Original subtitles

My name is Tonia, also known as Tits On A Stick.

I absolutely love my boobs.

Other than I have really overly large areolas...

I would say that lets take a piece of baloney. What do you think?

[squeals, laughing]

I was butchered, is what it was.

Three or four days after the surgery

it was like my nipple was rotting away.

It looked like somebody had taken

my right breast and, like, squeezed it.

I was like, "Oh, hes, you know, a little petite.

You know? Hes shorter than me.

So the adjective that came to mind

the first time you saw Paul naked

was petite. Hmm.

[stammers, laughing]

I [bleep] up.

It looks like The Grinch Who Stole Christmas.

By the third, fourth day,

the whole, entire nose was black.

Thats one of the scariest things that we see.

Maria is at such a high risk for necrosis,

if I see something that I dont like,

Ill just abort the case.

[male singer] ♪ I wanna be sexy ♪

♪ I wanna be hot ♪

♪ Fix me, make me beautiful ♪

♪ I wanna be perfect ♪

Its time to roller‐skate through he house.

Whoo‐hoo!

[screams]

My name is Tonia,

and Im also known as Tits On A Stick

cause I have a tiny, little waist

and a tiny, little butt

and these big, giant boobs.

My breasts look like two big watermelons.

I absolutely love my boobs,

but my areolas look basically like

the size of a saucer

that you would put your teacup on.

My first pair of boobs,

I went to 400 CCs,

which is about a C to D cup.

I absolutely loved them, and I thought,

"Well, I might as well make them a little bit bigger,"

and thats when I got my 800 CCs.

Thats when the attention started.

Thats when I started feeling fabulous.

Who doesnt love boobs?

So the third time I went in for my breast augmentation,

I basically went to the doctor, and I told him

I would like the biggest that he could make them.

I actually didnt know

what number it was gonna be

so then when I came out of surgery,

he was like, "2,000 CCs,"

and I was like, "Yeah, I got 2,000 CCs."

[laughs]

I absolutely love my boobs,

and along with the boobs

I also got a massage chair.

Im resting after a hard day work

of carrying around these big, beautiful breasts

all day long.

Im not really sure why I have back pain, but I do.

[laughs]

I am actually very happy with the result

other than I have really overly large areolas.

My areolas have grown

every time Ive had a breast augmentation.

In a perfect world, Dr. Dubrow

can take my giant areolas

and make them into perfect little quarter‐sized, beautiful nipples.

I feel like my nipples are so big

that I can tune in to Mars.

[laughing]

Oh, sorry. [laughing]

Like I dont have a nose. Look at that.

Honey, heres to being a Jackson.

Right‐‐ I couldnt‐‐ You know what?

Thats the only other...

My name is Maria,

and I am from Los Angeles, California,

and Im here to tell you how seven nose jobs

[bleep] up my nose, honey.

It looks like a melted candle.

Its too small.

I hate looking at my nose.

[bleep] up! I [bleep] up!

[laughs]

So cheers. Yes. Cheers.

[all toasting]

Can you believe Im the new Vice President

of the TransLatina Coalition?

I told you it was a promotion!

You were right! You were right!

Congratulations. Right?

Thats so exciting, Maria.

It is exciting.

I am a trans woman.

And when I was 18,

I put on females clothing for the first time,

and I felt like thats who I was meant to be.

Soon after that I would begin my transition.

You know, at that time I decided

Im gonna have my breasts done,

and I was gonna have a rhinoplasty, a nose job,

and feminization of the nose was a smaller nose.

Well, you know, Ive had a couple of surgeries on my nose.

Why you laughing, girl? A couple? A couple?

But whos counting, right?

Yes, thats true, true.

So actually the first, second, third

and fourth nose job I had great results,

but the reality is that people still sort of discriminated

and treated me horribly

because the fact that I was trans.

You know, I would be at a bar,

and people would have the audacity to come to me and say,

"You know, my friend says that youre a man. Is that true?"

It was a rude awakening,

and I honestly thought

that at every turn

the next surgery would give me access to that woman

that I felt inside.

I just wanted to‐‐ to be female and be accepted as female,

which led me to my fifth nose job.

Now, my fifth surgery,

I took my bandage off.

Oh, my God.

He left me what seems like its a big, deep dent.

It looks like a combination

between a pig

and The Grinch Who Stole Christmas.

Do you remember the Whoville nose she wanted?

I did want that.

Well, I got that.

You got it and then you said,

this was not a great decision.

After my fifth surgery,

I went to a doctor in Beverly Hills

to get a little bit of filler

injected into the dent

to sort of make it look more normal.

Five days after, my entire nose became black.

It had necrosis, and it had died.

So I made a decision to go for my seventh and last surgery.

I had told them, "I do not want an implant

because at any time that implant could come out.

But then right after surgery,

I found out that I had an implant.

I was really upset.

He says that basically he does not specialize

in removing a rib

and that the best thing he could do

is use an implant,

but Im thinking to myself,

"It doesnt aesthetically look normal.

