Not just the rich:
…cosmetic surgery is now primarily consumed not by the rich, but by the
working and lower-middle classes, sometimes even by the poor.
According to the American Society for Aesthetic Plastic Surgery (ASAPS),
about 1/3 of cosmetic surgery is consumed by people who make less than
$30,000 a year. About 70% of it is consumed by people who make less
than $60,000 a year. It is mostly women (90%) and mostly white,
middle-aged women (80% and between 35-55 years old).
Here is a more complete account. In the Reid bill there is a tax on cosmetic surgery. In my view cosmetic surgery is not just a zero-sum game but rather it leads to better matches, more matches, and more people who are happy with their looks or with the looks of their partner(s). It also leads to higher levels of trust. And it's a sector that has, overall, lowered costs over time.
For the pointer I thank Coates Bateman.