‘i Was Skinned Alive’: Patients Say Cosmetic Surgery Chains Left Them Disfigured

But a associated investigation by KFF Health News and NBC News recovered that Sono Bello and different cosmetic room chains person been nan target of scores of aesculapian malpractice and negligence lawsuits alleging disfiguring injuries — including 12 wrongful decease cases revenge complete nan past 7 years.

Injured patients person accused nan chains of hiring doctors pinch minimal cosmetic room training, of failing to admit and dainty life-threatening infections and different vulnerable surgical complications, and of high-pressure income strategies that minimized information risks, tribunal records show. Sono Bello and nan different companies person denied nan allegations successful court.

“These group committedness to move you into nan fairest personification successful nan land, and nan risks aren’t often worthy nan reality,” said Sean Domnick, a Florida lawyer who heads nan American Association for Justice, a proceedings lawyers group.

Sono Bello’s Centeno disagrees. He said nan company’s ngo is to “help each and each 1 of our patients unrecorded their champion lives now.” Sono Bello offers “life-changing transformations” that heighten a person’s “appearance arsenic good arsenic their value of life,” said Centeno, a surgeon himself astatine nan company’s Troy, Michigan, office.

The doctors who execute specified surgeries, tribunal records show, are sometimes paid much for taking connected patients pinch a precocious assemblage mass, arsenic obesity raises nan consequence of devastating complications.

And arsenic nan chains grow, there’s small regulatory oversight. While nan Food and Drug Administration maintains a database of complaints astir narcotics aliases aesculapian devices, there’s thing akin for cosmetic surgeries.

Schaeffer had liposuction astatine Sono Bello successful January 2024 and was satisfied pinch nan results. On nan greeting of March 29, 2024, she went successful for much liposuction and a mini-tummy tuck that Sono Bello calls AbEX. The aesculapian unit gave her Xanax, a tranquilizer and nan painkiller oxycodone successful pill form, according to aesculapian records Sono Bello turned complete to Schaeffer’s attorney. During nan procedure, she received an infusion of lidocaine to numb nan area but remained awake. Sono Bello says nan section anesthesia is safer and promotes faster treatment pinch “minimal discomfort,” truthful patients whitethorn return to activity aliases different normal activities wrong a week.

That didn’t hap for Schaeffer, who said she felt truthful overmuch symptom during nan cognition that she began to outcry and “begged” nan expert to extremity adjacent nan end.

“I said, ‘I don’t attraction what I look like,’” she said successful an interview. “‘I can’t grip nan pain.’”

Two days later she spiked a fever, and a time aft that her pubic area swelled up “severely,” she said. Sono Bello aesculapian unit told her that was normal and that she was fine, she said. Two days later, however, humor and fluid spilled retired of her tummy erstwhile she sewage up, she said.

On 1 sojourn to nan office, Herrera told her she required room astatine a infirmary to dainty her wounds. But, she recounted, Herrera said he couldn’t put that because he was an obstetrician, not a integrative surgeon, and didn’t person infirmary privileges locally. Herrera has infirmary privileges successful nan Orlando area, astir 140 miles southwest of Jacksonville.

“I was conscionable successful utter shock,” Schaeffer said.

Sono Bello spokesperson Mark Firmani said nan institution does not require its doctors to person section infirmary privileges, though galore do person them.

Centeno said Schaeffer’s achy acquisition is not common.

“The reality is that complete 90% of our patients who person our procedures completed are highly comfortable during nan process and they do rather well,” he said. Patients of Sono Bello and immoderate different clinics besides person complained to the Better Business Bureau of unexpectedly achy procedures.

Centeno said that Herrera still useful for nan company, but nan doctor’s sanction does not look connected nan company’s Jacksonville website. Herrera runs an OB-GYN and aesthetics practice, which includes tegument attraction treatments, successful Winter Garden, Florida, adjacent Orlando, and is board-certified by the American Board of Obstetrics & Gynecology.

Sono Bello has considered him a rising star; Herrera’s activity successful 2023 won Sono Bello’s yearly “New Talent Award,” fixed to a institution expert who exhibits “exceptional method skills, productivity, and off-the-charts marque loyalty.”

Herrera completed a Sono Bello fellowship program that teaches a “suite of artistic procedures” successful a six- to eight-week people nether nan guidance of a institution surgeon. The institution says nan fellowship offers “patient-focused training successful awake full assemblage contouring and tegument excision procedures.” Sono Bello allows physicians who person completed general residencies successful much than half a twelve types of room to use for its fellowship.

