Plastic self-mutilation
One of the more revolting trends nowadays is the prevalence of plastic surgery and its glorification through reports in the media, including TV programs such as Extreme Makeover, a horrifying show where people with severe self-image problems put themselves through awful medical experiments in order to erase what they think are their problems.

To me the average person looks fine and I'm certainly spending a good amount of time and money on skin care and grooming, but I see a huge chasm between applying moisturizer twice a day and having a weekly manicure, and putting oneself through laser resurfacing of the skin, nose jobs, facelifts, boob jobs, and major foot surgery so your feet will fit into a pair of these.

Many people have had life-enhancing cosmetic surgery after awful automobile accidents (for instance, one of my uncles), or for reconstruction of cleft palates (the son of one of my friends). These are truly life-saving procedures, in many instances, not only because of the mental benefits but also because of the improvement in functionality. However, putting an otherwise healthy body through the knife for the sake of looks alone is an experiment in futility.

What I have against nose jobs and facelifts is that they try to homogenize all faces into a characterless mask void of expression and individuality. One of the most beautiful young actors today, Adrien Brody, has luckily kept his nose in place, and therefore can play a more believable character than many others who went for the botox and the pug nose. Women who resort to boob jobs because they want to attract men are probably self-sabotaging their search for a worthwhile partner -- do they really want to spend quality time with a man that can't look beyond a bra size? Wrinkleless, expressionless faces can't erase the pain behind the self-loathing of a person who won't face the pain within. Liposuction is a great deal more disgusting and painful than exercising for 1/2 hr daily and eating a proper diet. And if your feet hurt in Manolos, get comfortable shoes, for Pete's sake! (and for $1000/pair, you can probably have custom-made shoes anyway).

Melanie Phillips has it right,

In fact, this is an age of spiritual emptiness. The fashion for bodily mutilation is the outward sign of the horrifying increase in those whose sense of themselves is fragile or shattered, very often because of the fragmentation of the family. . .
For this is a culture the inner emptiness of which finds expression in both violence and self-mutilation, to retreat from civilised values, deny reality and take refuge in a cosmetic defiance and pretence.

No amount of extreme-making-over will remedy a total lack of self-acceptance.