Their surgeries took place in the hostels and the surgeons were unknown people.
Isabella, ( trans-gender on the picture ) described it as very cheap and worth to get procedure. ( She must be lucky that unprofessional people has done everything right).
But if you look closer to this photo, you will see how roughly their job was done.
It is known that prostitution in Italy is legal, so trans genders are emigrating in here very often. These used-to-be males are even more popular than a female prostitutes in Pisa. The street in the picture belongs to trans-genders and the one next to it belongs to the female prostitutes.