The phenomenon of plastic surgery is one of the most fascinating debates in Iran today, particularly when considered in a religio-cultural context. One can view it as part of the larger ongoing conflict between the Islamic theocracy and Iran’s Persian heritage, which has been an element of the region’s history since the Islamic conquest in the 7th century. Despite the popularity of plastic surgery, both domestically and globally, the internal discourse seems to be more cynical and critical than promotional and supportive.
Religious circles criticize plastic surgery, with many clerics believing it to be a dilution of religious injunctions regarding modesty. Meanwhile, in an international context, many Westerners see this trend through an academic, anthropological lens. Questions naturally arise: How can this cultural-social phenomenon even exist in such a closed theocratic state? Does this phenomenon have any implications for international affairs? Are the Iranian and Western attitudes toward plastic surgery at all similar? Will the openness to plastic surgery make Iran more open to the West? The responsibility of the regime in answering the ethical and religious questions relating to plastic surgery has resulted in a deliberate opacity that has created, perhaps unintentionally, a cultural revolution in Iran.
Renowned British sociologist, Anthony Giddens, describes modernity as an uncontrollable force. Iranian society, like many others, deals with its citizens’ increased interest in superficiality and consumerism vis-à-vis the inner world of values and morality. Plastic surgery is clearly a way to upgrade one’s external presentation. The practice existed in Iran long before the revolution and, afterwards, was adapted as a means of rehabilitating those injured in the Iran-Iraq war. This beginning contributed to plastic surgery’s widespread acceptance; modernity, it seems, can find its place in even the most fundamentally Islamic country.
Many have the plastic surgery not only because of psychological and social pressures, but also because they view these operations as a practical necessity. The surgery not only satisfies momentary aspirations and whims to look prettier, more desirable, and socially welcome, but also gives individuals the ability to feel more confident in the dating and job market. People living in a theocratic regime feel responsible for both their physical well being and their individuality.
Though it is naïve to color the whole of the Iranian nation as religious, the moral discourse on plastic surgery is sometimes sidelined to Shi’a Islamic religious circles. But confining the discourse to religious circles overlooks the major question regarding whether plastic surgery should be considered a useless luxury or a real solution to peoples' physical problems. The immediate answer is that there is an obligation to not change what God created. In general, Shi’a Islam views God’s creations as “absolute perfection,” and therefore man must not change these creations in any way. However, Shi'a clerics that adhere to the concept of ijtihad, or independent reasoning, find religious solutions and justifications to cases that are not vis-a-vis with the notion of For these clerics, intervening in God's will in these cases only increases the value of the religion and does not deny it. There is no way, however, that the thousands of Iranians choosing to go under the knife are all disabled or physically deformed.
Some clerics claim that when people feel that their bodies are defective, they might have psychological problems, which could be considered disabilities or bodily malfunctions.  In such cases, plastic surgery is a viable way of preventing feelings of depression and low self-esteem. Either way, most Iranians, especially those who choose to undergo plastic surgery, ignore clerical opinion. Indeed, today's Iran – lively, vibrant, and gradually westernizing – is deviating from the course set by the Islamic Republic's founders. Ironically, people who just want to feel desirable and welcomed are paving this path; they are not necessarily trying to adopt Western conceptions of beauty and sexuality, nor overturn their societies.
A negative consequence of the demand for plastic surgery is the simultaneously induced “Iranian Gold Rush.” Many look to the black market to undergo plastic surgery. They put themselves in the hands of unprofessional and unauthorized surgeons and clinics, as there is more demand for the surgery than there are qualified surgeons to perform it. Moreover, patients often lack sufficient funds and so seek “bargains” from cheaper, unqualified surgeons.
The recently lifted international sanctions formerly imposed on Iran because of its nuclear aspirations indirectly drove the black market. The sanctions led to inflation and increases in the cost of living within the country, causing many young men and women to be unable to afford plastic surgery, therefore leading them to resort to cheaper, illicit services. Many women who were in relationships, especially those in “temporary marriages” who lose their virginities, wish to "renew" themselves through plastic surgery. Because of religious reasons, the state cannot sanction this procedure, forcing these women to undergo hymen replacement through black market operations.
Although most Iranians do not consult the clerics before going under the knife, the internal debate among clerical circles has actually helped cosmetic surgery maintain its popularity. The multitude of clinics and surgical facilities in the state are evidence of this. The theocratic regime wishes for people to live in progress and prosperity. Clerics understand popular desire to become more attractive, whatever the motivation might be. The global reach of social media has made it increasingly difficult for religious leaders to enforce a negative image of cosmetic surgery.
Religious officials ultimately submit to popular demands without a thorough religious debate, as officials are not clerics, and despite the similarities between these two groups, it is these authorities that decide what is and is not acceptable.
However, once the floodgates are opened, Iran’s clerics will not be able to reverse the trend towards plastic surgery, as it would force them into a ridiculous position. Despite plastic surgery being a real concern for the clerics, they know this is a battle that they have already lost. Once religious law decided by non-clerical authorities allows for plastic surgery, clerics have no real power to reverse these permissions.
By its very nature, the trend towards plastic surgery in Iran has influenced many small and unreported social revolutions in the country, all of which are affiliated with modernity, progress, and Westernization. The sum of these small cultural revolutions manifests in the ongoing conflict between new societal trends in the Islamic theocracy and Iran’s Persian heritage. The debate now taking place over such issues will inevitably culminate in Iran’s “true” revolution.
 Ronen A. Cohen, "The Identity Designers of the Self Sexuality, Beauty, and Plastic Surgery in Iran", Ronen A. Cohen (ed.), Identities In Crisis In Iran: Politics, Culture and Religion (Lexington Books, 2015), pp. 140-142.