transplant-To question 1, the same people who have always done so: the middle class. To question 2: no one. Designer drugs will trigger natural endorphins by that point.

pdc-I sincerely hope that we never achieve physical uniformity. This has nothing to do with ideology and everything with aesthetics. On the other hand, by the time it becomes a problem, cosmetic alteration will probably have advanced to the point where one's natural appearance will never see the light of day.