Alchemist -- I understand where you are coming from. However, as a surgeon who operates on cosmetic patients, I have to disagree with one of your statements:
[quoteWhat is especially troubling about strictly cosmetic surgery is that the potential down side of cosmetic surgery is so much larger than on medical surgery.][/quote]
While there are exceptions, most surgery for "medical" reasons is done to remove a cancer, fix a heart valve, relieve intestinal obstruction, etc, etc. It is necessary surgery which oftentimes must be done expeditiously. There are risks and potential complications and not every operation turns out perfectly.
Cosmetic surgery, on the other hand, is elective surgery. One is not rushed into surgery and therefore one has the opportunity to do research, seek the opinion of several surgeons and make an informed choice. Once a surgeon is chosen, then a discussion should be held with the surgeon to explore all possible risks and complications. Cosmetic surgeons will only operate on healthy individuals -- I will even postpone surgery if my patient has a cold! Properly done on a healthy patient, most cosmetic operations go very well and patients are satisfied -- there is NOT a large potential downside to cosmetic surgery.
After surgery, most patients just go on with their lives and rarely mention it to others. The big brou-ha-ha occurs when the rare patient who does have a problem becomes vocal on the internet, etc. This gives more credence to this person's rants than it actually deserves.
I find my biggest problem is that a few patients have unrealistic expectations of their results -- they expect perfection and nothing other than perfection is acceptable. Despite all my discussion and warnings, they fail to accept that Mother Nature is the big 900 pound gorilla in the room. I find it interesting that a patient with a 98% excellent result will instead dwell on the remaining 2% which isn't exactly perfect. There is no arguing with these folks. I do my best to try to identify and weed out these patient prior to surgery -- but I am not perfect and occasionally I end up in endless discussion with them after I have operated on them.
Bottom line: cosmetic surgery, performed by an experienced surgeon, on a healthy patient who has realistic expectation about the results will usually end up quite favorably.
Dr Jacobs