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If a friend came to me and said "I want surgery to change X part about me" my concern would not be based in this notion that looks don't matter, or that one is necessarily wrong to have issues with self-esteem, or that I am somehow blind to my own charms and blessings.
My concern would be that for someone who gets up in the morning and doesn't like who they see in the mirror, that surgery will not fix what ails them.
Are you being honest with yourself that you could just get one surgery, and then you would be happy? That it would remedy what gnaws at you?
I may be somewhat biased as I have seen a relatively large number of people who obviously could not stop at just one. Maybe I have been blessed with whatever set of nature/nurture impulses to have arrived at the point where I wake up and like who peers back at me in the bathroom. I am perhaps lucky to fit into the right social/demographic niche such that I am not bombarded with messages telling me I must find myself inferior to my better peers all day. Yet I cannot convince myself that I am wrong to have this base skepticism that (outside certain specific instances) surgically altering oneself will lead to greater happiness.
I had a plastic surgeon come up in one of the podcasts I listen to. I remember him saying that there was a category of people, I don't remember the whole set of criteria, but I remember that it was young-ish men, that he simply would refuse to operate on, specifically for this reason. He had too many experiences of people in that category (again, I don't remember all of the qualifiers) exhibit this exact phenomenon, and they'd keep coming back for something else, then something else, then something else, and it just wasn't healthy for them.
I would have thought that it would be women who are more likely to have this problem, which is why it stuck out in my memory that he called out men.
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That is a valid concern, and one that I would have if a friend of mine told me something similar.
But I am careful not to let it become a fully general counterargument. Surgery for cosmetic purposes is not as qualitatively different from working out or getting a nice haircut as it seems (and the latter does involve cutting off parts of yourself). You can break your back at the gym. A bad diet can give you brittle bones. Once you have broken it down into risk versus benefit, then there is little else to add that isn't moralizing.
Even more important is that self-image and self-regard are not the only pertinent metrics. If I end up depressed again, I'd rather be fit and depressed. If I'm suicidal, I'd rather be hot and getting laid while feeling suicidal. As I've insisted, I am neither depressed or suicidal right now (and you better believe I'm grateful for that).
Similarly, being taller has benefits even if you don't appreciate them. Being rich improves your life, even if the hedonic treadmill mostly beats compound interest as the most powerful force in the current universe. I'd rather cry in a limo than on a bus, and I've cried on a bus.
I believe so. I think I'm unusually good at introspection and understanding what makes me tick. Am I 100% confident of that? I'd be a poor Bayesian if I was that blase about things. I do not claim to be perfect, but I am confident enough that I don't worry about it. I've done that worrying in the past, and it wasn't particularly productive.
If the surgery goes well, I might opt for more. I am unlikely to, unless it ends up botched and I urgently need revision. As you can see, I have waited a long time, and haven't rushed into things. That counts for a lot.
I am also aware that the surgery is not a panacea for all that ails me. I have reasonable expectations. I am pursuing all available avenues for self-improvement, while the relief from severe depression gives me the will and energy to do so.
At the end of the day, this is a personal decision. I am most accountable to myself, and I've stamped that decision only after a lot of internal debate. I discussed my intentions with friends and family well before I decided to bite the bullet. I've even written about it here. I'm not sitting and crying while looking at myself in the mirror, God knows I've never felt that awful about my looks. I just want to be more handsome than I already am, and can afford the surgery while being willing to accept the risks.
I would disagree that there is little qualitative difference; I'm not inclined to psycho-analyze otherwise I might wonder at the glibness of comparing surgery to a haircut. But I would also disagree that moralizing is unimportant, or is irrational, or actively harmful.
This rationale will persist after your first surgery. You could still be depressed and incrementally hotter, should you get just one more. Think how many more chicks you'll score with that extra edge. Who knows how your life will be transformed tipping yourself from the 84th to the 85th percentile in looks?
You say that, but the time my dad, a very qualified surgeon, tried to give me a haircut? He cut off a good chunk of my earlobe. Good thing that he's a great surgeon, he managed to get it back on without too much scarring. I'd rather not trust him with future plastic surgery.
If you're inclined to moralize more than I am, be my guest. It's a free country, or at least a free forum.
I am a reasonably rational agent, even when depressed. I am pretty good at making expected value calculations, so if I do get the surgery (which is far from certain, even if I intend to), I think I can make those decisions as I go. My plastic surgeon, on finding out I was a psych resident, tried to pimp me by asking me if I was confident that I didn't have body dysmorphic disorder ( @Throwaway05 might find this funny). And I was able to argue, with the facts on my side, that that's not the case. He wasn't being serious, but I had a serious answer. I stand by it. You can do a lot of things if you're not an idiot about it, and I've been accused of many things in my life, but rarely have I been called stupid.
In other words, if I genuinely think a slope is slippery and leads to bad places, I'm going to go take a hike to somewhere safer. For now, I think my shoes have got the grip
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