It doesnt look pretty."

I know that people are sort of looking at me,

saying, "God, that girl went to far."

If Dr. Nassif can help me

and reconstruct my nose

and take this implant out...

I just wanna move on with my life.

Clink, clink, clink.

Well, okay, okay, okay. Nothing but the best.

[female singer] ♪ When Im out with my girls ♪

♪ Its a holiday ♪

I had an exam yesterday that basically measures your body fat.

The main machine, the de‐‐ whats it called?

DEXA scan. DEXA scan.

Something like that.

So what percent body fat are you now, 23?

No. I think it was, like, 26 or... 24?

...something like that. It was bad, yeah. 26?

So went back to a 16‐hours fasting.

Yeah, good. Just two days.

Ive already lost 4.4 pounds.

There you go. Honestly.

Now, look, I mean, feel.

Yeah. I‐‐ Im not‐‐

Thats good. Yeah‐‐ okay, hold on. Wait a minute.

Now, let me just‐‐

Dont grab my‐‐ But‐‐ But wait a minute.

[laughing]

[gags] Fat jokes.

Sick of em!

So you know how I lecture around the world

about being careful about fillers in the nose?

Yes. And necrosis?

Oh, no.

So we have this patient named Maria.

Shes transgender. [Dr. Dubrow] Okay.

And she went through feminization procedures with her nose.

Okay, theres your necrosis. Oh... ah...

So this is a very complicated case.

Can you please send in Maria?

Hi, Doctor. Well, youre tall. Hi, Maria.

Hi, how are you doing? Nice to meet you. Dr. Nassif.

Hi, Maria. Terry Dubrow. Nice to meet you.

If the doctors say no to me today,

I will just have to come to terms

with the reality that I have no other choice

but to live with this [bleep] up nose.

How long have you guys been together?

Five years? Uh, five years.

We just got married. We just got married.

You just got married? Two months ago.

Congratulations. Thats great. Thank you.

So we know you had a bunch of feminization procedures.

I did.

Wed love to hear, starting from the beginning.

I had my breasts done.

I had a tummy tuck,

lipo on my arms and my back,

lip fillers.

I had had my cheeks done.

And I had five nose jobs.

The fifth time I went to have

my rhinoplasty done, but it just was terrible.

And I had a dent that was not filled,

so it had injected filler,

and right away felt this heartbeat on my nose.

Wow.

So I called the doctor.

He gave me pain medicine and said to wait.

Yeah. So thats what we call a delay in diagnosis.

Thats one of the scariest things that we see.

It was terrible.

By the third, four day

the whole entire nose was black.

[Dr. Nassif] Thats a medical emergency.

Immediately you have to dissolve the filler.

You need aspirin, you need steroids,

Cialis, you need hyperbaric oxygen,

you need nitropaste.

Anything in the world that you can do

to get the blood flowing

is extremely important.

Otherwise, youre gonna have necrosis.

So you went to find a doctor

for your seventh surgery. Yeah.

I had asked him to not put a implant in my nose,

but later I would find out that I have an implant in my nose.

Hmm, okay. So now youre here to see us.

I know that I have to go bigger with my nose.

Ive got an understanding

that small doesnt necessarily equal feminine.

Okay, good.

I think the journey with all the surgeries

made me realize that I had to sort of accept

that the world is going to see me as the world sees me,

and that no matter any amount of surgerys gonna change

how people see me.

Okay, I like‐‐ yeah, we like hearing that.

Uh‐huh. Think what I really need to do,

get you in the exam room,

lets see what are the possibilities.

Okay. Thank you. Lets go do that.

You thought the tissue death you had before was significant.

Hold on to your glasses

because it could be a lot worse.

Soon as I opened up my gown,

first thing he said was, "Oh."

Freaked me out, I said, "Im never touching myself again."

Yeah, I dont blame you.

♪ I wanna be perfect ♪

So heres the scar from the necrosis.

[Dr. Dubrow] Yeah.

And then the skin just kind of stuck together.

Can you turn off the light?

[Dr. Dubrow] Yeah. Ill turn off the light.

Whoa, yeah. Look at that.

[Dr. Nassif] Look how thin the skin is.

The fact that you can see

the light shine through Marias nasal skin

indicates that the necrosis

caused so much damage to it

that if you operate on it,

it could be very challenging

to make the changes you want

and to get it to heal.

For me to do this for you,

take a piece of rib,

take some tissue from your scalp...

Okay. ...open up your nose.

And to make it look less pinched from the front,

we have to make your nose wider.

Ive seen him do this thousands of times,

and hes the best in the world at this by far,

but theres still the possibility

that the blood supply is not adequate enough

to keep the tissue alive,

and if you thought the tissue death you had before was significant,

hold on to your glasses

because it could be a lot worse.

I hope to God that doesnt happen.

You just actually, you know,

put a‐‐ made us all feel like [bleep].

