Popular transgender Jessica Alves has reportedly undergone thousands of cosmetic procedures. But her latest procedure may have been her most extreme.

Jessica recently had 6 of her ribs removed, and now has a 15 inch waist. That’s extremely tiny – especially for a person that was born a male.

Rib removal surgery is to remove one or more ribs and rib resection is the removal of part of a rib. The procedures are done for various medical reasons, and sometimes for cosmetic reasons also – as a form of body modification.

Here’s what she looks like now:

But she didn’t always look like this. Jessica used to be a dude named Rodrigo. He loved plastic surgery then too. In addition to having his face done up like a plastic doll, he also had fake abs.