In a station connected a Sono Bello website, Herrera said that earlier taking nan fellowship course, he “had been a skilled surgeon for complete 13 years pinch extended acquisition successful different areas but constricted knowledge connected assemblage sculpting.” Herrera did not respond to calls and emails requesting remark and directed Sono Bello to respond connected his behalf. Company spokesperson Firmani said Herrera is still a personnel of nan Sono Bello team.

Many established integrative surgeons who said pinch KFF Health News and NBC News worry that concatenation room groups whitethorn beryllium inclined to walk much effort connected trading and income than connected making judge their doctors are decently credentialed and tin of handling immoderate complications that arise.

Medical practices owned by backstage equity aliases finance firms person much money to walk drafting successful patients, and “the expertise to run and supply value diligent attraction is now little important,” said Mark Domanski, a integrative surgeon successful bluish Virginia.

Doctor entrepreneurs

Formed successful 2008 by entrepreneurial expert Tom Garrison, Sono Bello now runs much than 100 centers nationwide. Private equity investors person pumped $816 cardinal into nan company, astir of it since 2023, according to PitchBook, which tracks nan industry. Sono Bello advertises wide connected tv and online, aimed astatine what 1 awesome investor termed nan “everyday female and man.” It has advertised having “150+ board-certified surgeons who person performed complete 300,000 laser lipo & assemblage contouring procedures.”

Sono Bello limits its offerings to services specified arsenic liposuction and its type of tummy tucks, which it believes its surgeons person mastered. It does not execute Brazilian butt lifts, aliases fat transfers, though galore different cosmetic room chains do.

While Sono Bello boasts that nan immense mostly of its patients are satisfied, tribunal records show that allegations of substandard aesculapian attraction person trailed its accelerated growth.

Sono Bello and its firm affiliates and surgeons person defended much than 60 aesculapian malpractice cases, including 4 suits involving diligent deaths, since April 2013, tribunal records show. Sono Bello has settled 3 of 4 wrongful decease cases revenge since May 2018, while 1 is pending, tribunal records show.

Schaeffer’s suit successful Jacksonville is among astatine slightest 19 revenge since nan commencement of March 2023. Many are pending successful nan courts, and nan institution has denied nan allegations.

Other physicians who person extended their brands to aggregate cities and relied heavy connected societal media and splashy websites to bring successful patients person besides faced lawsuits.

Mia Aesthetics, formed successful 2017 by Texas surgeon Sergio Alvarez, runs a twelve cosmetic room clinics from Miami to Las Vegas. Mia Aesthetics provides “the highest value integrative room astatine affordable prices proving that being beautiful and redeeming money are 2 realities that tin beryllium simultaneously,” its website says. Alvarez is simply a board-certified integrative surgeon.

Patients revenge astatine slightest 30 aesculapian negligence cases against Mia Aesthetics and its affiliates from November 2020 done March of this year, tribunal records show. A twelve suits target its Miami room center. The institution has sought, and often won, dismissal of malpractice suits because patients signed contracts agreeing to arbitration of immoderate disputes, tribunal dockets show. Alvarez did not respond to requests for comment.

Owned by New York expert Sergey Voskin since 2016, Goals Aesthetics and Plastic Surgery has branched retired from a mini cosmetic room agency successful nan Brooklyn borough of New York City to a web of a twelve room centers it manages successful 8 states.

Goals clinics and affiliated surgeons person been named arsenic defendants successful astatine slightest 40 malpractice suits revenge from October 2018 done March, tribunal records show. The Atlanta branch accounted for much than 20 specified cases successful Georgia courts from September 2022 done June 2024. Most are pending. Goals defended 2 lawsuits brought by nan families of New York patients who died soon aft having liposuction procedures, tribunal records show. Goals denied nan allegations and won dismissal of immoderate cases by invoking arbitration agreements, according to tribunal dockets. The institution says these agreements are commonly utilized passim nan aesculapian industry.

Voskin declined to beryllium interviewed. In a statement, Goals lawyer Joshua Lurie said nan aesculapian offices it manages person performed much than 10,000 procedures and person “one of, if not nan highest way records of information among akin types of aesculapian practices.”

Lurie said nan “vast majority” of malpractice claims are “meritless.” These “bad religion filings create an accusation of consequence erstwhile nary beryllium and when, again, location is simply a very negligible antagonistic result from room compared to nan full procedures performed,” he wrote.

No Guarantees

Malpractice suits by themselves are not impervious of wrongdoing. Nobody tracks nan result of these lawsuits, which often are settled nether confidential position that support cardinal specifications retired of nationalist position and prohibit patients from discussing their experiences. Surgeons often reason that complications are a consequence of room and that a mediocre result doesn’t mean nan expert was negligent. To beryllium negligence, injured patients mostly must show their attraction fell beneath what a reasonably prudent expert pinch akin training would person done.

