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Like many of her contemporaries who believe anything can be fixed by a make-over, she decided to deal with her self-esteem issues the laziest way possible. Instead of putting all that money into a further education so she could gain some intellectual clout, into learning a set of skills or into getting involved in a gratifying project, (things that would have improved her sense of self-worth and as a bonus would have made her a less useless member of society, but have the downside of requiring will, time and effort), she just took the short-cut of a few nip and tuck. If you think about it, the way she chose to spend her money mirrors the way she earned it.
For the record I have nothing against plastic surgery (I have defended its use in the past), as long as the people who use it understand it's not going to make you a better or more worthwhile person, and that improving the outside doesn't mean you can stop working on the inside, something that obviously totally escape Heidi.
Heidi is not now and has never been insecure.
I don't think Spencer is the source of the problem either...she was long insecure before she met him and I don't think there is any evidence of Spencer encouraging her to get such drastic plastic surgery...
That's a little naive. Do you know the inner most thoughts of Heidi? The expression is never judge a book by its cover,just because things look fine doesn't mean that they are.