Cosmetic Procedures Are Booming, But Ethical Conversations Are Falling Behind—What Experts Want You to Know

LOS ANGELES — Shula Jassell, a 25-year-old from Southern California, often finds herself staring in the mirror and feeling unhappy about the size of her chin. She has thought about getting filler to make it look bigger. But every time she considers the cost, the pain, and the fact that the results only last about a year, she hesitates. Then she wonders if a surgical implant would be a better long-term solution—even though the idea of going under the knife genuinely scares her.

“I just try to remember self-love, you know? Beauty is in the eye of the beholder,” Jassell says, talking through her internal struggle. For now, she has talked herself out of getting any work done.

But millions of Americans are not talking themselves out of it. Cosmetic procedures—from Botox injections to facelifts to weight-loss drugs like Ozempic—are more popular than ever. And as these treatments become more common, a growing number of experts say we need to have a much bigger conversation about what all of this means for our health, our wallets, and our sense of self.

Why This Matters for You

If you have ever scrolled through social media and seen a perfectly smooth forehead, a dramatically slimmer waist, or an ad for “baby Botox,” you are not alone. These images are everywhere. And they are shaping how we think about our own bodies. Whether you are considering a procedure yourself or just trying to understand the world around you, the boom in cosmetic treatments raises important questions about pressure, choice, and what it means to feel good in your own skin.

What the Data Shows: Cosmetic Surgery Is No Longer Just for the Rich

According to C. Bob Basu, MD, president of the American Society of Plastic Surgeons, demand for cosmetic surgery has risen sharply in recent years across every age group and ethnic background.

“Forty years ago, perhaps people would think, ‘Cosmetic surgery is for the super-rich or the celebrity elite. It’s not for regular folk.’ That’s not the case anymore,” Basu says.

One of the biggest changes he has noticed is that younger people are now opting for procedures. Instead of waiting until their 60s to get a facelift, many people in their late 30s and early 40s are choosing “deep plane” facelifts. Others are getting “baby Botox” in their 20s to try to prevent wrinkles from ever forming.

This shift is not just about vanity. Experts say it reflects a cultural change in how we view aging and appearance. Many people feel pressure to look young and “presentable” in the workplace for longer periods of time. As Michael Obeng, MD, a board-certified plastic surgeon in Beverly Hills, puts it: “We are aging slower and of course we are working much longer than our moms and grandmothers worked. In the marketplace, we have to look presentable.”

The Ethical Gap: Why Bioethicists Are Playing Catch-Up

Despite the boom in cosmetic procedures, many bioethicists say plastic surgery is not a priority in their training. Arthur Caplan, PhD, who heads the Division of Medical Ethics at New York University Grossman School of Medicine, explains the problem bluntly.

“If you’re getting into bioethics and you rotate to learn about medicine, you go to the ICU, you go to places where the palliative care is for dying people, you’re looking at transplants. Nobody rotates to plastic surgery,” Caplan says.

This means that plastic surgeons often have to set their own ethical boundaries without much guidance. They have to decide for themselves which procedures they are willing to perform and which ones cross a line.

Some experts worry that the medical profession is being stretched too thin. Aasim Padela, MD, who studies bioethics and Islamic thought at the Medical College of Wisconsin, points out that the primary goal of medicine is to restore health or prevent the loss of health.

“Certain types of procedures, body modifications, interventions—whatever you want to call them—may not meet those goals or even be aimed at those goals,” Padela says.

He raises concerns about how medical resources are used. When doctors and clinics focus heavily on cosmetic work, it can take time and attention away from treating serious illnesses. This is especially relevant with drugs like semaglutide (Ozempic, Wegovy), which were originally developed to treat diabetes but are now widely used for weight loss. While these drugs can offer real health benefits for people with obesity, their use has expanded far beyond medical need.

Religious and Philosophical Perspectives: What Do the Faiths Say?

There is very little official guidance from major religions about cosmetic procedures. But theologians, philosophers, and religious leaders are starting to speak up.

In March, the Vatican released a document that criticized what it called the “cult of the body.” The document warned that when people modify their bodies “with relentless frenzy,” the body becomes a “body-object” that a person “owns” rather than is.