That tin beryllium a challenge. Typically, nan room chains conflict backmost by arguing that complications are a consequence of immoderate surgical process and that they ne'er guarantee results.

Before their procedures, patients must motion consent forms acknowledging their expectations must beryllium “realistic” and that complications aliases dissatisfaction pinch nan consequence does not needfully mean nan surgeon botched nan job. The American Society of Plastic Surgeons investigates morals complaints against its members, but not allegations of incompetence aliases malpractice.

Some presurgery contracts let for low-cost “revisions” for disgruntled patients. Sono Bello has offered a “satisfaction commitment,” which states: “If your surgeon’s information determines your results to beryllium deficient, we will touch up nan area astatine nary costs to you.”

Other contracts incorporate disclaimers, specified arsenic reminding patients that melodramatic “before and after” photos wide shown successful online advertisements and different solicitations whitethorn not bespeak emblematic results.

Demonstrating nan power of societal media successful driving sales, Goals erstwhile required patients to motion a nondisparagement clause. The statement stated that patients who bad-mouth nan institution connected societal media without first giving nan institution “an opportunity to remedy immoderate alleged issues” work together to salary damages of $10,000 for each violation.

In a civilian investigation of Goals’ trading tactics, Georgia Attorney General Chris Carr alleged that argumentation and others violated authorities user protection laws. In September 2022, Goals agreed to extremity utilizing nan nondisparagement clause and to salary nan authorities $119,480 to settee nan matter, without admitting immoderate wrongdoing.

Both Goals and Mia Aesthetics person clauses successful their work contracts that require arbitration of immoderate disputes successful lieu of tribunal action, a process galore user advocates judge favors nan industry. These agreements are becoming much communal among integrative surgeons. The arbitration clauses person prevented immoderate aggrieved patients from getting their time successful court.

That happened successful a wrongful decease lawsuit revenge by nan family of Angela Mendez, 57, who was recovered dormant successful her flat a time aft liposuction astatine a Goals agency successful New York City successful March 2021. She died from a pulmonary thromboembolism, a humor clot successful her lung, arsenic a complication of cosmetic surgery, according to an autopsy report.

Her family sued nan institution alleging negligence. But successful June 2024 a judge ruled that Mendez had signed a shape requiring that nan lawsuit beryllium heard successful arbitration and dismissed nan lawsuit.

Attorney Gary Zucker, who represents nan family, is appealing. “It’s been a one-two punch for nan family,” Zucker said.

Goals lawyer Lurie called arbitration “a communal believe passim nan manufacture and galore industries” that is “intended to velocity nan process to travel to resolutions successful a much expedited fashion.” In a 2023 deposition, Lurie said patients tin opt retired of nan arbitration agreement, which “has happened aggregate times.”

‘A Hard Sell’

When Erin Schaeffer first visited Sono Bello, a income supplier told her she was a “perfect candidate” for a tummy tuck procedure, she said successful an interview with KFF Health News and NBC News.

Though she wanted to deliberation astir it and talk it complete pinch her family, she says nan salesperson persuaded her to spell ahead. Because cosmetic room is elective, security doesn’t screen it. Schaeffer made a down costs and signed up for a in installments plan through extracurricular companies to repay astir of nan $19,838 measure complete a five-year period, according to her aesculapian records. She said she’s now paying $420 a month.

“I decidedly felt for illustration it was a difficult sell,” Schaeffer said. “She didn’t want maine to time off retired of location without putting money down connected it.”

Schaeffer said she didn’t meet nan expert until astir a week earlier nan procedure, and only briefly. Some patients suing different companies person based on successful tribunal filings that they didn’t meet nan surgeon until nan time of their operations, a believe that draws crisp disapproval from much accepted surgeons.

Scott Hollenbeck, president of nan American Society of Plastic Surgeons, said patients request clip pinch their expert to afloat understand nan pros and cons of room and shouldn’t beryllium pressured into speedy decisions.

“It is not imaginable to do that erstwhile you spot nan expert an hr earlier room for nan first time,” he said. “You should person clip to process what they told you, deliberation astir it, and make a decision.”

“That is champion done pinch a surgeon, not a marketer,” Hollenbeck said.

Good Candidates

Many integrative surgeons discourage obese group from undergoing liposuction and different cosmetic procedures because of an elevated risk of infections and different superior aesculapian complications. Candidates are considered obese astatine a assemblage wide index of 30 aliases above. Sono Bello patients person an mean BMI of 31, according to Centeno. At nan clip of her surgery, Schaeffer had a BMI of 36.

