Dec. 2, 2009 -- The former-miss Argentina 1994 died this week following complications from a gluteoplasty procedure to enlarge her buttocks, prompting public mourning in her country and a wave of raised eyebrows abroad.
Doctors say surgeries to enhance the buttocks are still rare in the United States, but that they have slowly gained ground in the past 10 years, both in board-certified practices at home, and among the growing number of patients who seek potentially dangerous bargains on buttock enhancement surgery in medical tourism abroad.
Solange Magnano, a 38-year-old model and mother of twins, remained in critical condition with acute respiratory deficiency for three days after her surgery in Buenos Aires, according to The Associated Press. Her friend Roberto Piazza told the AP that the procedure involved injections and the liquid "went to her lungs and brain."
Magnano died Sunday of a pulmonary embolism, officials announced.
Dr. Renato Saltz, president of the American Society for Aesthetic Plastic Surgery, said it was impossible to tell from news coverage whether or not Magnano's pulmonary embolism was just a rare complication that can happen after any surgery-- buttock augmentation included -- or if the death was the result of unsafe practices.
"I'm not sure if they're injecting fat, or if they're injecting silicone. Free silicone [not in an implant] is not approved to be used like this in humans in any country," said Saltz.
Pulmonary embolisms are a blockage to the main artery of the lung, often caused by a blood clot. If doctors were indeed injecting fat, Saltz said the pulmonary embolism was likely due to complications. Saltz said precautions such as patient screening, medications and postsurgical care can prevent blood clots in surgery.
However, anything loose in the bloodstream may cause an embolism, including silicone accidentally injected into a vein instead of the rear end.
"The danger is that [silicone] is a very unforgiving, viscous oil or gel -- if it's injected in any volume into the bloodstream ... it will migrate and it can block things," said Dr. Julius Few, director of the Few Institute for Aesthetic Plastic Surgery and clinical associate at the University of Chicago. "If the gel got in, it would be devastating."
If not for an embolism, there are other risks inherent to buttock augmentation surgery. Few said patients who do not choose injections may go for a single silicone implant rather than fat injections.
Silicone Injections, and Other Risks of Buttock Enhancement Surgery
Yet, the larger incision and location of the buttock augmentation implants puts people at a high risk for infection.
"When you're putting artificial implants into the area, it's going to be a higher risk area for infection," said Few. "With implants, the complication rate is 40 percent. …. With fat injections, the complication rate is very small -- in my experience the complication rate is 2 percent."
Few says new techniques, especially the practice of using a patient's own fat for injections, has made buttock augmentation surgery much more appealing to some.
"In the Latin American and African-American communities it is a popular procedure, it has fairly stable growth," said Few. "But in the U.S. it's not in the top five."
Buttock augmentation peaked in the U.S. in 2007 before the economic downturn slowed cosmetic surgeries. That year 5,325 people had buttock augmentation surgery and 3,787 people got a buttock lift from doctors certified by the American Society for Aesthetic Plastic Surgery. In 2002, 614 buttock augmentation surgeries were performed.
Doctors in the U.S. said an unknown yet significant number of people are also clamoring for buttock augmentation surgery abroad, and many of these patients show up in their offices with problems.
"I have no more details on what happened [with Magnano], but I have seen patients in my practice with large volumes of oils, gels, silicones injected. They can have a whole host of problems," said Few.
"One of the things that is popular, especially in South America and Europe, is injection of silicone," said Few. "In Argentina one of the draws is that it's less expensive. … It becomes tempting abroad to just shop for price."
Saltz agreed there are more patients who seek these surgeries abroad, especially if they are cheaper and more popular in that country.
"There are a lot of American patients who now for price reasons are going abroad -- and there are a lot of great surgeons abroad, but they are usually not the ones advertising on the Web, advertising with tropical locales on their backgrounds," said Saltz.
"We're very concerned because it seems like some of our U.S. citizens are being lured by the false advertisements … and it's your life," said Saltz. "Don't just go for less expensive operations."
Saltz and Few recommended patients check out the credentials of a plastic surgeon, check the anesthesiologist's credentials and check whether the surgery will be performed in an accredited office.
Without such checks, mishaps like the one that happened to two women in Florida this February may befall patients.
Sharhonda Lindsay, 32, of Tampa, who is not a doctor, surrendered to Tampa police Feb. 11 after two local area women went to police with injuries from a botched buttock augmentation.
One woman reputedly paid Lindsay $500 for 40 injections into her buttocks, and the other paid $250 for 20 injections of a homemade combination of commercial silicone gel and saline, apparently to enhance the appearance of their buttocks, according to police reports.
The women -- Andrea Lee, 30, and Zakiya Teagle Carswell, 33, -- ended up in the hospital with damage to their kidneys due to the injections.
The Associated Press and ABC News' Dan Childs contributed to this report.