The 50-year-old woman who underwent a botched breast implant surgery said she was shocked to learn Pirnia's license had been revoked.
"I could not believe it," she testified during Pirnia's trial.
Many states offer information on who can practice medicine and whether doctors have been subject to disciplinary action. Information on selecting a cosmetic surgeon is available on the Web sites of professional groups such as the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons: surgery.org and plasticsurgery.org.
Cosmetic surgery can generally be performed legally by anyone with a medical license, but industry groups recommend seeking surgeons who have been certified by the American Board of Plastic Surgery and are members of the major cosmetic surgery societies.
Part of the problem with unlicensed cosmetic surgery may be that the public increasingly sees the procedures as simple and routine.
"I think the publicity about a 'Botox party' makes people think it's very simple," said Dr. James Wells, the president elect of the American Society of Plastic Surgeons.
Botox injections to treat facial lines have been around for more than a decade, but it was only earlier this year that the FDA specifically approved the treatment as cosmetic procedure. That approval allowed doctors to advertise Botox as a way to erase wrinkles, leading to a flood of media attention about the procedure and reports of "Botox parties."
Read a report about Botox parties.
"Patients do more investigation, more analysis of purchases of electronics equipment than in seeking out physicians," said DiSpaltro.
In Florida, word of Hawkins and Hendrix's silicone "pumping parties" spread through South Florida's transsexual community, witnesses in the trial testified.
"I had seen their work, so I was more than comfortable with them," said one witness, Terrell Belle, who had injections to his breasts, hips and buttocks. "Viva [Hendrix] said she was a nurse, but I don't know what kind."
The fact that Hendrix is a transsexual himself may have made some clients more at ease, but others said they simply wanted to save money.
"I did it because it was a cheaper way out," testified Denise Jones, 29, a nurse who said she had silicone injections from Hendrix and Hawkins.