Looks do matter - in all aspect of life - because we are vain creatures. But your natural looks really only have to be above a certain very easily met threshold. Presentation is more important: watch you weight, have a look that's right for you, take care of your skin, fitting clothes, etc. Then the dreaded "confidence" and similar personality traits can bump you a bit in either direction.
For example that girl in your spoiler. Sure she had some sort of operation done, but look at other differences in the pictures: mascara, eyebrows done, tan, smile, and a wave of hair on the side of her face. Those make a bigger difference than her nose. She's a perfectly fine looking young woman in the left pictures with her natural self.
[I have no problem with cosmetic surgery, generally. You get one life, if it makes you feel good go ahead. I personally just want to look like I look for the most part.]