kind of a disconcerting situation imho. let’s assume the surgery is desired by the caretaker. in that case i find it difficult to imagine a motivation that is solely in the best interests of the person with Down’s Syndrome. and what’s more, where one might exist that, in fact, such motivation may not be misguided, however well intentioned.
where desired by the person with DS, i would certainly seek the advice of psychologists and psychiatrists as to the person’s expectations. knowing what little i know about DS, i don’t think a person with DS is able to make a well informed decision to have what (i assume in the case in question) is an elective procedure.
like @rooeytoo i have to wonder if in either case, the root expectation is that plastic surgery will mask the underlying condition – and thinking about it a second time, what other expecttion could there be?
i suppose that in cases where a person with DS is aware of public stares and wants to at least look more normal (whatever normal really is), and surgery can accomplish that, then it may be beneficial to him or her. i can’t think of another reason why surgery should be performed in this kind of situation.