Alfaro is a maxfax who will accommodate those who WANT the surgery to improve aesthetics even though there might not be a clear cut functional reason to do it or even if their present aesthetics are 'fine'.
Note how; 'WANT' is different from 'NEED'. So, alfaro accommodates requests from those who WANT maxfax if he thinks getting it will make them look better. So, no contingency from him that the person have functional issues or have a lot of
aesthetic deviations from the norm.
As to people on JSF telling people they don't NEED maxfax, it's to cut down on the many 'lookism' types who come here who confuse NEED with WANT. Like they might want max fax to look more like a male model and with that ask what they 'need'.