[laughing]

Let me put [bleep]...

Terry, if you wanna scare the crap out of your patients,

thats fine, do it, on your patients, not mine.

Relax a little, brother.

And Im scared.

The truth is that if it was somebody else,

another surgeon, Id probably just settle and live with it that way,

but I trust that Im in the right place.

All right, so I think if we can try

to end on a positive note now,

Im up for it. Im in.

All right, three, two, one, exhale.

Bring it up.

How does that feel? Is that okay?

Its tight and it feels like its ready to pop.

Well, dont pop. No. [laughs]

My names Sarah, and my breasts look like [bleep].

The right one looks like youve squeezed a grapefruit.

Theres an indentation at the bottom,

and then extreme scarring

around both of my areolas

I wish I had never wouldve even...

touched them. I know it.

I was butchered, is what it was.

You were butchered.

That was scary times, Sarah.

You wouldnt even get out of bed.

After my divorce,

I wanted a little pick me up

and a little refresher.

They werent where they used to be.

Gravity.

Ive gone through four breast surgeries

in 13 months.

Fifth time,

hmm,

I dont know.

[Dr. Dubrow] Okay.

Let me guess. You have something interesting?

I‐‐ You know, this not so much‐‐ Complicated.

...interesting. Yeah, look at this.

Sarah has had multiple surgeries.

Wait. What happened to her areola?

She lose half of it? I have no idea.

Can you please send in Sarah?

Hi, how are you doing? Sarah, hi. Dr. Nassif.

Nice to meet you, Dr. Nassif. Im‐‐

Hi, Sarah. Terry Dubrow. Pleasure to meet you. Im Sarah. Dr. Dubrow.

Nice to meet you. Ive been with Sarah

through all of her four surgeries,

and somethings not working.

She needs to do something about it.

Its time to get this done correctly.

So history is critical.

So take us back to the first surgery youve had.

What happened? I wanted double D.

Double D. Were going for it, huh?

I would say just less than two months later,

my right breast swelled up...

Mm. ...like double the size.

Were you sick with fevers and chills?

[Elsie] She did. I felt‐‐ yeah, real sick.

Then it looked like somebody had taken

my right breast and, like, squeezed it like that.

I noticed there was an indentation at the bottom.

I was freaked out.

I didnt know what‐‐ what was going on.

So I called the doctor

and as soon as I opened up my gown,

he‐‐ first thing said was, "Oh."

I knew that wasnt good.

And then he said, "This has never happened to me before."

I was scared.

Thats gotta be hematoma.

Oh, yeah, you bled in there, hematoma.

You absorbed the blood mostly,

and then the body reacted to the remaining blood

by forming scar tissue.

Yeah. Classic.

Un‐drained hematoma.

Im not even a breast surgeon,

but I know, if someone comes in with instant swelling

following surgery, hello, thats a hematoma

just like you would get in a facelift.

How did this doctor not know that?

He said, "Well, we can‐‐

well go ahead and well do another surgery."

He says, you know, "Ill fix it."

Come out of surgery, you know,

the indentation was still there.

And then on top of it,

the suture around my areola,

it was an open wound.

I was pissed. I was real pissed.

Now Im not dealing with just the indentation.

Now Im dealing with the scarring.

Im like, "You know, come‐‐ what do I need to do?"

And he kept promising me he was going to fix it.

Yep. So then third surgery

was the same thing all over again.

So went back through a fourth surgery.

[Dr. Dubrow] How did that go?

Um, not well at all

because three or four days

after the surgery,

the bottom part of my right areola

was kind of opening up a little bit.

It was like my nipple was rotting away.

Its still not fixed.

Down here? Yes.

Okay.

And then the scarring around the, um‐‐

[Dr. Dubrow] Areola? ...the areola

and it still swells.

Still have pain.

Thats kinda weird, having swelling in the breasts.

Super weird.

Normally swelling

is due to the accumulation of fluid,

either by bleeding into the pocket

or having some lymph fluid come in from the armpit,

and if thats the case,

thats extraordinarily unusual,

and, frankly, very weird.

I mean, Im scared.

Im scared to have any procedure done again.

I dont to do it. I pushed her, actually,

to make the appointment...

[Dr. Dubrow] Okay. ...because I know that you guys

specialize in revisions and‐‐ Yeah.

So... Sarah,

what do you want to do about this?

Breast implants‐‐

not necessarily for everybody.

[Dr. Nassif] Silicon implants gonna come out.

Damn it. The nose completely collapsed.

Sinks in right where my whole middle finger is.

Oh, wow.

Like, does it look weird right now?

[laughs] It looks pretty bad.

[laughing] Yeah.

♪ I wanna be perfect ♪

So first of all,

in terms of scar tissue,

this one has whats called grade‐four encapsulation

where its firm and its been displaced up here,

so your mound is up here.

This one has the same kind of grade‐four encapsulation,

but you have a severe distortion right here

on the right lower portion. Right.

