I had 2 alterations appointments, and a 3rd to make sure everything was good. I had to have my dress shortened, taken in, adjusted in the waist, and some protective fabric added around the arms. Oh, and bustled too.
She told me it was all fairly simple! The bottom needed to be hemmed, cups sewn in, belt sewn on, bustle added, and taking in a few small places on the bodice, that's it! It fit almost perfectly when I tried it on!