In January of 2018, Alves has spent just more than PS500,000 on various cosmetic procedures, including injections 51 of them plastic surgery. Alves has undergone liposuction and gel filler injected into her shoulders, biceps and triceps. Minoxidil is also used topically and has also had hair transplants as well as numerous facelifts. Alves also wears tinted contacts lenses and has had 12 rhinoplasties. The first plastic surgery she underwent was done at 17 to eliminate the gynecomastia. At the age of 19, her first nose job was done. In March 2020, she has spent approximately PS650,000 on 60 procedures that make her look like an Barbie doll. Alves recounted that pre-transition she was trying to disguise her masculine insecurities by trying to make her appearance more like a surgeon, "I'd always felt feminine and when I had to struggle to be manly with my appearance, I decided to look as masculine as possible instead ... However, no matter how much I resembled Ken it was impossible to ease the discomfort of being Barbie inside.
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