote on the mailing list, with some additions.
I hate pressure from mainstream society that pushes people to have surgery or do other possibly harmful things to their bodies in order to conform to narrow appearance standards. I especially hate that these standards are coming to have so much to do with having a successful career in many fields. (E.g., fat people tend to get paid less and get promoted less regardless of their job performance; fat performers find it harder to get work; I suspect other kinds of plastic surgery are all but necessary for other high profile positions these days.)
I disapprove of individuals' giving in to this pressure because I think it harms other people by increasing the pressure on them. But I try not to judge such people harshly because it's very hard not to give in and sometimes a person has no other options, or thinks they have no other options. (However, I do very deeply disapprove of individuals who make a publicity stunt out of their surgery, because that vastly increases the pressure on others.)
Some people say "I'm doing this [conforming appearance change] for me, not because I feel pressure or want to conform." Some of the time I'm skeptical that appearance standards play little or no part in these people's decisions. I think some people might not be aware of the conformity motives. But I don't have direct data, I only have the circumstantial fact that there are a lot more of these "for me" changes in the direction of conformity than away from it. So here I tend to hold my opinions lightly.
I am neutral on the act of changing one's body more or less permanently for reasons other than conformity to mainstream society (e.g., getting piercings or tattoos).
However, following these positions to their conclusion requires me to to disapprove of people who get reconstructive surgery - for example plastic surgery to fix scarring from an accident or to reconstruct a breast after a mastectomy - because these things usually bring someone's body more into conformity with societal appearance standards. I don't really disapprove of reconstructive surgery though. When I examine why, I discover that I believe "It is OK for people to put their bodies back the way they were if their bodies change suddenly or in an unnatural manner because of trauma or a medical problem they didn't have any control over, but it's not OK for people to 'improve' their bodies." But how do I draw the line between a "sudden or unnatural change" to one's body or a more gradual or natural one? Clearly aging is a gradual and natural change and an injury from a car accident is a sudden and unnatural one, but what about weight gain caused by taking a medication?
Argh. It's so hard trying to keep straight all the things I think other people should do. :-)