Wearing cute, trendy and a tad bedazzled jeans, a classy sleeveless black button-down top, skin pumps and carrying a Coach purse, 28 year-old Katy-native Sha Ross is the type of mother of whom others are jealous. She has a petite size-zero build, flawless porcelain skin and a warm smile. From afar, it appears that Ross has it all.

"Looks are very deceiving," she says.

As Ross waits for her pre-op appointment with Houston plastic surgeon Dr. Franklin Rose, she reminisces of the last time she sought his help to overcome challenges by going under the knife almost a decade ago. At 19 years old, she wanted large breasts, plump lips and a thinner chin— and underwent medical procedures to look like Pamela Anderson, augmenting her chest size from 34B small C to a shapely 32F.

"I don't even recognize myself," Ross continues.

Once a Goth girl and Hooters waitress, teenage Ross wanted attention, and she was willing to take her clothes off to get it. She was the subject of MTV's reality show I Want a Famous Face, which chronicled the plight of young adults who were compelled to go to extremes to resemble celebrities.

Ross' obsession with Pamela Anderson began when she flipped through Playboy. She then plastered her bedrooms walls with posters of Anderson, hoping to lose enough weight to one day become a Playmate. When Playboy approached her to pose nude for a special edition college girls issue, it was her chance to audition for a centerfold spot.

Ross did radio promotions, signed autographs and greeted fans, all while refining a natural (or unnatural) girl-next-door look, which was fashionable at the time. She was told she had the face of a Playmate, but not the body.

She was consumed with what to wear, how to do her makeup, how to style her hair. She spent many hours at the Playboy Mansion sporting fishnets, skin-tight tiny black tops and tall spikes.

Against the advice of other working professionals, Ross convinced herself that breast augmentation — and Dr. Rose — were the answer. It was a risk for her 5-foot, 4-inch frame, a gamble that paid off. Once the swelling went down, the new curvaceous Ross was one of the Playboy editor's choice ladies for a 2004 Voluptuous Vixens release — and the cover model.

She gained the attention of many gentlemen callers.

It was what she wanted. To be in every magazine. To be famous, wealthy, a household name.

At least, that's what she wanted back then.

Fast forward nine years

Ross is anxious, excited, nervous. She remembers being happy with her previous results, but on this day, all she wants is a leaner Brooke Burke look: About a full C cup.

Now, all she wants is to be a good stay-at-home mother for her 18-month-old and 5-year-old girls, who love summer water parks, arts and crafts, shopping and making hand soaps. The older child is lively, full of energy, outgoing, the type of person who's never met a stranger. The youngest is a tad shy, the complete opposite of her sibling.

As a family they attend WoodsEdge Community Church in their Woodlands neighborhood every Sunday.

"It's amazing how your kids change your life, change your views and change your world," Ross says. "I just want to take a hammer and shatter my 19-year-old dreams. Pop culture, reality television — it's when you are that young that it's easy to get caught up in the 'excitement,' but you have no idea how it's going to affect you later in life."

The regrets poured in after getting pregnant with her first child. Her breasts were so large, they triggered back pain. She wasn't able to produce enough milk to breast feed. Today when Ross picks up her kids from school, she feels judged by other moms.

"You are stereotyped because you look a certain way," she says. "Women can be very critical — though I wished I looked like them, like a regular mom. I stick out like a sore thumb, and I never want my kids to be embarrassed because of me, because of how I look. My kids are my biggest accomplishment, they are what I am most proud of."

Ross has recently started a line of children's clothes, RyRy's Angels, in honor of her brother Ryan who passed away when he was run over by a motorcycle at age 8. Her custom designs comprise everything from bows to footwear, all with a little bling. Some pieces she's sold to her close friends, some she's kept for her children to save a few bucks. Having children is very expensive, she notes.

"They are too young to know what I am doing or what I did in my past," she says. "At one point they'll figure it out. They'll see it online. I'll cross that bridge when the time arrives, I'll sit down and be truthful."

A week later: The surgery

Ross' life may have changed drastically, but her sassy Texas side was showing as she had been fasting in preparation for the breast reduction procedure: She was ravenous for a plate of enchiladas, beans and Mexican rice.

In the surgical theater, Dr. Rose prepared to extract the 500cc saline implants and replace them with a new generation "gummy bear-like" silicone gel pair, possibly 275cc or 325cc. With the weight gain, weight loss and pregnancy, her breasts had descended and they were out of proportion with her smaller body structure. Rose dubs this surgery the typical mommy makeover.

"The manufacturers will tell you that there's more implants per capita sold in Houston than anywhere in the world, and more than in Los Angeles," Rose explains. "One can make the argument that this city is a bit over augmented — the average implant is 400cc."

When Dr. Rose was training at New York University, he carried out one augmentation per 10 breast reductions.

That's the opposite in Houston, and par for the course, Dr. Rose thinks. The silicone implant was invented at Baylor College of Medicine 1962 by Thomas Cronin and Frank Gerow — the 1997 Lawrence O'Neil film Breast Men with David Schwimmer and Chris Cooper documents that journey — and is an important part of Rose's 25-year practice: He's performed close to 6,000 procedures and placed 12,000 implants.

He can recognize a good candidate, and he's not reserved to turn away patients that aren't emotionally or physically suitable to undergo surgery.

"Plastic surgery isn't like going to the salon," he says. "Though I know the media sometimes portrays it that way."

For this reporter with a camera on hand, Dr. Rose sets some ground rules: How to walk during surgery — very slow movements, he says — which sterile areas need to be avoided. He even helps me with the proper way to attach a surgical facial mask so it will not fog my spectacles.

Robed in scrubs, hands sterilized, Rose sketches surgical lines in Ross' chest. With muted music playing in the background, the conversation turns to evaluating the tissue and the similarities between this procedure and a tummy tuck. The scalloped ripples from the saline implant are apparent, something that's prevented with new gel implants, he says.

He begins with the right breast. Dr. Rose uses a cutting tool to outline the skin around the areola, then begins scoring the skin. Some has to be removed; tissue has to be removed; fat has to be removed; and anything that's disposed of is weighed until an appropriate size and shape is achieved.

An hour into the surgery, the old implant is exposed and carted off. It's clean and intact, with just a few traces of flesh.

As if he were a sculptor, Dr. Rose surveys and molds the skin to reconstruct the breast, wrapping it around the nipple until he's satisfied with the appearance and position. He decides on a 350cc implant, though he's willing to discard it and try another size if it doesn't offer the perfect fit.

It works.

Rose scrutinizes his decision, thinks about it, talks about it to his medical colleagues and to to himself . . . then, he moves on. He's pleased.

He proceeds to apply sutures for support and sews the skin shut. His movements are precise, intense, choreographed, a dance of needle and fiber. The incisions are permanent, though in most cases they will fade and become imperceptible over time, he explains.

From beginning to end, the four-hour operation goes without complications.

The reveal

Sha Ross is in the midst of a divorce, and with a custody case still pending, it's time for her to retreat to private life. But before that, she's hoping her story will help others who are looking at plastic surgery for the wrong reasons to think again.

"If I can convince one young teenage girl to make a wiser decision and follow a different path, that's something I can be proud of because there are a lot of things I am not proud of," Ross explains. "Regardless of whether you have children or not, your life is not your own. The decisions you make when you are 19 can really affect your future for the rest of your life.

"Beauty comes from within and the type of person that you are, the way that you live your life and how you feel about yourself. As long as you have a beautiful heart, that's what makes you beautiful."

Ross is happy with her new look — and thrilled to restart her life as a modest mother of two adorable little girls.