Tonight’s Botched was one for the books. 

For the first time in the E! show’s seven-season run, Dr. Terry Dubrow broke down crying during a patient consultation. 

The patient’s name was Serena, a 22-year-old singer from Canada.

“At 16 years old, I decided to transition to a woman by taking hormone replacement therapy,” she explained in a confessional. “Hormones can make you look more feminine but they can’t do everything that plastic surgery can do for you.”

As a result, she’s since had a breast augmentation, a rhinoplasty, Botox and fillers in her check, chin and lips. In visiting the Botched docs, she hoped that they could not only fix her mishandled boob job, but increase the size of her breasts as well. 

However, this wasn’t necessarily the reason Dr. Dubrow got emotional. His reaction actually came when Serena was talking about her childhood.

“I loved my parents,” she told the surgeons. “I always had a really great relationship with them…Anything I wanted to do, very accepting. I’m so thankful I had that because I have friends who had different situations, like being kicked out or told not to do what they’re doing. And it sucked.”

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