New Jersey doctors uncovered a black market of cosmetic butt enhancement injections when half a dozen women showed up at hospitals with skin infections and abscesses on their bottoms this week.
State health officials are still trying to discover who was responsible for the dangerous infections, and what substance was being injected into the women's rear ends.
"By state regulation hospitals and health care providers are supposed to report any unusual outbreaks," said Dr. Tina Tan, a New Jersey state epidemiologist.
"This was certainly unusual," she said. "We're still not entirely sure what was injected."
It's not the first time a group of women ended up in the hospital with a mysterious substance injected into their behinds.
"Usually it's industrial silicone, it's the stuff that you buy at Home Depot," said Dr. Renato Saltz, president of the American Society for Aesthetic Plastic Surgery.
Tan has also seen reports of caulk and petroleum jelly injected in black market cosmetic procedure rings.
In January 2009, authorities in Tampa, Fla., arrested Sharhonda Lindsay, 33, for allegedly injecting two acquaintances' with a product believed to be a homemade combination of commercial silicone gel and saline. The women apparently went to Lindsay to enhance the appearance of their buttocks, according to police reports.
According to Debbie Carter, a spokeswoman for the Hillsborough County, Fla., Sheriff's Department, one of the two women who received the injections paid $500 for 40 injections into her buttocks, and the other paid $250 for 20 injections.
J.D. Callaway, another spokesman for the Hillsborough County Sheriff's Department, said Lindsay -- who is not a doctor -- has been charged with two counts of practicing medicine without a license. The charge is a third-degree felony that he said could carry a sentence of five years in prison.
Several calls to Lindsay's listed home phone number showed that the number had been disconnected.
Past Black Market Injections Threatened Lives
Saltz warned that injecting unsanitary, unregulated materials can frequently result in serious medical problems. "They cause tissue death, they can migrate to your lungs and kill you," said Saltz.
Tan said the women investigated in New Jersey are recovering from their infections well. But in the Florida case, the homemade injections had one mother fearing for her daughter's life.
Andrea Lee, 30, and Zakiya Teagle Carswell, 33, both were hospitalized at Tampa's Town and Country Hospital after suffering severe reactions to the shots they received at the hands of Lindsay on Jan. 29, 2009.
Lee's mother, Doretha Belnavis, said her daughter began feeling ill around 3 a.m. the day after the injections. Belnavis said her daughter was admitted to the hospital at around 7 a.m., and doctors treated her for life-threatening damage to her kidneys.
Belnavis said she hopes her daughter's case serves as a warning to others.
"I hope this educates the community and also people having these procedures of the side effects and everything that they can have doing these procedures," she said. "Going to someone who is unprofessional and unlicensed is committing suicide, because you don't know what you're getting. It's playing Russian roulette with your life."
Saltz said it's unclear whether doctors are dealing with an actual increase of illegal buttock injections, or whether news media have gotten wise to the problem.
"We didn't used to hear about that happening in the States," said Saltz. "It used to be [happening] in South America, or in Central America."
The procedures still make up a small number of all cosmetic procedures performed. Only 4,996 buttock or gluteal implants were performed in 2009, compared to 2 million Botox treatments and 311,957 breast augmentations.
But buttock augmentation was up 37.5 percent in 2009 from the previous year and buttock lifts were up 34.6 percent, according to statistics from the American Society for Aesthetic Plastic Surgery.
Research Pays When Going for Cosmetic Procedures
At the same time people's interest may not match their diligence in doing research on the procedures.
"They'll use the advice of a friend and not do their research," said Dr. Phil Haeck, president elect of the American Society of Plastic Surgeons. "Too often we hear, people went to a spa and they never saw a doctor -- it's beyond belief what you hear people will do without at least checking credentials."
Haeck said unlike surgery, there is little regulation on which medical "professionals" can do injections. So even if a consumer goes to an M.D., Haeck recommends asking tough questions.
"Where were you trained? Do you have a state license in a medical specialty and is it posted?" said Haeck, adding that patients should also ask how many of the same procedures the doctor has done before. Even if an assistant ends up injecting Botox, Haeck said patients should be alarmed if a doctor has never taken their medical history, or if they can't tell that the needles have been sanitized.
If the women in New Jersey and Florida had researched a bit more, they might have realized that procedures to plump the behind don't typically involve injections of foreign material.
Saltz said doctors mainly use three techniques to enhance a derriere.
There's "fat injection, sucking fat from your tummy or from your thighs and injecting it into your buttocks," said Saltz. Another technique is called a "butt lift" or "a body lift."
"It's a great technique if a patient loses a lot of weight," said Saltz. "What you do is just lift up and remove the rest of the extra skin.
"Or there's gluteal augmentation using implants," said Saltz.
Those implants may be medical-grade silicone, similar to the ones used in breast augmentation.
But many doctors are seeing lay people who assume anything with the word "silicone" in it means it is the same substance as what plastic surgeons use. The public might even ignore how doctors use silicone in implants.
Dr. Rhoda Narins, a clinical professor of dermatology at the New York University School of Medicine, said that such unfortunate cases are an all-too-common result of people seeking cosmetic enhancement at the hands of untrained professionals.
"I have treated patients who had horrible results with permanent disfigurement after injection in spas and homes of commercial grade silicone by unlicensed technicians," Narins said. "These unlicensed people inject large amounts of a substance that clearly says on its Web site that it is not to be injected into animals or humans.
"There have been deaths in Florida from commercial grade silicone with injection into blood vessels of large amounts of [this] product," she said.