The Surge (also called The Operation) is an internationally standardized and performed medical procedure mandated by the new society that plays a central part in the plot of the Uglies series. The Surge consists of many steps, taking place over a single twenty-four hour period, half of which is spent in anaesthetic stasis. The Surge is mostly cosmetic, but also involves major surgery being performed on the nervous, immune, and neurological systems. The point of The Surge itself is to promote and inspire peace among its recipients, with the idea that beauty ultimately trumps all forms of inequality and bigotry - Things like race and orientation don't matter when everyone is beautiful. The Surge is performed at the age of sixteen on every citizen in the world (although some cities perform it at age 18, and is hinted to be performed at 15 in some) and is strictly regulated by The International Committee For Morphological Standards ("The Pretty Committee"), which converges yearly to exchange notes on things such as innovations, anaesthesia techniques, and standard levels of attraction worldwide (because of the cities attitude towards codependence, these meetings are mostly just to make sure every city is making their recipients the same kind of pretty, and to not have any one city have more attractive post-ops). The schedule for The Surge is as follows: 24 hours before: No food or liquid is to be ingested by the patient. It is requested that the patient rests as much as possible beforehand and dressed comfortably for the operation. It is also asked that the patient does not pack heavily for their transition into New Pretty Town, as they will most likely throw it away afterwards. 1 hour before: The patient is collected by a warden of the state and is taken into peaceful custody. They are delivered to the city hospital and are taken to a waiting room while their operation tank is prepared. 10 minutes before: the patient is stripped of all clothing and is lowered into a Surge Tank, a large glass tube which suspends the body in a thick fluid swarming with nanobots which deliver nutrients and oxygen to the body. The patient is put under anaesthetic. At this point, The Surge begins. The first step involves grinding away the patients skin and replacing it with new grafts, which are incapable of scarring, burning, or bruising. The patient is then transformed from the top down, starting with giving the face perfect symmetrical proportions and new plastic cheekbones. Natural teeth are replaced with teeth made of aircraft ceramic. Eyes are replaced, or at least altered, to give added shine, colour and depth. After this, the patients nervous system is fine tuned for better reaction times and higher self-awareness. The skeletal structure is changed for a more attractive body shape and height, and joints are padded for ease. Bodily organs are improved or replaced, and the immune system of the patient is technologically enhanced. After this, the final step of the invasive surgery is to create small lesions on the upper parts of the brain. These lesions impede creativity, violent behaviour, apathy, dysphoria, adrenaline release, and cause the new pretties to forget grudges. These lesions ensure that The Surge works to its full potential of inspiring peace, as the impeded aspects could cause chaos if left unaltered. To allow the body time to recuperate, burn away unwanted fat, and to allow the musculature of the patient to be altered to a beneficial state, the patient is put under electrolysis for 8–10 hours. When the patient is taken off electrolysis and wakes up, the surgery is considered complete.
For about two weeks afterwards, the patient experiences extremely sensitive skin, as their new grafts toughen up to withstand pressure. This sensitivity is likened to having extremely bad sunburn.
This operation, performed at the median age of sixteen, is only the first of many surgeries. When a new pretty reaches a certain age (25 or so), they are given the surgery that transforms them into middle-pretties. This surgery is entirely cosmetic (unless the pretty is entering a job which requires creativity and quick-thinking, in which case, some lesions are removed), and can be performed in an afternoon. The second Surge gives the pretty light crows feet and a few grey hairs, which inspire trust and authority. There is no official third surgery, though a crumbly can undergo multiple life-extension surgeries which allow them to live into their mid two-hundreds comfortably and attractively.