Unfortunately, they don't deem it unnecessary. They are not trying to keep up with the "Jonses". They are trying to outdo the "Hiltons" that all live in similar bubbles as they do. There is no way all of these celebrities have Body Dysmorphic Disorder (which is soon to be renamed Body Dysmorphic Syndrome). These people don't know what to do with their piles and piles of cash, thusly, why not "improve" oneself? When celebs don't have plastic surgery the public wonders why and criticizes them. When they do, and it usually is done to an excessive degree, we criticize them as well. It's a vicious cycle, and it happens to average folks as well.