'It's food, drink and injections'
By THOMAS C. TOBIN
© St. Petersburg Times, published April 18, 2001
FORT LAUDERDALE -- A new epidemic has come to South Florida, brought on by greed, self-loathing and the quest for beauty.
Thousands of people are submitting to illegal cosmetic injections to their faces, breasts, hips, buttocks and calves, state health officials say. Most often, the officials say, the person doing the injecting is not a licensed doctor, and the substance in the needle is liquid silicone, which the Food and Drug Administration has banned for injection into humans.
Vera Lawrence, a 53-year-old Miami secretary and mother of two, died last month in the Broward County suburb of Miramar with 36 fresh needle marks in her hips and buttocks. She allegedly was injected in a friend's apartment by Mark D. Hawkins, a 36-year-old Greenville, S.C., man who also worked as a house cleaner.
Hawkins was charged with manslaughter, third-degree felony murder and practicing medicine without a license after an autopsy showed Lawrence died from a silicone embolism in one of her lungs.
Others have complained to state officials about disfiguring and painful side effects from botched cosmetic injections, including permanent nerve damage, cysts, bulges, bruises, bleeding from needle sites, even herpes infections from dirty syringes.
And in a quirky South Florida twist, many of the procedures are taking place at in-home gatherings that resemble Tupperware parties or multilevel marketing meetings, said Enrique T. Torres, chief investigator for unlicensed activity with the state Health Department.
A woman told state investigators she went to such an event in a Fort Lauderdale warehouse district, where wine, low light and music set the mood.
Recently a group of freshly injected women were seen leaving a condo in the comfortable Miami suburb of Aventura. A local television crew spied them patting their numbed faces and studying their reflections in car windows.
No arrests were made in that case, but an investigation continues.
"It's food, drink and injections," Torres said. "They gather, they eat, they drink, they have cash and everybody watches."
Some customers can well afford to pay for legitimate treatments but are lured by claims that silicone injections, still legal in some countries, are more permanent than the collagen injections they can receive legally in the United States.
Less discriminating are the poor and middle-class customers who turn to unlicensed practitioners simply to save money.
The customers range from models and wealthy homemakers to people with advanced AIDS who want to plump their gaunt faces. They also include a significant number of male transsexuals -- men who believe they are women and who find that injections to the cheeks, lips, breasts, buttocks and calves help them appear more feminine.
Investigators are working on a handful of cases in other parts of the state, some as far north as the Panhandle. The problem also has surfaced across the country. But in Florida, it is largely a South Florida phenomenon.
The state began cracking down on illegal cosmetic injections about 18 months ago with an initiative dubbed "Operation Hot Lips," though investigators say it appears the problem has been around much longer and is more prevalent than anyone imagined.
The autopsy of Vera Lawrence, for example, turned up old needle marks and other evidence that she had undergone injections for some time.
In addition, police think that Hawkins, the man accused of injecting her, is the same man whose injections recently sent a Charleston, S.C., woman to the emergency room for pain and lumps in her breast.
The woman complained in a call last month to the South Carolina Medical Association, saying that a man she knew only as "Mark" had been injecting silicone for years, and that his clients included exotic dancers in South Carolina. She also said he often brought his trade to Miami.
"When we were formed they always knew a problem existed, but we uncovered Pandora's box," said Torres, the state investigator, who estimated his seven-person unit has its thumb on less than 1 percent of the problem.
"This is in every corner, everywhere, because there's money to be made and people want to look good," he said. "If the state would be so kind as to give me 10 more investigators, they would be over-loaded the moment they started work."
People with problems from the injections show up almost daily at the Coconut Grove office of Mariano E. Busso, a noted dermatologist who teaches at the University of Miami.
"Some people get good results, but we see a lot of complications, and the complications can happen at any time during your lifetime," Busso said.
Recently, he hospitalized a woman who got a silicone injection on her smile lines in 1993. "Eight years later, her face blew up like a balloon," Busso said.
One cheap injection of silicone can migrate to other parts of the body, cause inflammation and cost thousands of dollars to correct with a gradual regimen of steroid injections or surgery, he said.
Across South Florida, the cases are beginning to pile up.
On March 29, investigators arrested David Blanco, a 45-year-old Venezuelan man who for years had come to Miami once a month to perform unlicensed cosmetic injections with silicone and other products.
One day in 1999, undercover investigators watched as a steady stream of people entered a small Miami apartment and waited in the cramped living room for the man they knew only as "Doctor David." In the suitcase he brought from Caracas, Blanco, who is not a doctor, always carried a crude brochure. Written in Spanish, it was a hand-drawn face with arrows connecting prices with body parts.
Labios (lips) $200. Patas de Gallo (crow's feet) $250. Moldear Nariz (nose job) $250.
Most of the 200 to 300 people on his client list were AIDS victims who lost weight and wanted to improve their appearance, Blanco told investigators.
In another recent case, investigators raided the apartment of a Miami transsexual whose bedroom was outfitted with a leather treatment chair and an array of syringes, anesthetics and injectable substances. The stainless steel instrument cart was as spotless as a licensed physician's, but the signs of illegal injections were everywhere.
The woman, once known as David, had just paid nearly $1,700 for four 40-pound tubs of a clear silicone product used for sterilizing medical implements. Traces of the substance were found in some of the syringes recovered from the trash.
In September, Angelina McCabe, 48, was arrested in Palm Beach County as she networked through local beauty salons to get referrals for her lip injection business. Although licensed as a registered nurse, McCabe had no authority to perform the injections on her own, investigators say.
She was reported by a salon owner who suffered pain, bleeding and swelling after a free trial lip injection from McCabe. Doctors later said the victim suffered a severe staph infection. A worker in another salon reported getting herpes from one of McCabe's needles, according to a state report.
In addition to $2,200 cash in McCabe's medical bag, investigators said they found used syringes and implements covered with dog hair.
While their efforts are aimed at unlicensed practitioners, investigators lamented in interviews last week that they also are in the business of saving consumers from themselves.
While most victims believe they are being treated by licensed doctors, they almost never check. Others are aware of the situation but do not view cosmetic procedures as medical treatment.
Regulators are up against a sociological tidal wave. More than 60 percent of Americans surveyed last year say they approve of cosmetic surgery and nearly 80 percent say they wouldn't be embarrassed to have it -- up from the previous year, according to the American Society for Aesthetic Plastic Surgery.
Surgical and non-surgical cosmetic procedures performed legally in the U.S. increased 25 percent last year and were up a whopping 173 percent between 1997 and 2000, the society found.
Baby boomers led the way, and wrinkle-reducing injections were by far their most popular cosmetic fix.
The trend of illegal injections is only magnified in cities like Miami, where a thriving glamor culture collides with a large population of immigrants. Investigators say 70 percent of injection victims they see are from countries where medical care is delivered in more casual settings like a doctor's home.
"They are playing Russian roulette with their health," said Torres, a former Florida state trooper who is befuddled by the obsession with beauty.
"If God didn't give it to me, I don't want it," he said. "There is no magic pill."
- Thomas C. Tobin covers issues across the state of Florida and can be reached at 727-893-8923 or by e-mail at firstname.lastname@example.org.
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