If this were a TRUE makeover show...
the candidates/contestants would have self-esteem counseling on top of the cosmetic surgery. If they have birth defects, I have no problem with them getting cosmetic surgery, since it will help them feel "normal" in society.
But with them living their entire lives with abnormalities, they should have counseling/therapy on top of that rather than just getting a new body and new face and feeling "complete" on that solely.