Its just a big wide scar here.

You could do one of two things‐‐

one, take these implants out,

put a new pair back in. Right.

With that comes the risk of re‐encapsulation,

which may occur very quickly.

It may never occur at all.

Yeah. Second option is

no implants,

take scar tissue and implants out,

tighten up, so you have no chance

of having a breast implant complication

because you dont have breast implants. I know, I know.

It scares me to think

that I may have to get my breast implants removed.

I feel like theres not enough tissue,

so Ill be left with no breasts,

and Im a woman,

and I want to have breasts,

and I want to feel like a woman.

So if you visually subtract

this volume from this overall volume,

a lot of breast tissue left, right?

Yeah.

Not a‐‐ Not a small B.

Right, no?

I dont think so.

Because look. This‐‐ all of this is you.

Generally speaking,

a patient is only a good candidate

for implant removal and a lift

if they have at least two centimeters of thickness

in the upper portion of their breasts.

Sarah has about five centimeters.

So that really makes her an excellent candidate.

I mean, I have a feeling that youre gonna be happy.

You gotta think about, okay, pain free.

Right. Mm‐hm.

Thats whats gonna be important for you.

Where do you think you are right now?

Then Ill tell you what I think?

Um...

well, I waited this long

because I didnt trust anybody.

You know? Okay.

It was traumatic. I dont wanna have to go

through all of this all over again,

you know, with a different doctor.

Right. So, um...

I think, um, leaving it up to you,

I would feel very comfortable

because youve gained my trust.

Thats a good thing. Thats...

Thats important. Yes, it is.

Lets get rid of these implants. Buh‐bye.

[Dr. Nassif] Um, we have something in common.

She has‐‐ Yeah. Thumbs?

Oh, yeah.

Here are my thumbs.

Its a sign that you are

very, very intelligent and smart,

so I like my short, little cute thumbs.

Were rare.

Let me ask you a question. Do you have intense sugar cravings late at night?

No.

Do you have a flatus problem, a gas problem?

I sure dont.

Well, you dont have that much in common.

[Sarah] We should weigh them.

Oh, my god, you are so funny.

Youre not gonna weigh my boobs.

[Sarah] I am‐‐ Im gonna weigh your breasts.

I absolutely love my boobs. Its like Im pregnant.

Its like Im carrying around two baby boobies.

Booby babies.

Can you see a number?

Four, five pounds.

Four or five pounds? Yes.

Its going up and down.

cause youre not staying still.

When I get older,

I am going to carry my boobs around with a walker.

I will roll them around

with me wherever I go. [laughs]

They are amazing. [laughs]

The thing is my nipples

keep growing.

Are you serious?

Yeah, like not right now,

like theyre not, like, growing right now.

[laughing]

How do you know?

This is the size of my nipple.

Oh, wow. Look at it.

Look closer.

To me... I would say that

it looks like a piece of baloney. What do you think?

Lets see. Ew.

Can I put this on there? Oh, my God.

No! Ahh!

[both laughing]

Definitely cutting back on my baloney consumption.

Hors doeuvres are served.

We have to make them equal.

Want a cheese sandwich?

Im like a full‐meal deal.

Its crazy to think that‐that the size of my areola

is the size of a baloney.

Thats huge.

No, but they need to be this size.

Like yours. You have the most perfect‐‐

Look at how cute that is.

Do you think theyre the size of a pepperoni?

Yeah. Really?

You have freaking pepperoni.

Thats the normal size.

When I look at my areolas,

I think that they should be smaller.

So I can get that complete Tits On A Stick look.

My boobs are not going anywhere. Im gonna have them till the day I die.

Like, does it look weird right now?

[chuckles] It looks pretty bad.

[cackles] Yeah. So...

[Dr. Nassif] Good morning.

How you doing?

Oh, good. I am kind of calm.

I feel that Im in good hands and...

You are. Yeah, I trust you.

Now we just gotta see how your nose is gonna trust us.

When youre performing an eighth revision rhinoplasty on a patient,

whos had nasal tip necrosis from a filler,

this is always scary because you never know whats gonna happen.

If I see something that I dont like, Ill just abort the case.

For Marias surgery today, my team and I will begin

by harvesting cartilage from her rib and fat from her stomach.

I will then open the nose and remove her old implant,

then use spreader grafts to add some height on the anterior septum,

alar batten grafts to open up the airwaves

and articulating rim grafts to open up the nostrils.

Finally, Ill add my custom‐made "glue canoe" to build up the dorsum,

so Im gonna inject nanofat from her stomach

in to the nasal tip scars to help reduce the uneven texture.

Lets start the nose. Can I have a medium skin hook and a 15 blade?

She had a filler and immediately started to necrose.

[woman] Wow. This is fibrin glue

and were mixing it with cartilage

in order to create an implant for her.

I call it the "glue canoe."

The glue canoe is a new technique that Ive been working on.

