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It is really a class issue. Elective cosmetic surgery can be tough to get covered under insurance. So it is an economic thing. Millions of people on SNAP with no healthcare while the elite play with aging and off label prescription medication usage.
I don't think people respond to it that way, but I think that there is something there.
I had a gf who lived in a camper in an RV park. She could afford a touch of botox a couple of times a year. She was 50 and looked 40, if not younger. You would have never guessed she did that.
And taking the time off work to recover is unrealistic for working class
There was a meme about ten years ago that went around showing a lot of celebrities before and after cosmetic surgeries with the caption “you’re not ugly, just poor” and that seems to align pretty closely with your sentiment.
and i am both ugly and poorly