First of all, most people who get work done don't do it because they believe they need it; they do it because they want it. There's a big difference. Maybe to you it seems like one would have to be desperate in order to have work done, and maybe that's why you assume someone must be in need of therapy if they want to have something done. But to many people, having a cosmetic procedure is just not that big of a deal. They're not desperate. It's just something they've kind of wanted for a while, they have the money, they do their research, and they go for it.
Secondly, it's usually not much of a mystery why people (the ones who don't need it for health reasons) want to get cosmetic surgery. They want it because they want to be better looking, because society values good looks, and because certain aspects of life become easier when one is good looking. They want it because they want to feel desirable and they want to be desired. They think it would feel empowering, and they'd like that nagging sense of insecurity or dissatisfaction they have with a particular feature to go away. They don't need a therapist to tell them that, or to help them stop wanting to be good looking and desirable. Most people want to be good looking and desirable; that doesn't make them mentally ill or seriously troubled.
In an ideal world would people care less about appearance - both their own and others? Sure. But we're talking about a theoretical world here, and I would never expect someone to live aspirationally for a theoretical world some people wish could be real, if doing so means they have to forego things that would make them feel comfortable and happy in their real lives in the world as it actually is.
DA
First of all, most people who get work done don't do it because they believe they need it; they do it because they want it. There's a big difference. Maybe to you it seems like one would have to be desperate in order to have work done, and maybe that's why you assume someone must be in need of therapy if they want to have something done. But to many people, having a cosmetic procedure is just not that big of a deal. They're not desperate. It's just something they've kind of wanted for a while, they have the money, they do their research, and they go for it.
Secondly, it's usually not much of a mystery why people (the ones who don't need it for health reasons) want to get cosmetic surgery. They want it because they want to be better looking, because society values good looks, and because certain aspects of life become easier when one is good looking. They want it because they want to feel desirable and they want to be desired. They think it would feel empowering, and they'd like that nagging sense of insecurity or dissatisfaction they have with a particular feature to go away. They don't need a therapist to tell them that, or to help them stop wanting to be good looking and desirable. Most people want to be good looking and desirable; that doesn't make them mentally ill or seriously troubled.
In an ideal world would people care less about appearance - both their own and others? Sure. But we're talking about a theoretical world here, and I would never expect someone to live aspirationally for a theoretical world some people wish could be real, if doing so means they have to forego things that would make them feel comfortable and happy in their real lives in the world as it actually is.