Using the patients finely diced cartilage

and then using biological fibrin glue,

you put it together in a little mold,

then you can customize building, for example,

a complete brand‐new dorsal profile.

Silicone implants gonna come out.

Thats kind of a short silicone implant.

Usually its a long boat.

[woman] Thats it? Yeah. The nose completely collapsed.

Sinks in right where my whole middle finger is.

Tough, tough, tough nose.

Damn it. So now our goal, rather than putting implants in,

is to reconstruct Marias nose with her own native cartilage.

So with these spreader grafts, youre recreating height on the anterior septum.

High on the bone? [Dr. Peng] Yeah. Agreed.

Marias previous surgeon removed as much cartilage as possible,

making the nose smaller.

And now, Im using everything to reverse it,

the whole enchilada. At least six different types of grafts.

And of course, the final icing on the cake, the glue canoe.

Okay, I see it. You good? [Dr. Peng] Yeah.

Is it too high already? [Dr. Peng] No, it looks good.

Need to look. Oh yeah, that looks beautiful.

So we only have that nanofat.

Im just gonna inject a little bit along the dorsum too.

Just to help the skin heal a little bit better.

Nanofat is multipotent stromal cells.

In other words, the fat has been emulsified so there are no fat cells.

Were just injecting the liquid in to the skin for skin rejuvenation.

And because Maria is at such a high‐risk for necrosis,

Im not just gonna sit there and cross my fingers and see what happens,

Im gonna pull out all my tricks to keep her skin alive.

Hard nose, huh? So lets finish closing up.

Ladies, thank you all.

Fantastic. Excellent job.

So we go to the gym, and hes like,

"Youre doing the same weight as me, so you should bring it down a little bit.

Cause you dont want to look too manly."

Either Brittany is freakishly strong,

or Paul is incredibly weak.

I think you know what the answer to that one is.

So if someone asked you your cup size, what would you write down?

34 K, or 36 K. [Dr. Dubrow] K?

Jeez.

Wow.

Down the alphabet.

Next stop is Z.

♪ I wanna be perfect ♪

Youre gonna be good. Uh‐huh.

Sarahs very brave to go through this again.

I know she had a lot of hesitation because it is scary,

but I think shes reassured by Dr. Dubrow and Dr. Nassif

that its going to be good.

Sarah, how are you? Very good, Doctor.

How are you feeling? Good. Real good. Yeah.

So, breast implants, you have not been friends.

Its like that one friend. Every time you hang out them,

you say to yourself at the end of the night,

"Im never hanging out with them ever again."

Lets get rid of that friend of yours.

Lets ditch this friend.

[Dr. Dubrow] For Sarahs surgery today, I will begin by making incisions

below the breasts to access the pockets.

I will then remove the implants

and release the scar tissue on the right breast

to get rid of the indentation.

Next, Ill perform a breast lift

by making incisions and excising skin

before finally downsizing her areolas.

All right, so theres the implant pocket.

Oh, look at that. Its a textured breast implant.

So now, because the concern of

the anaplastic large cell lymphoma,

this rare kind of breast cancer thats associated with these,

you have to do a little bit more careful exploration of the pocket

to make sure theres no evidence of any of that.

Yet another reason to take her implants out.

Sarah has textured surface implants.

Originally those were designed to try to prevent both

implant movement and capsular contracture.

It didnt work very well and, in fact,

now we know that it can predispose patients

to a very rare form of breast cancer.

All right, lets remove scarring in the areolar skin

and start working on the breast tissue

and see if we can get her a shape. Look at this.

Wears in to her ribcage.

You can see the texture mark. Wow.

So the dent in Sarahs right breast is actually due

to scar tissue formation after an inside bleed.

So the key to relieving her of that dent

is to remove the scar tissue

and do a breast lift. Magic.

Now, before I commit Sarah to this on the right side,

lets make sure we can get something like it on the left.

And this tattoo isnt doing us any favors either. No.

Basically I just have to ignore the tattoo.

Its just gonna go where its gotta go. Yup.

All right. Could you sit that up, please?

Huh. Its pretty good. Theyre definitely sisters.

I love it. You know what?

If I ever see you again, thats too soon.

Sarah and her implant, buh‐bye.

Lets close her up and get her into recovery.

[Dr. Nassif] Whats going on, my friend?

Heres a patient named Tonia.

Hello. Okay?

It looks like her breast is about to explode.

Yeah. Tonias happy with these,

but doesnt like the size of the areolas.

So, why dont we bring Tonia and see if we can give her

some good advice and maybe help her?

Can you please send in Tonia?

[Dr. Dubrow] Tonia. Well, hello.

How are you? Love that hair. Hi.

Dr. Nassif. Thank you.

How are you doing? Nice to meet you.

Hi, Tonia. Terry Dubrow. Hi.

Dr. Dubrow is so cute.

Oh, my gosh. Wow!

So tell us about how you went to

this very significantly,

visually impactful state youre in now.

