The plastic surgeons I've encountered (I work in an operating room) are extremely meticulous about their work. The post about plastic surgery after a car accident is spot on -- many times after people have experienced a traumatic accident, they might have their lives back but they are left with many issues and require reconstruction to have increased function -- facial reconstructions are important and something called "free flaps" or "tram flaps," when they take skin an muscle tissue from a donor or another part of the patient's body to "patch" someone up. They also are the ones to reattach fingers after traumatic amputations. Quite amazing, really.

Plenty of people get plastic surgery every day for many reasons.. breast implants following a mastectomy, etc. Celebrities populate the plastic surgery wards because their career depends on their looks. They are under the scope of the entire world, not just their own mirror in their own bathroom. Some celebrities are judged on the merit of their work - music, acting, etc.. Most are not (so it seems).