Do you give your Sim children plastic surgery if they don't look pretty enough for you?

If their proportions are messed up I usually do a quick edit in CAS.
Had a kid who always looked fat regardless of his actual weight, like he could have max muscle and low fat and somehow look like the only exercise he gets is typing on a keyboard.

No. If you are born ugly in my game, that is the hand you were dealt. Although I have been known to attempt to breed the ugly out of a particular family that has a few too many uglies in it. It's like a personal challenge. ;)

I've only ever done this once, for Alexander Goth in TS2. He had an unfortunate face.

Has to be some thing extreme, tbh I don't recall ever doing it to a child (have done it to townies who I move in to households!)

When my sims grow up they can have a plastic surgery if it suits their story, but not many have done that.

As I'm doing the 100+ Baby Challenge, I'm actually enjoy seeing the different ways the genetics play out. I never change anything but the hairstyle and outfits.

I don't because sim children change so drastically from child to teen. Its too hard to tell how they will look until they age up. Besides, my favorite part of this game is seeing how the dna plays out from generation to generation.

Same feelings like @duhboy2u2, I'd rather see their genetics play out in potentially interesting ways. It's so lovely to see prominent features of my initial sims end up passing down a line of children.

I believe in letting the children grow up. Then, I change the outfits, hair colour, and hairstyle first. And if they are chubby, I do the Athletic Aspiration in game and slim them down in the game. Only after that, I modify if there are features that bother me.