I started off with 400 CCs.

[Dr. Dubrow] Your first pair? My first pair.

Okay, so how many years ago was your first breast augmentation?

So, about 20‐something years.

Just turned 51. [Dr. Dubrow] Okay, okay. Very good.

How long did you have those for?

For ten years. Then I went to 800 CCs.

A more natural 800. A very natural 800.

[Dr. Dubrow] And so what cup‐‐ And I had to beg and plead

that doctor to make them at 800.

Cause he was like, "No." Why didnt he want to do it?

He was a real hard‐ass about, um‐‐ Safety?

[Tonia] Uh... He was very conservative.

How dare him? I know!

Damn it, I want them big.

Going from 400 CCs to 800 CCs,

you significantly increase the risk of breast complication.

Like, tissue atrophy, scarring,

or thinning of the skin.

Thats why its not a good idea.

And thats when I went from the 800 to the 2,000.

2,000? 2,000.

On‐‐ In each? Yeah.

Yeah, these are 2,000.

I went in there telling him

that I wanted to go the biggest,

safest, that he could do.

Safest? Biggest, safest.

This is a different doctor though, right? This is a different doctor

because our doctor is now deceased.

She had the same doctor. [Sarah] Yeah.

Unfortunately he was ran over. God bless him.

But, anyway, he doesnt go past 800.

Why did you want to go from 800, which is really, really big...

[Tonia] Uh‐huh. In fact, its the maximum size they make.

To this big?

I dont know. I think it was just that whole turning 50 thing.

So in a way this is kind of

your version of a midlife crisis to go this big?

Yeah, but they said not to use the word crisis.

So its a midlife...

Manookie? Mi‐‐ Meh‐‐

Transformation? [Tonia] Transformation.

You coulda done what he did. He just‐‐ He got a Ferrari.

I‐‐ Yeah, thats true. True.

Some people buy big boobs,

some people buy Ferraris,

when theyre having a midlife crisis.

In Pauls case, he bought the Ferrari

cause he already has the big boobs.

So if someone asked you your cup size, what would you write down?

30‐‐ I think it came out to 34 K or 36 K. [Dr. Dubrow] K?

Jeez.

Wow.

[Sarah] I didnt even know that.

Going down the alphabet.

Next stop is Z.

[Sarah] Jeez. [Dr. Nassif] Yeah.

Do you have any complications with those very large implants?

Well, what happened is that the areola is like about that big around now.

Okay. It stretched. About the size of a baloney.

And I want them the size of a pepperoni.

Thats a very significant reduction

from a baloney to a pepperoni. Thats a huge reduction.

Thats huge. Yeah. So Tonia thinks her areolas

look like pieces of baloney.

If that were the case,

she would have "baloney‐olas."

Why dont we go in and have a look? Okay, lets go.

So you know what those two little vampire marks are.

Leaches.

I was so drugged up, to be honest.

I just remembered these black things wiggling.

Are you willing to reduce your breast implants down to zero?

Is he crazy?

I need my boobs wherever I go. [giggles]

♪ I wanna be perfect ♪

In terms of the transformation

from the baloney to the pepperoni...

[Dr. Nassif] Theyre bouncing up and down. There goes the baloney‐‐

[laughing] Right.

Flying off.

[Dr. Nassif] How nice. Okay.

Hopefully. [Dr. Nassif] Hello.

[Dr. Dubrow] Hello.

So, obviously, if youre gonna reduce them

to a pepperoni size,

with the average size of an areola

is about 38 millimeters.

Itll go from 75‐‐ Oh, my God, thats so tiny.

Itll go from 75 to 38.

Okay? So thats a lot.

So the question is,

at this breast size,

can you safely reduce the areola

and allow it to heal

and not have a big, giant wide scar.

Lets test where youre at right now

in terms of areola reduction.

The way you do that

is you basically see‐‐ you do this.

Okay? Thats a lot of tension

on the surrounding tissue.

The biggest problem with Tonia

is that her breasts are so large,

her skin cant stretch anymore.

Thats why her areolas are so big.

She basically is running out of skin

to cover her 2,000cc implants.

If you would allow these implants to be removed

for about a year,

what that would allow the overlying tissue to do

is thicken up a lot.

And then, at that time,

you can have an areola reduction,

allow that to heal.

Then you potentially could re‐expand them slowly

and have it preferentially expand the breast skin

and not the areolar skin

and maybe keep that reduction.

So are you willing to reduce your breast implants

down to zero for a period of time?

No.

[Sarah laughs]

Theres no way shes gonna do that.

No, think about it.

But youre asking me, like‐‐ thats like,

"Couple years from now, couple‐‐"

Im, like, 51.

Is he crazy?

I need my boobs. I love my boobs.

They are part of me,

and I need them wherever I go.

[giggles]

I dont know‐‐ With her personality,

can you imagine seeing her with pancake breasts?

No... Shed be so sad.

