Another one! Rodrigo Alves is celebrating his birthday by doing what he does best —plastic surgery. The Human Ken Doll, as he is famously known, underwent his 10th nose job, a chin implant, and cat eye lift despite doctor’s orders.

“Thank you very much to Dr Sadr and Dr @dr.keshavarzian for the amazing birthday day today with lots of good Iranian cakes and juices to speed up my recovery after my nose job and chin implant. Where most of people celebrate their bday with a party I celebrate mine looking after my self,” he wrote on Instagram. However, Rodrigo took a big risk because he was warned by Dr. Paul Nassif on a recent episode of Botched that he could lose his nose completely if he went under the knife again.

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“The issue is that what we call the soft tissue envelope—that’s the skin. By you having three surgeries in a period of 12 to 15 months, destroyed your tissue. The skin’s no good,” Dr. Nassif told the surgery-obsessed flight attendant. “If you try to insult your skin one more time now while it’s healing, there’s a high possibility that if you let one of these doctors touch your nose now, this will turn black and then die and fall off.”

However, that clearly did not stop Rodrigo, 34, who also detailed his cat eye procedure, which lifts the eye brows and stretches the corners of the eyes, in a video for his followers. “The most [important thing] is in spite of everyone saying that my nose was crippled and that if I had a surgery it would fall off Dr @farshidmahboubirad performed a great procedure and fixed my breathing giving me a cute dolly nose,” Rodrigo added. In total, he has reportedly spent over $400,000 on his transformation.

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Hopefully, this will be the last time Rodrigo goes under the knife — but we aren’t holding our breath.