Natalie Carnes, PhD, a feminist theologian at Duke Divinity School, says we need a wider conversation about beauty that does not place the burden solely on women.

“Beauty is something that’s good. And beauty is something that is good to pursue,” Carnes says. “Botox and Ozempic and face-lifts, they’re all ways of really narrowing the cultural ideals of beauty.”

Different religious communities have different approaches. Jerry Chidester, MD, a member of the Church of Jesus Christ of Latter-day Saints, says he sees a wide range of opinions within his faith. Some stricter interpretations discourage cosmetic work, but in Salt Lake City—where Chidester practices—the broader culture is much more accepting. Several studies suggest the area has a high number of plastic surgeons and procedures per capita.

When patients ask him whether they should have an operation, Chidester keeps it simple.

“I’m like, ‘Look, if you want to do this or not, it’s up to you,’” he says. “It’s literally your body. Who cares if they think you’re doing it for vanity or for function or whatever? It is none of their business.”

Sheila Nazarian, MD, a Jewish board-certified plastic surgeon, uses her understanding of the Torah to guide her thinking. She believes it is acceptable to modify the body if the issue is causing real distress.

“If it’s bringing distress, then it’s OK,” she says. “My patient population, they’re all pretty well-adjusted, happy, successful, intelligent people. But they need help with one little thing that they’d just rather not think about anymore.”

Michael Obeng, MD, a Christian, says he rarely feels tension between his faith and his work. But in 2018, he reached a “crossroads” when he began thinking about gender transition surgeries. He consulted several pastors and religious leaders, but “nobody could give me an answer,” he recalls. Ultimately, his faith led him to limit his practice to some gender-related procedures like breast augmentation, stopping short of genital gender-affirming surgeries, which he sees as harder to reverse.

The Personal vs. The Social: Is It Really Just Your Choice?

Ivory Kellogg, a 29-year-old actor in Los Angeles, understands the tension well. She feels pressure as a woman to consider cosmetic work, but she also wants women to have the freedom to choose.

“There’s this expectation that once you hit 35, you think about doing a mini face-lift. That’s a lot of pressure,” Kellogg says. “At the same time, I do want women to feel like they’re allowed to do whatever they want. Like if you want to have a face-lift, that’s your prerogative.”

But many experts say it is not that simple. Abigail Saguy, PhD, a sociologist at the University of California Los Angeles, argues that these choices are shaped by powerful social pressures.

“It’s important to think about how those choices are constrained and to think about the social pressures,” Saguy says. “This is a social issue. It is a collective problem. But it’s continually treated as an individual issue and what individual people should do.”

In other words, when you see a friend or a celebrity getting Botox, it is easy to feel like you should too—even if you were perfectly happy before. These pressures are especially strong on social media, where algorithms constantly serve up images of “perfect” bodies and faces.

Practical Takeaways: What You Can Do

If you are considering a cosmetic procedure, experts offer the following advice:

– Ask yourself why. Are you doing this for yourself, or because you feel pressure from others? If it is the latter, take a step back.

– Do your research. Not all providers are equally qualified. Look for board-certified surgeons and ask about their experience.

– Consider the costs—financial and emotional. Many procedures require maintenance. Botox wears off. Filler dissolves. Facelifts may need to be repeated. Make sure you are ready for the long-term commitment.

– Talk to your doctor about real health benefits. Some interventions, like GLP-1 medications, can improve your health. But if you are only seeking cosmetic changes, make sure you understand the risks.

– Remember that you are not alone. Many people struggle with these decisions. It is okay to talk to a therapist, a trusted friend, or a religious leader about what feels right for you.

The Bottom Line

Cosmetic procedures are not going away. They are becoming more common, more accessible, and more accepted. But as the technology advances, the ethical conversations need to catch up. Experts are calling for more training for doctors, more guidance from religious communities, and more honest conversations about the social pressures that drive so many of these choices.

In the end, the decision to modify your body is deeply personal. But it is also shaped by the world around you. Understanding that world—and your place in it—is the first step toward making a choice that truly feels like your own.

Source: MedPage Today