What is the ruling on breast augmentation surgery (chest incision) that is a dire medical necessity due to a congenital chest defect and a deficiency in the rib cage, along with the desire to perform it for cosmetic purposes and to preserve life? Is it permissible or forbidden? And how can one perform prayer after the surgery if unable to stand due to the effect of anesthesia for a week? Is gesturing permissible?

There is no objection to performing the surgical operation; rather, it may become obligatory to preserve life, but on condition that the surgeon is qualified, the success of the surgery is expected, that it does not lead to greater harm, that there is no less harmful alternative, that it is for removing a birth defect or preserving life, not for adornment, and that a woman performs it if a qualified one is found. If you are unable to stand after the operation, then pray sitting; if you are unable to, then pray on your side, and nod your head for bowing (rukūʿ) and prostration (sujūd), making the prostration lower. If you are unable to do that, then signal with your eyes.