SHE appeared on the cover of FHM, and wore nothing but leaves and a sign saying ?Back to Eden, Close All Zoos? when she posed for a campaign for the People for the Ethical Treatment of Animals. Who would have thought that Avi Siwa, the sultry morena built like a Barbie Doll, could have issues with her body?

?I was flat, I was really flat,? says the 5?6, 107-lb Siwa in a husky voice, talking about her figure. A breast augmentation would take care of that, though in the case of the starlet, it took?gasp!?four surgeries to actually get it right.

Now 28, Siwa had her first augmentation eight years ago in a mall clinic.

?At the time it looked okay,? says Siwa, who was further convinced when she saw pictures of the surgeon?s celebrity clientele. The operating room, however, was a different story. ?It was dark, not well kept,? she says. ?But I was there and I had already paid.?

Even so, she didn?t leave a satisfied customer. Unable to get the breast size she desired (?because my doctor said they were too big for my proportion?), she later found out that the silicone implants were placed above her breast muscle, resulting in a hard and unnatural look.

Strangely, Siwa returned to the same clinic a year later to go for another augmentation. Like her first surgery, the second was not to her liking: it was still not big enough for her, and again, the implant was fitted above her breast muscle.

Siwa then turned to a European doctor for her third augmentation in 2004.

His clinic was nice and clean, but like her earlier surgeries, she left disappointed with the size and appearance of her bosom. ?Hard and fake,? she says. ?And the gap between my breasts was big.?

Others would have thrown in the towel, but not Siwa, whose fourth breast augmentation happened in January 2008, after she chanced upon one of the doctors of multi-specialty aesthetic institute Beverly Hills 6750 on Ayala Avenue, Makati.

?I really saw the difference,? says Siwa who was impressed with the medical team?s professional approach.

The augmentation was performed by Rene C. Valerio, a seasoned plastic surgeon and member of a number of medical associations, among them the International Society of Aesthetic Plastic Surgery, Philippine Board of Plastic Surgeons, Philippine Association of Plastic, Reconstructive and Aesthetic Surgeons, and American Society of Aesthetic Plastic Surgery of which he is the only Philippine-based Filipino plastic surgeon on board.

Dr. Christine Atienza, an associate plastic surgeon and first assist to Dr. Valerio, says Siwa underwent a Revision Surgery for Severe Breast Contracture (severe breast firmness secondary to significant scarring of the capsule). After removing her third implants and the thick capsules that constricted the implants, Valerio and his team placed US FDA-approved silicone gel-filled implants below Siwa?s breast muscles to eliminate the chance of a too-firm look.

Atienza says doctors had no choice but to incise Siwa where her previous surgeons sliced her?under her breasts??but with the proper surgical technique,? she says, ?hopefully we prevent the development of unfavorable scarring.?

Siwa admitted to feeling ?a little scared? on her fourth surgery. ?But vanity saw me through,? she says with a laugh.

From the look of things, surgery no. 4 is a success in so many ways. For one, she finally got the size she wants: a 36C.

Secondly, she doesn?t feel the need for other aesthetic enhancements. ?This will be my last,? she says of her breast augmentation.

More importantly, being satisfied at last with her breasts allows her to focus on other things?her career, for instance. She will launch a clothing line in January. She is in charge of hip nightspot Club Ascend?s public relations.

?I feel really blessed. Everything?s happening for me now. The challenge is to keep up, and to work harder.?

Right from the start

Though Beverly Hills 6750?s patients are still mostly first-timers seeking aesthetic enhancement, the last two years have seen a spike in the number of clients looking for ?re-dos? of surgeries that were either botched by their original doctors or below a patient?s satisfaction.

Dr. Bernabe Marinduque, medical director of Beverly Hills 6750 and a cosmetic gynecologist, suggests ways to avoid an unnecessary second (or in the case of Siwa, third and fourth) surgery:

1. Research on the procedure you?re about to undergo. Don?t just go online or read books, talk to people who have had the same surgery, and doctors who have performed it. Educating yourself leaves little chance for surprises or disappointment.

2. Know your doctor. Check on his medical background, how much experience he has, and find out which societies or boards he belongs to. A cosmetic surgeon may be just as skilled as a plastic surgeon, but according to Dr. Marinduque, the former has less training than the board-certified latter. And an aesthetician, he adds, could be anyone, from a hair dresser to a makeup artist, so do not entrust your body and life to just anyone.

3. Inspect where the operating room is. If surgery is to take place in a non-hospital-based operating room, find out how hygienic the place is, and if the clinic has been accredited by the Department of Health and has a business permit.

Also, Dr. Marinduque prefers treating patients with preexisting conditions such as heart disease, diabetes or hypertension in a hospital, where there are colleagues and equipment available in case of emergency.

4. Have realistic expectations. Accept the fact that an aquiline nose isn?t appropriate for an Asian face, or that you?ll have to exercise and watch what you eat even after liposuction. Plastic and cosmetic surgery is there to enhance your appearance, not turn you into someone you are not.