It is bonkers, but there seems to be quite a few in the world of "aesthetic" surgery.
The ones that do terrible cutting edge facial surgeries on the mega rich which always look apalling on the early adopters, but give the surgeon practise to eventually get it right.
Obviously there's a similar impulse in those doing experimental surgery for other conditions such as burns, maxfax, ortho etc but those are last ditch attempts to improve life, not preying on the mentally unwell.
I guess people like him don't make the distinction, and neither do his patients, but hopefully someone will draw a line, if only the lawyers.