Come on, man. Thatd be so mean.

So wait a minute, but‐‐ but question is...

can you leave here

basically saying, "Leave them alone"?

Yeah.

Im so happy

that Tonia is going to leave her areolas alone.

Long live baloney nipples.

Great to meet you. Thank you. Thank you so much.

Its good to meet you. Thank you, guys.

Isnt it nice you just dropped by to see me?

I know. Oh, baby.

Yeah, about six weeks.

Oh, look who it is. [Dr. Dubrow] Hey, can I call you back?

[Dr. Nassif] Go say hello to Young Zinmadinemous. Let me call you right back. Bye.

Hello.

Its Brittany.

Hello. Hello.

How are you, beautiful?

Good. How are you? Good to see you.

Brittany is my fiancé. Shes my soul mate,

and Im totally in love with her.

Im the luckiest man in the world to be married to her.

You look beautiful. [Brittany] Thank you.

You look perfect. Because shes watching every

friggin thing she eats. Of course she is.

Well, because Ive been working out all the time.

I want, you know, to look my best.

So she wants to get ripped, is what she wants to do.

You are ripped. By the way, Ive seen‐‐

So we go to the gym, and hes like,

"You know, youre doing the same weight as me,

so you should bring it down a little bit

cause you dont want to look too manly."

Im like... [laughs]

If Brittany is doing the same weight as you,

its not Brittany who should go down.

You should go up in weights.

Hmm. Either Brittany is freakishly strong,

or Paul is incredibly weak.

I think you know what the answer to that one is.

So your first reaction when you saw‐‐

When he took his shirt off, you saw the back hair. Go...

Uh... it wasnt that bad.

Dont‐‐ I dont have that much back hair.

[Brittany] First saw him naked... My ears are the issue.

...I was like, "Oh, hes, you know, a little petite."

You know? Hes shorter than me.

So the adjective that came to mind

the first time you saw Paul naked was petite.

Hmm. [Brittany laughs]

You know‐‐ you‐‐

Although no man ever wants a woman

to call them "petite"

the first time they see you naked,

in Pauls case,

its kind of a compliment.

By the way, just so you know,

he scored.

You, on the other hand, you did well, too.

Hes a very lovely human being,

with a lot of back hair

that youre going to be managing for a lot of years.

So congratulations on that.

Aw, thank you.

Okay. Uh‐oh, PDA, PDA.

[Dr. Nassif] How are you, Maria? Im doing good.

How are you? How are you?

Good to see you. Good. How are you?

So you know what those two little vampire marks are.

Leaches. Really?

Yeah.

And the reason why we did the leaches

is because your nose at the end,

right around here,

was getting a little purple.

[Dr. Dubrow] Yeah. Okay.

At the recovery center,

I had to have leaches put on my nose.

I was so drugged up, to be honest.

I just remembered these black things

wiggling on my nose,

but it seems like they did what they needed to do

cause I dont have necrosis in my tip.

So we made an implant for you,

of straight cartilage

that was shaped perfectly along your dorsum.

Oh, great.

In addition, I injected a little bit of nanofat

inside of your nose and on the skin,

especially on the left side.

[Dr. Dubrow] Okay. We just have to see how you heal.

Lets just take a peak.

All right. Okay, put your head back for me.

Okay.

The only thing that I had noticed a little bit... So she does have it.

...that this area seems a little more swollen.

Yeah, I mean‐‐ it is.

I could not build up this side

as much as this side.

[Maria] So far Im happy with the way it looks.

Obviously Ive not been able to see the entirety of the nose,

so Im excited to get this [bleep] off my face. [chuckles]

Thank you. Pleasure.

Thank you, Doctor. [Dr. Dubrow] Congratulations.

Its great. Pleasure.

Nice to see you. Nice to see you.

How you feeling? I‐‐ Oh, like a million bucks.

I know, right?

So, first of all, I was a little bit surprised to find

that you had textured breast implants,

and so, you know, textured breast implants

right now are very, very controversial.

Have you heard about this? Really? I did not.

So theyve been associated with a cancer

called lymphoma,

and although its very rare,

its better to have them out.

Wow. [Elsie] Thank God.

So buh‐bye, textured breast implants.

So lets take a look. All right.

[Sarah] Im very nervous.

Are they gonna be too small,

one nipple looking to the left,

one to the right or... [laughs]

You never know.

Im hoping you have some upper fullness.

Yeah, there we go.

[Elsie] Oh, my gosh, you do.

[Dr. Dubrow] Oh, you do, dont you?

La la la.

All right, now...

Okay, so thats pink.

That looks good. Thats a good thing.

And thats pink. Yay.

Theyre cute and theyre perky.

You know, with breasts,

Well, more than a handfuls a waste.

I like them.

Theyre cute.

And the chance of a breast implant complication is...

[Elsie] Zero. Zero.

Zero. No breast implants! Yay!

Thank you so much, Dr. Dubrow.

All right, Ill see you soon.

