Cultural views on plastic surgery are critical here. I see a clear contrast between underlying beauty standard assumptions, like “you should look natural” vs “you should look like a sex machine”. both allow for a certain amount of body modification but one of them pushes for a transformation to bodily extremes. With the elevation of hip-hop culture and Kardashian-style ‘upgrades’ i think the US and canada are heading towards a culture where perfectly attractive people get tons of surgery, i think driven by anxious status seeking.