that's how it was in the beginning. cosmetic surgery got its start with doctors who were trying to reconstruct the mangled bodies and faces of world war 1 veterans who had been maimed by shrapnel and explosions.
but there's not much demand for that kind of cosmetic surgery in times of peace. there's much more money to be made by tapping into women's media fueled narcissism and insecurity to con them into pointless and expensive surgery. the male side of this also exists, but tapping into male narcissism/insecurity doesn't manifest as cosmetic surgery, instead it comes in the form of selling them gym memberships, paid training routines, workout supplements and anabolic steroids.