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I assume this to be rhetorical. Howeverin essence you assume that there is a culture to speak of that it could immediatly consider itself to be a part of or a piece it of which it is already a part but showing to be a working element to and of which it has shown to have mutual respect to. (chicken & the egg perhaps) Again you are assuming there is a culture already drawn up willing & able to be accepting.

Who draws up the boundaries.

\i suppose in answer to the question it's No. How can plastic surgery be a subculture when it is by all accounts the culture itself. The question's answer is that the people who rely on the surgery are the subculture, existing by means of the surgery's existance. (So now we also know the answer behind the chicken & egg)

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