Any woman that thinks plastic surgery will solve their emotional problems is a loser. Granted, there are exceptions for disfigurements arising from birth defects or injuries/diseases for which there are exceptions. Sexuality is much more an attitude than is appearance.
Besides, as the song goes, "Ain't nothin' like the real thing, baby..."
Poor Howard...maybe he likes her for her personality. I like Howard but his taste in women is reduced to: skinny, youth, phony boobs, strippers, porn stars, preferably bleached blondes. Facial features don't matter if the woman has phony boobs, bleached hair, and is thin. She actually looks like a very young Joan Rivers.
This woman is homely. Her eyes are too close together, her boob job is a disaster -- she is thin, but that doesn't mean she has a nice body -- just that she's thin. You gotta figure that that's the best she will ever look and she is far from attractive.
But she has the elments that attract Howard: young, skinny, phony boobs, bleached blonde hair. Howard is too insecure to date a natural woman like his ex Allison.