"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 website 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.
The reports suggest buttocks enhancement is a growing trend, as women strive to emulate celebrities known for ample posteriors.
At licensed medical practices, the procedures make up only a small number of all cosmetic procedures performed. About 5,000 buttock or gluteal implants were performed in 2009, compared with 2 million Botox injections 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 the American Society for Aesthetic Plastic Surgery.
Dr. Terry Myckatyn, plastic and reconstructive surgeon at Washington University School of Medicine in St. Louis, said the reasons someone would seek out a buttock augmentation procedure range from significant weight loss to an injury that has led to buttock atrophy.
"On the other hand, other individuals may possess buttocks that appear of normal proportion to most individuals and have not sustained some fluctuation in body weight or injury," Myckatyn said. "These individuals may be trying to achieve some form of ideal dictated by the ideal buttock appearance as dictated by trends in pop culture, or in other cases due to perceived ethnic norms."
In all too many cases, people seeking buttocks enhancement don't seek out important information on the procedures.
"They'll use the advice of a friend and not do their research," said Dr. Phil Haeck, president 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 there is little regulation of which medical "professionals" can do injections. So even if a consumer goes to an medical doctor, Haeck recommends asking tough questions:
"Where were you trained? Do you have a state license in a medical specialty and is it posted?" Haeck suggested, 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.
Few, of the American Society for Aesthetic Plastic Surgery, offered the following tips to lessen the risk of being harmed by an unlicensed practitioner or an unapproved product:
The primary thing to remember is knowing who is doing the injecting and what setting are they injecting. Patients ideally need to be seen by a board certified plastic surgeon or dermatologist, when considering injections of any kind.
The patient should not be afraid to ask to see the box for a given injectable or get a copy of the stock number for the given injectable, if they are uncertain about the injection product for the face.
One should ask "is the product FDA-approved for the purpose you are planning to use?" If not, "what are the safety concerns" or "what are the risks for me using this product?"
Classic red flags include injections offered in a non-traditional setting, like someone's home or mall; a person offering treatments without making you aware of the risk and benefits; unwillingness to discuss your options; or the person insisting there are no risks. There is no such a thing in medicine.
For more information on how to avoid risky cosmetic injections, check out www.injectablesafety.org.