Brazilian Plastic Surgeon Is Charged in Patient’s Death

RIO DE JANEIRO — A celebrity plastic surgeon has been charged in the death of a patient, in a case that has drawn attention to the dangers posed by risky elective cosmetic procedures in a country that is generally seen as being obsessed with beauty.

Prosecutors said the surgeon, Denis Furtado, who is known on social media as Dr. Bumbum, or Dr. Backside, injected the patient, Lilian Calixto, 46, with a far larger dose of PMMA — a synthetic resin that is also known as acrylic glass, and is used in cosmetic surgery to reduce wrinkles — than is considered safe.

The surgeon’s mother, Maria de Fátima Furtado, was also charged with assisting Furtado during the July 14 procedure — known as a buttock lift. Also facing charges were his girlfriend and an assistant, who acted as a surgical technician despite having no medical training.

Prosecutors said that neither Furtado nor his mother had a license to practice medicine in the state Rio de Janeiro, where the procedure took place.

According to the charge sheet, Calixto arrived in Furtado’s penthouse apartment, which was used as a makeshift clinic, on Saturday afternoon. About six hours later, once the procedure was over, she started feeling sick and was taken to a nearby private hospital. She died within six hours, of cardiac arrest.

The procedure, prosecutors wrote, was carried “under the false promise of immediate beauty, selfishly motivated by greed and an easy profit.”

Furtado, who has made repeated appearances on Brazilian television programs and has 650,000 followers on Instagram, took to social media to defend himself, maintaining that he had a doctor’s license in other states and that he had performed 9,000 procedures without incident. “I haven’t committed any crime,” he said.

As elsewhere, many people in Brazil consider beauty essential, not only to secure a partner, but also for career development and even social ascent.

One of the country’s best-known poets and composers, Vinicius de Moraes, who co-authored the song “The Girl From Ipanema,” also wrote a widely cited poem called “Woman Recipe” that begins: “May the very ugly ones forgive me, but beauty is fundamental.”

It is not uncommon for jobs in Brazil to require candidates to have “good appearance.” Women often cite workplace pressure in explaining their willingness to take risks and spend considerable portions of their income on aesthetic procedures.

Brazil and the United States are among the countries with the highest number of cosmetic surgeries. While breast implants and liposuction are still by far the most popular procedures, the demand for buttock augmentation has been sharply rising.

Silicone implants or fat transfers are safer means of attaining the similar results, but they are also more expensive procedures that require hospital care and greater recovery time, said Dr. Níveo Steffen, president of the Brazilian Society of Plastic Surgery.

“People are seduced by the promise of cheap, immediate results,” he said. “They see ads claiming they’ll walk out of a one-hour consultation with a new backside. But it’s a lie, and they end up paying the price.”

While the use of PMMA injections in buttock lifts is not illegal in Brazil, there are limits on the amount that can be applied, and the Society of Plastic Surgery has issued repeated warnings against performing the procedure.

“The chances of having complications are extremely high,” Steffen said. “It’s dangerous.”

There are 6,400 accredited plastic surgeons in Brazil but another nearly 12,000 doctors and self-titled specialists perform these procedures without proper medical training, according to the Society of Plastic Surgery.

The results are shocking: in one year alone, the injection of PMMA caused complications or deformities in nearly 17,000 patients in Brazil, according to a survey published by the association in 2017.

This substance, PMMA, grabbed headlines in 2014 when Andressa Urach, a runner-up in a Miss Bumbum beauty pageant, was hospitalized in septic shock after injections to build more voluptuous thighs.

“I had plastic surgery like I going to the supermarket,” she said at the time. “I wanted to take out ribs to have a slimmer waist. I wanted to cut off my toes to wear smaller shoes.”

She said that limiting the amount of PMMA allowed wouldn’t have stopped her: “I would have gone to four or five doctors, getting a little bit from each one.”

Since Furtado’s case was publicized, other cases of false doctors have come to light. Daniela Terra, a police commissioner who heads a precinct in charge of crimes against consumers in Rio de Janeiro, is working on the cases of a massage therapist and a nurse who used social media to advertise cosmetic procedures they weren’t legally allowed to perform.

Terra said that prosecuting these cases was difficult because patients tend not to come forward unless they have a severe complication, and because many unregulated procedures are carried out in private locations, such as apartments and hotel rooms.

The police are also investigating the case of another woman, Mayara Silva dos Santos, who died on July 20, after undergoing a similar procedure in a hotel room.

The victims, Terra said, are low- and middle-income women looking for cosmetic procedures that promise the same results as surgeries that would cost 10 times more if performed legally.

Unauthorized practitioners can charge $500 to $1,000 for a procedure on the backside, she said. The low price draws patients from other states and even other countries.

“It’s an obsession,” she said. “The cult of beauty is bigger than people’s concern for their health.”

The latest death might draw attention in Brazil to the dangers of PMMA and other risky procedures, but is unlikely to solve the problem, said Steffen.

In theory, state health authorities are tasked with ensuring laws are followed and doctors are accredited. But with Brazil only beginning to recover from its worst recession on record, state budgets are depleted and officials have been swamped by a string of health crises, including outbreaks of Zika and yellow fever.

Educating patients can also be difficult.

While many prospective patients are tempted by the cheap price tag, Steffen said the main allure of PMMA is the speed and relative ease with which it can be applied.

“They want a miracle,” he said.