An HSA can pay only for qualified medical expenses.
In Pub 969 on page 9, the IRS says that "Qualified medical expenses are those expenses that generally would qualify for the medical and dental expenses deduction. These are explained in Pub. 502, Medical and Dental Expenses."
As you probably know, cosmetic procedures are generally not considered to be qualified medical expenses. However, you mentioned "pain", and the alleviation of pain is covered by the statement in Pub 502 (page 2):"Medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness."
This becomes a medical decision. Will your doctor state in writing that this procedure was done primarily to alleviate pain, and that the cosmetic nature is incidental to that purpose?
For example, breast enhancement is considered cosmetic, but when it is required after a mastectomy, it is no longer precluded from being a qualified medical expense because it was part and parcel of the proper treatment for breast cancer.
So why are you doing this? To alleviate pain or to look better? And if alleviating the pain is important to prevent "a physical or mental disability or illness", then the fact that it will improve your cosmetic appearance is not relevant.
So ask your doctor if he/she is willing to put this medical opinion in writing.
P.S. don't ask the HSA custodian about this; it is not their call.
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