UKEng, to be honest changing the way someone looks doesnt really change the self esteem, it masks the issue. If the need for surgery is to fix some very obvious problem (and note, this is some sort of deformity) then it is permissable.

Changing the outside very rarely changes whats on this inside UK.

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"Diplomacy is the art of saying 'Nice doggie' until you can find a rock - Will Rogers"