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

For children when they age up, the only thing I will change is their hairstyle and clothing if I don't like what the game has generated for them. Now, when they age up to teen, I do the same, plus make-up and eyebrow shape sometimes, and I will change their physical appearance if they have the 'no chin' syndrome which 9/10 times they do. That's the only thing I'll consistently change on my Sims' offspring.

However, I did change a child's hair and eye color once because she aged up without either parents colors. I have no idea why, but it bugged me. It wasn't a throwback situation, for instance, a grandparents, great-grandparents, etc. colorings, in which case I would've been fine with it. I created both her parents.

Most of the time it’s just the pushed up chin/jaw for me.

I don’t really care if my sims are traditionally attractive, but I do edit by adding cc facial features to make them more detailed. Most of the sims I make I consider pretty, but I also go out of my way to make sims of different back grounds and body types. And I do have some sims I made purposely ugly, like my count Olaf sim.

In terms of kids, I do edit them to make them look more like their parents. I play with a lot of biracial couples & I use cc skin tones, and it bothers me if their skin tone doesn’t match their parents.... so I’ll usually pick a tone between the 2 parents. I’ll also change hair color (why does sims make every child with red hair) so it matches the character more. Then I’ll add cc to make them more detailed, but that usually waits until they are teens.

*edited bc I didn’t answer the question....

In my legacy save I never change them, and for others I’ll only make minor adjustments (add freckles, change hair or eye color, fix “cartoon” like features). The biggest change I’ll sometimes make, is fixing the super wide heads the game likes to give them.

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.

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.

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.