Well, often they are highly skilled. Like Dr. Sean McNamara in 'Nip/Tuck', he has the technical know - how to perform all kinds of complex plastic surgeries. He can transform a person's appearance in many ways. Another characteristic is that they are sometimes morally ambiguous. In 'Face/Off', Dr. Walsh is involved in a very dangerous and ethically questionable procedure. He is following orders but still, it's not a normal or legal kind of surgery in the real world. And in some fictional cases like Dr. Frank - N - Furter in 'The Rocky Horror Picture Show', they are extremely creative, but in a very strange and often disturbing way. He creates his own unique beings with his 'surgical' skills, which is not at all like normal plastic surgery but shows a high level of creativity within the fictional world.
Many fictional plastic surgeons are shown as having a god - like complex. They have the power to change people's lives through their surgeries. For example, Dr. Sean McNamara can make someone who is considered unattractive into a beauty, which gives him a certain power over his patients. They also are often in a world of their own, with their own set of rules. Dr. Walsh in 'Face/Off' is operating in a world where face - swapping is possible, which is a far - flung concept from our normal reality. And Dr. Frank - N - Furter in 'The Rocky Horror Picture Show' is in his own little universe where his rules for creating and modifying his 'creatures' are the only ones that matter.
Famous fictional plastic surgeons usually have a certain air of mystery about them. Take Dr. Sean McNamara again. He has a private life that is full of secrets and his work often intersects with his personal problems. They also tend to be in high - demand. In the fictional worlds, people come to them with all kinds of requests, whether it's for vanity reasons or to fix some sort of disfigurement. And they are often at the center of the story. In 'Face/Off', the whole plot revolves around Dr. Walsh's ability to perform the face - swap surgery. Without his skills, the story couldn't progress. In 'The Rocky Horror Picture Show', Dr. Frank - N - Furter is the main character and his 'surgical' creations are a big part of what makes the story so unique.