I think it's more horses for courses, and can also vary considerably between what different demographics, both contemporary and historical, think of as "perfection". Hollywood is largely driven by white western males, so they naturally favour your "20% silicone", although that does seem to be undergoing a gradual change of late, but that's not the case for world cinema as a whole; you'll find far fewer wannabe Barbie Dolls in African cinema, for instance.
From a people portraiture perspective, especially candids, there is also a night and day difference between what a photographer would most typically want to shoot in a studio vs. on the street. The former is very much about some ideal of perfection, with hours spent on makeup and clothing the model(s) and setting up the lighting rigs, before the camera even gets turned on, whereas in the streets and fields, you are totally going to home in the people with the most interesting features, and those often tend to be very much the definition of imperfection. You are actively looking for the aged faces with more lines than a metro map, more piercings/tats than Vogue would likely ever consider acceptable, and anything else that really tells a story about the kind of life the viewer of the resultant image might imagine them to live. For the right images, there is absolutely value that can be measured in both clicks and dollars there too.
Also, why limit it to women implanting silicone to comply with some visual aspirational idea of perfection being forced on them by men (mostly), media, and entirely unrealistically proportioned dolls? Have you seen the lengths some men are going to as part of the "looksmaxxxing" fad? There's going to be a Darwin Award winner there real soon now, I'm sure.
