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Plastic surgeons are trained to minimise scars rather than to create them as ends in themselves. Yet, some competent adults seek scarification: the deliberate production of permanent scars through cutting, abrasion, cautery or related techniques for aesthetic, expressive or identity-related purposes. The ethical question is whether surgeons should provide this type of service. This letter argues that they should usually decline. Scarification does not ordinarily fit the professional ends that justify surgical wounding, and autonomous request alone does not justify surgical provision.