She told me she wants a sexual restoration surgery and the only thing I can think is she wants to look good for other men.

Yeah, if my partner walked up out of the blue and said "I'm getting this surgery to improve my sexual experience" and we hadn't had long conversations about our relationship and how it might benefit us both first, I would be very distressed too!

After serious relationship problems it can take years and years to rebuild trust again. You certainly aren't wrong for expressing some lack of trust in your wife's motivations. The difficult part is to not obsess over it. And it's really difficult to not let those feelings of suspicion consume you once it gets started.

Have you thought about marriage counseling? Bringing up these fears with a third party might help diffuse he awkwardness and help you express your distress with your wife.

In most of my experiences with perceived paranoia, it wasn't paranoia at all. Paranoia is defined as a feeling that isn't based in fact, whereas hypervigilence from trauma can make you over sensitive to factual signals and that can create suspicion or cause you to second guess yourself.

In the past, when I felt suspicious of people I would question my instincts and mentally beat myself up for doubting another person. But those suspicions almost always ended up being based in fact, and listening to and addressing those initial worries would have been the healthier thing to do. After lots of therapy, I'm able to handle suspicions a lot more clearly, and can rationally work through them without getting overloaded by hypervigilence.