When I got back to Virginia after my daughter’s accident, I kept wondering what her treatment would have been had it happened here. Most countries’ health coverage applies just to reconstructive care, not aesthetic. Brazil, an outlier, sees more continuity between the two, “likely a means to push their own agenda, but that they also have a point,” says Alexander Edmonds, the author of “Pretty Modern: Beauty, Sex, and Plastic Surgery in Brazil.”

Our system in the United States makes the kind of hospital treatment my daughter received a matter of privilege. While her procedure might be considered reconstructive rather than cosmetic, whether she got a chance to see a plastic surgeon would depend on where she was getting treated. For example, hospitals visited by patients on Medicaid are less likely to provide the option of a plastic surgeon, and Medicaid does not cover cosmetic surgery unless the procedure is medically necessary — which, in my daughter’s case, it was not.

Beauty standards continue to rise, yet access to cosmetic care is rarefied.

When I went to my daughter’s pediatrician’s office to get the stitches out, the nurse hesitated at first. She’d never seen stitches like hers, with the thread visible only at its entry and exit points. She brought in two doctors just to check she was doing it right. None of them knew for sure, but when pulled from one end, the thread came out easily. I asked about what the care would need to be like going forward to minimize scarring. Sunscreen, they all said.

I inquired about lasers and stem cells and any other tools that might be in a plastic surgeon’s toolbox. Their nonresponses told me that this was overkill, which made me defensive. I wasn’t asking because I was going to go out and get them. I just wanted options. We tend to romanticize scars. “The lessons of life amount not to wisdom, but to scar tissue and callus,” writes Wallace Stegner in “The Spectator Bird.” But the benefit of having money is to not face consequences.

It’s been months since my daughter’s fall, and her scar is healing, along with my anxiety about it. My daughter is still processing the shock of what happened to her.

If the scar doesn’t completely go away on its own, when she’s older and if she wants it, we can get her more treatment, which we’ll have to pay for out of pocket. Luckily, we can afford it. I won’t need to lie to her about what I know to be true, that controlling how we look is a big part of how we exert our power in the world. To do so isn’t superficial any more than to be uninterested is a mark of moral superiority. She won’t need to wear her scar as a badge of toughness, and her inability to live with it won’t be a failure of personality. She’s allowed to want to feel beautiful.

Sushma Subramanian is the author of “How to Feel: The Science and Meaning of Touch.” This story was supported by the journalism nonprofit the Economic Hardship Reporting Project.

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