cosmetic underclass
n. The class of people who can't afford, or who are wary of, cosmetic surgery.
Cosmetic Underclass — those who can't afford plastic surgery and are thus forced to forever look their age.
—Faith Popcorn & Adam Hanft, Dictionary of the Future, Hyperion, March 01, 2002
Gus McGrouther, Britain's first professor of plastic surgery, warns that we are in danger of creating a "cosmetic underclass'', a lumpen mass of self-loathing, ordinary-looking people who avoid surgical enhancement for fear of the knife, or silicone poisoning, and lose out as a result.
—Lesley White, “What happened to your face?,” The Times, February 11, 1996
1996 (earliest)
In a world which has created a "new cosmetic underclass", plastic surgery should have the same moral value as treating heart disease, Britain's first professor of plastic surgery said yesterday.
—Glenda Cooper, “Professor aims to give cosmetic surgery a new complexion,” The Independent, February 06, 1996