Beauty is in the eye of the Beholder, and that means it may be in the eye of your potential boss. Today on Good Morning America, a story featured women who believe they need plastic surgery to improve their chances for a job. Age bias and the pressure to look good is often felt most intensely in the workplace, especially in our youth-obsessed culture. Studies show that traditionally good-looking people are perceived as smarter than others, make more money, and are even 5 times more likely to be hired. The continuing influx of women, recent recession, and corporate downsizing is making work environments more competitive than ever, increasing pressure to look polished and youthful. As the ancient Greek philosopher Aristotle once said, “Beauty is better than all letters of recommendation.” Like it or not, looks matter.

And while going under the knife won’t guarantee employment, it can dramatically improve your looks and self-esteem. The effect your appearance has on your self-confidence is more than skin-deep; it has an enormous impact on your health, the quality of your life, and your future outlook. Of course none of us can control our age, but we can control our confidence, which is essential when searching for a job. Any way you look at it, appearing fresher, looking sharper, and feeling healthier will give you a better shot at keeping a job or getting one.  As one of my patients told me, “I feel that appearing well put together, energetic, and youthful earns people’s respect and attention, and ultimately gives me greater credibility. I am convinced that looks make you money, so I think of surgery as an investment. Plastic surgery isn’t about beauty. It’s about power.” By making subtle but important changes to your looks, cosmetic surgery is a valuable, low-risk investment in your future health, happiness, and well-being. (From my best-selling book Change Your Looks, Change Your Life, Quick Fixes and Cosmetic Surgery Solutions for Looking Younger, Feeling Healthier, and Living Better.)

Contrary to stereotypes, many of my plastic surgery patients are not wealthy. And they are disproportionately female. There is no logical reason that women and working class people should bear the burden of this reform.

I also worry that it will encourage more Americans to seek potentially dangerous plastic surgery in Mexico and other less regulated locations.

It will force doctors to play the role of tax collector. The distinctions between cosmetic and medically necessary procedures is often not clear and doctors will vary in their interpretation of whether a specific procedure is taxable.

And by taxing bonafide treatments by medical doctors, but not less-vetted treatments by cosmetologists and non-medical personnel, the government would essentially be giving a financial incentive to individuals to seek treatments using non-FDA approved substances by non-medical personnel. Charging a tax on medical procedures done in a medical facility, but not if they are done in a spa or nonmedical facility makes little sense and can lead people to compromise their treatment in an effort to save money.

This is the beginning of a dangerous slippery slope of taxing medical services. By starting with a group that is diverse and devoid of specific political representation, legislators now expect little opposition. But this effects every American in that we all expect that our medical care is not going to be taxed. What would be next?