Some people are born with huge noses, or big bags under their eyes, or puffy eyelids that make them look tired all the time. Some women breastfeed 5 kids and have no shape after. Some women get terrible skin damage on their stomachs as a result of pregnancy. Some people lose weight and have a lot of extra skin. Some people have birth marks/skin tags/moles on their face that they don't like. Some men have gynecomastia. People have double chins or no jaw line or whatever.
I just don't have any moral opposition to wanting to improve one's physical appearance. It can lead to vanity, but it doesn't lead to or indicate vanity per se.