Ruptured implants from botched breast enhancements, infections from illegal Botox-like drugs, deadly shots of industrial-grade silicone. Welcome to the terrifying world of illegal plastic surgery.
"We're running into a rash of this," said Dr. Franklin DiSpaltro, president of the American Society for Aesthetic Plastic Surgery.
"It scares me."
A handful of recent horror stories illustrate what many health officials say is a growing problem.
From California to New York
A doctor who had his medical license revoked in Riverside, Calif., was sentenced to more than 14 years in prison last month for performing illegal liposuction and breast augmentations that several patients testified caused pain and infection.
A 50-year-old woman testified that the doctor, Abdolvahab Steven Pirnia, was supposed to perform a 3-hour breast augmentation procedure, but it became an excruciating 8 ½ hour ordeal, with the implants rupturing twice, spilling onto her clothing. Another of Pirnia's patients — a 17-year-old girl — suffered infections after he performed breast implant surgery.
In Florida, Donnie "Viva" Hendrix and Mark Hawkins are on trial for unlicensed practice of medicine, manslaughter and third-degree felony murder. Police say a Miami secretary, Vera Lawrence, died in March 2001 after Hendrix and Hawkins injected industrial-grade silicon into her hips and buttocks. Medical examiners say the silicone entered Lawrence's bloodstream, leading to her death.
Several witnesses have come forward in the trial to allege Hendrix and Hawkins held "pumping parties" in a friend's apartment, where they would charge several hundred dollars for each illegal injection of silicone.
The FDA banned silicone injections for cosmetic purposes in 1991, although several clinical trials are testing ways to use it safely. The effects do not fade with time, as with collagen injections, but it can produce bumps and unattractive swelling.
The defendants' lawyer has claimed the witnesses in the case were unreliable.
In New York, prosecutors charged Eliezar and Iris Fernandez last month with impersonating physicians and injecting at least two people with an illegal Botox-like drug called Hyacell. The treatments left Freddy Borges, 47, hospitalized for months with a facial inflammation and infection, prosecutors claim. Another patient, Joan Lusk, 63, said she developed severe inflammations after receiving Hyacell injections in her face and hands.
New York state regulatory officials say such cases are on the rise, and a Florida health department investigator calls illegal silicone injections a "huge industry." Officials also say they are seeing more cases of unlicensed laser hair and tattoo removal.
Why Do They Do It?
These operations may seem obviously unsafe in hindsight, but experts say many people are too cavalier when deciding on plastic surgery. Embarrassment, desperation, the desire to save a buck, or excessive trust may send people to dubious cosmetic surgeons.
"We're all very susceptible to a non-licensed charlatan promising all sorts of things," said DiSpaltro.
In some cases, victims simply trusted their medical practitioner and never investigated their track record.
"They were bargain shopping, but they didn't know that he had a bad history," said Tim Johnson, senior investigator for the Riverside, Calif., district attorney's office, discussing the victims of Pirnia. "People tend to trust their doctors."
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.