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

I normally don't change them with plastic surgery. A new haircut and some pretty clothes can make a big difference, no need for surgery. I always wait until they are adults before I even consider plastic surgery and the vast majority of my sims can stay as they are.

I can't remember ever changing children.. not because they are pretty or not but because they usually look pretty much the same.. except for skin, hair color ect. I actually like it if their features are different than the norm. I'm sure if they came out in a way that didn't fit my story though I would without hesitation. Like if I needed a red headed child for example.

I sometimes change teenagers because that's when the problems show up for me. I often play male and female caricatures and the genetic mix is often pretty bad. If the father is a slim hipped, jutting jaw, hooked nosed, barrel chested brute and he marries a perky nosed, heart shaped face, voluptuous woman the chance of their teens turning out somewhat symmetrical is pretty close to zero. Sometimes though they are still left as is also, it just depends on what's going on in the game... it's really not about pretty. It's about the story.

I never edit the kiddos when they are born in my game.

I do however take a look in CAS and randomize a few children just to see what their combined genetics look like beforehand. Some sims go on to try for kiddos, some start collecting cats instead.

If girls have their dads nose or boys have their moms mouth

They're not all perfect, but I prefer for the kids to have the genetics given to them by the game. Whatever I get, I roll with it.

For example my sims may be missing a chin. Or they have too much chin. Just minor adjusting to what I consider problem areas.

Like others have said, only minor adjustments until their teens, and then it's only to slight adjust a hideous feature, like Darrel Charm's nose.

To keep things interesting for myself I just deal with what I’m given. If the child has features that bother me I’ll probably have another kid and get rid of the undesirable one when he is a young adult. At least that way the family tree gets interesting. I also randomise traits.

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. ;)

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.