Recently I was asked by a client to retouch a corporate headshot photo that I took of her. I usually touch up minor skin blemishes and fly-away hairs, but this request was more than that. She told me that in the past year she had suffered severe medical issues resulting in a weight gain that she was uncomfortable with. I can relate.
When I get such requests, I have no problem tweaking the image to make them happy... after all it's their face and a lot cheaper than plastic surgery. We all just want to look good.