The concepts of beauty and sexuality are often associated with the modern Western world, whereas it is widely believed that preoccupation with external appearance contradicts Islam. A new study released by Ariel University's Middle East Department Head Dr. Ronen A. Cohen, however, found that in the Islamic Republic of Iran, citizens are free to carve their identity through plastic surgery and sex changes. Indeed, Iran boasts the highest rate of nose jobs in the world. Surveys carried out in both Tehran, Iran (88 participants) and Tel Aviv, Israel (97 participants) during 2013-2014 regarding the readiness of people to have plastic surgery, sought to identify social streams, religious dependence and independence, and attitudes towards religion as a factor in making decisions about surgery. The survey also inquired into the participants’ social strata, their marital status, religious identity and the reasons behind peoples' decision to have surgery.What was the most surprising thing you discovered in your study?That less and less people are consulting the clerics before choosing to go through plastic surgery. Less than ten percent are consulting them in Iran, while in Israel it is around 4%.How did the results in Iran compare to those in Israel?In Iran, the type of surgery chosen is apparently related to religious identity. For example in the case of rhinoplasty, 42% of people who underwent the surgery were religious and 58% were traditional. In comparison, in Israel, 27.2% were religious, 50% secular and the rest traditional. In the case of breast plastic surgery, 100% of the clients were traditional, and for “other” surgeries, such as liposuction, facelifts or virginity fusion, 95.7% were religious and 4.3% were traditional. Is cosmetic surgery taboo in Iranian society as it is in other societies?No!News came out recently that Iran under President Hassan Rohani has the second highest executions rate in the Middle East, and one of the five main reasons is homosexuality. The BBC reported last month that clerics accept the idea that a person may be trapped in a body of the wrong sex and are actually pushed into having gender reassignment surgery. Could one of the reasons why the regime turns a blind eye to sex changes be because homosexuality is a crime punishable by death in Iran, and gender reassignment can decrease the number of homosexuals?Just to be precise, Iran never said that those homosexuals who were executed are homosexuals. Iran claims that those people have been accused of adultery. Nobody is deluding himself that all the executed that are under the tag of “adultery” are homosexuals, or that there are no homosexuals under this category. Iran as a theocratic state enabling these people to choose to change their gender, whatever it might be. Actually, Iran wants a society which lives in peace with its sexual orientation.How does cosmetic surgery run counter to Islamic law? The Muslim scholars had to ask themselves what motives led to the desire of these Muslims to have aesthetic surgery performed on them. “Is it to be condemned as a futile luxury, or does it answer a real physical and psychological need?” In response to this question and assessment they divided the issue into two basic categories the first of which deals with “essential surgery genuinely needed to correct congenital or acquired defects.” In such cases they decided that the surgery was permissible since “it is not meant to change the creation of God.” The second category was “surgery performed for beautification” and, in this case, they decided that “the surgery is unnecessary and is therefore unlawful (haram) and not permissible.”The general conclusion that can be reached from this debate is that, Islam, like any other civilized philosophy, has its own interpretations and guidelines. Islam does not completely reject plastic surgery and even welcomes it as long as it benefits the patient’s health. The real question that needs to be asked here is whether the surgery is done to bring about physical benefits - and so is permissible - or psychological benefits –whose necessity is more difficult to prove. The religious approach towards those who choose to have aesthetic surgery for the purposes of luxurious self-indulgence is certainly negative as this is not a case of “sound legitimate reasons.” There is, however, a wide area of ambiguity about this issue that leaves space for interpretation and the need to make decisions, since the technological, economic, political, and spiritual issues differ from one cultural tradition to another. In the case of Islam any decision-making about religious issues gives the Ulama the responsibility to calculate what the nature of a patient’s surrounding culture is in order to arrive at an optimal decision regarding the patient’s physical and psychological needs.