However, Utah, the center of Mormon religion, boasts one of the highest concentrations of plastic surgeons in the U.S., and many Mormon women take advantage of their services. Several cultural factors come together to influence LDS women to have surgery, including the social value placed on marriage and motherhood, and high birth rates that move women's bodies away from the mainstream cultural ideal. Physical beauty is a marker of status for women in both mainstream and Mormon society, rendering plastic surgery a useful tool for gaining and maintaining symbolic capital in both worlds. Perfectionism embedded in the faith further encourages surgery, and proscriptions of modesty that permit tight fitting, but not skin baring, clothing allow for negotiation of postsurgical bodies in accordance with Church doctrine, permitting LDS women to employ surgical technology to fashion a mainstream, yet simultaneously Mormon, identity using the visual language of the body.