Well keep a close eye on this, okay? Okay.

Thank you so much, Dr. Dubrow. Thank you, Doctor.

It has been a very long journey to get to where Im at today.

I am done with having anything done to my nose for sure.

Im [bleep] beautiful.

[speaks Spanish]

♪ I wanna be perfect ♪

[female singer] ♪ I feel so free ♪

♪ I feel so free ♪

[Sarah] When I look at my breasts now in the mirror,

I dont wanna stop looking at them.

The best part about it

is that I dont have to worry

about any complications with implants

because I dont have any.

I feel I look way better without them,

and its more me.

Its more Sarah.

Hey, yall! [Elsie] Oh, my God, there she is.

Hi! [man] Oh, wow, look at you.

How are you? You look amazing.

Hey, beautiful.

You look amazing.

Oh, my gosh, you look beautiful.

Thank you, thank you.

Dr. Dubrow did such a fabulous job.

She looks amazing.

Look at you. I feel so good.

I couldnt be more thankful for you.

You gave me courage.

You gave me my little fight to push through it all.

Im so proud that she was able

to go through with this.

I think it was very brave of her,

and now shes enjoying the life she deserves.

Youre the best. Im so happy for you.

Dr. Dubrow did an amazing job.

I know. I know. Im‐‐

Im happy. I dont have any more pain.

I dont have to worry about fiddling with bathing suit tops.

I can wear whatever I want to wear.

Just... go.

[Elsie] You changed your life.

That‐‐ Totally. Im happy.

I can tell. I love your smile.

Thank you. [Elsie] Aw.

[Sarah] Before my surgery,

my right breast looked like squeezed grapefruit.

There was indentation at the bottom,

I experienced pain after any physical activity,

and there were scars around both of my areolas.

But now, thanks to Dr. Dubrow,

I have two beautiful breasts

that are implant free,

and the pain and scarring are gone.

I couldnt ask for anything more.

I feel amazing.

All right, enough of this. Lets get in the water.

[overlapping chatter] Lets get charging.

You dont need implants to feel like a woman.

If it aint broke, dont fix it.

If it is broke, go to Dr. Dubrow and Dr. Nassif

cause theyll fix it.

[female singer 2] ♪ Good morning ♪

♪ Even on Tuesday ♪

♪ I witnessed even this Thursday ♪

♪ Hey! ♪

♪ Every day is a really good day ♪

♪ I just wanna have fun ♪

♪ Hey, hey, lets go! ♪

[Maria] It has been a very long journey

to get to where Im at today.

People would look at me before

and be like, "Ooh, what the [bleep] happened to her nose?"

Now people look at me and say,

"Damn, bitch." [laughs]

Ive known Maria through literally five different noses,

and the last time I saw her,

Im not gonna lie,

it kinda looked like Miss Potato Head.

Hoping that this will just enable her to be free.

Come on already. I wanna see her. Right?

[Maria] I do feel that my nose now is more feminine.

Whether people think that I was born female

or that I wasnt, none of my business anymore.

I am done with having anything done to my nose for sure.

Im [bleep] beautiful.

[speaks Spanish]

[crowd cheering]

[no audible dialogue]

[speaks Spanish]

[woman] Fabulous. Maria looks fabulous.

As a mom, you know, thats all we want,

is our children to be happy,

and the doctor did a beautiful job.

I just have to call him for me.

Next week.

Over here.

[Jason] Maria looks amazing to me.

She always looks amazing.

Just... outstanding.

I wanna thank each and every one of you

for being here today.

For a long time

I looked at myself,

and I did not think that that could be fixed.

I wanna thank Dr. Nassif.

Without him I would not, you know,

have this new, brand new spanking nose

that I love.

Lets have a cocktail.

[woman] Yeah!

[Maria] Before my surgery,

I had a [bleep] up nose, honey.

My nose looked like a melted candle.

It was super small

with zero projection,

and I had an implant that I just hated.

I really felt like I had gone too far

to be feminine,

but now, thanks to Dr. Nassif,

my nose fits my face.

It has proper projection,

and that horrible implant is gone.

I finally look like the woman that I feel on the inside.

I look like the perfect woman now, honey.

Bye‐bye, [bleep] up nose.

You wanna see it?

I can see it.

Profile. Oh.

That nose, mwah.

She looks perfect.

[woman] Growing up, I wanted to look like Dolly Parton.

Only way that I could do it was through plastic surgery.

What is the ideal goal? 2,000 CCs.

Youre perfect for a total disaster.

My breasts look like theyre melting.

[Dr. Nassif] Terry is gonna have to need to come up

with something new and innovative.

Good luck, my brother.

Im not sure why those guys left this.

Oh, boy. Are we gonna be here a while.

When I look at my nose, its ugly. I look like a freak.

Yeah. Well, [bleep]. Its really bad.

[Dr. Dubrow] If youd like to be considered for Botched,

share your story at botchedcasting.com.