There is stability of creation and stability of physical laws. The unchanging creation mentioned is constancy of the laws that govern the universe. Change is allowed if it follows the Laws. Any changes that do not follow these laws are repudiated.

Desire to undertake reconstructive or cosmetic surgery arises out of dissatisfaction with defects and the associated embarrassing appearance. The defects are due to injuries that according to the principle of injury must be removed. Thus technology to remove or correct defects is not opposing or denying God’s creation. A serious issue would arise if a human were to be dissatisfied with God’s primary. God’s creation is optimal and is perfect. Humans cannot conceptualize a better creation that they then prefer. Deliberate effort to change God’s primary creation without valid reasons is misguidance. There is a risk in tampering with nature without following the physical laws on which the universe is built.

BEAUTIFICATION

God made humans in a perfect image. He however also allowed them to enhance their physical appearance by wearing clothes, using perfumes. These measures improve appearance do not change primary creation. Humans in disobedience undertake other forms of beautification that change basic creation.

Prohibited procedures are tattooing, shortening teeth, widening gaps between teeth, and plucking eyebrows. Circumcision is an allowed procedure. Male circumcision is recommended on hygienic grounds. Opinions differ about female circumcision.

Fraudulent procedures that are prohibited are wearing wigs, dyeing hair to hide age, and hymenal reconstruction. There are other forms of beautification. For example increasing body weight and changing body shape by dieting is common and was practiced by women at the time of the prophet without objection.

RECONSTRUCTIVE/RESTORATIVE SURGERY

Reconstructive/restorative surgery is carried out to correct natural deformities, deformities due to disease, and deformities due to complications of disease treatment.

Malformations may be congenital or acquired. The distinction is not important because many of the congenital malformations are due to environmental factors operating in utero. The purposes of surgery on congenital malformations are: restoration of the normal appearance to relieve psychological pressure & embarrassment and restore function. These purposes do not involve change of primary creation but are restoration of the primary creation to its state before the injury.

Similarly restorative surgery for deformities due to disease or treatment do not involve change of primary creation since they are returning to the normal.

Surgery for hiding identity of a witness is allowed. A surgical operation to reveal the true gender of an apparent hermaphrodite is not change of creation but is an attempt to restore primary creation altered by hormonal or chromosomal damage. Such operations have another objective of trying to preserve or restore the reproductive function.

COSMETIC SURGERY

Cosmetic surgery has a sole purpose of enhancing beauty with no medical or surgical indication. It can fulfill the purpose of preserving progeny, hifdh al nasl, if carried out for beautification in order to find a marriage partner.

Expensive cosmetic surgery violates the purpose of preserving wealth, hifdh al maal. It violated the principle of preservation of religion, hifdh al ddiin if carried out with the belief that God’s  creation was ugly.

Under the principle of motive, qasd, we look at each individual case of cosmetic surgery and judge it based on the intention. As mentioned above a simple cosmetic surgery operation may lead to the noble purpose of marriage. We however must consider the benefits of cosmetic surgery against its harm under the principle of injury. The Law gives priority to prevention of injury over accruing a benefit.

The principle of hardship cannot be applied to cosmetic surgery because there is no life-threatening situation necessity to justify putting aside normal prohibitions. Pursuit of beauty in not necessary for life and good health. Beauty is in any case a nebulous intangible entity that is very subjective.