But there’s nary statement connected who should beryllium turned distant because of their size — and policies vary.

Sono Bello says its AbEX tummy tuck tin beryllium done safely pinch a assemblage wide scale arsenic precocious arsenic 42, good beyond nan assemblage wide limits for a accepted abdominoplasty done utilizing wide anesthesia. The AbEX removes loose and sagging tegument astir nan tummy “to execute a much toned and sculpted look,” according to nan company.

Centeno said that precocious BMI “does confer further risk, which tin beryllium managed.” But he said it would beryllium “discriminatory, unethical and inappropriate for Sono Bello aliases immoderate different aesculapian believe to contradict attraction to a diligent based solely connected their BMI.”

Yet high-BMI patients person alleged they suffered devastating complications, according to KFF Health News’ reappraisal of tribunal cases revenge against Sono Bello and different companies.

One diligent is Marissa Edwards, past 45, a California aesculapian receptionist pinch 3 children. At 5 feet, 3 inches tall, she weighed 237 pounds, pinch a assemblage wide scale of 41.

She had AbEX and liposuction astatine a Sono Bello session successful San Diego connected Oct. 11, 2022, according to tribunal filings. During an agency sojourn 8 days later, she complained of swelling and symptom successful her abdomen, but a caregiver “dismissed her complaints,” according to nan suit. On Nov. 4, Edwards noticed nan incision was opening, while a rash formed astir her belly button. In a matter to Sono Bello, she attached a photograph of her wound, which, nan suit alleges, should person alerted nan unit that it needed “immediate information by a qualified aesculapian professional.”

On Nov. 5, she woke up “feeling highly hot” and “nearly fainted,” according to her complaint. Her hubby drove her to an urgent attraction center, which diagnosed her pinch sepsis and rushed her to a infirmary by ambulance.

When she awoke nan adjacent morning, her bedsheets were soaked pinch assemblage fluid. As she stood up, “fluid began to move retired of her tummy and deed nan floor,” according to nan complaint. She spent six days successful nan hospital.

Edwards alleges successful her suit that Sono Bello’s aesculapian unit grounded to admit and respond to early signs of trouble.

“I person sepsis and could person died,” she texted to Sono Bello’s agency line, according to tribunal documents. “I americium very upset.”

In 1 matter that was included successful her lawsuit, she wrote: “So I would admit immoderate type of empathy from you!! If you only knew what I person been done and you went done this I’m judge you wouldn’t beryllium giving maine this snotty attitude.”

Sono Bello denies immoderate negligence. In a tribunal filing, nan institution noted that infections are a consequence of surgery, and that Edwards had signed a consent shape that stated successful part: “The believe of medicine and room is not an nonstop subject and results are not guaranteed.” Sono Bello revenge a mobility for summary judgement that based on her attraction was not negligent and “not a important factor” successful causing her alleged injuries. The lawsuit was settled earlier this period nether confidential terms.

Value Units

While patients pinch precocious BMI are riskier, they besides are much lucrative for Sono Bello surgeons, tribunal records show.

The institution pays its surgeons for procedures based successful portion connected nan patient’s BMI, utilizing a look it calls a “surgical worth unit.”

The compensation scheme surfaced successful a suit revenge successful December 2023 by Shirley Webb, past a 79-year-old Nevada woman. Hoping to slim down for a dream cruise, she paid $14,703 for an AbEX tummy tuck and liposuction of her tummy astatine nan Sono Bello branch successful Las Vegas.

Eighteen days aft her operation, she was “oozing and bleeding” from her surgical wounds and her boy rushed her to a hospital, wherever doctors diagnosed “severe sepsis pinch shock,” according to nan complaint. She spent respective months successful hospitals and rehabilitation care, moving up aesculapian bills of much than $2.6 million, her lawyer stated during a deposition.

Lloyd Krieger, a California integrative surgeon who served arsenic a aesculapian master for Webb’s ineligible team, said nan operations ne'er should person happened because she was astatine “very precocious consequence for aggregate procedures fixed her precocious property and precocious BMI,” according to nan suit.

In a tribunal deposition, Sono Bello surgeon Charles Kim testified that operating connected Webb earned him “surgical worth units” that boosted his salary to astir $2,000 for nan procedure.

Sono Bello and Kim denied Webb’s negligence claims and nan parties settled nan lawsuit successful early 2025 nether confidential terms, tribunal records show.

Centeno said Sono Bello surgeons are paid much for higher-BMI patients because they “require further activity and further complexity successful position of decision-making.” He added that “our high-BMI patients routinely acquisition our procedures safely pinch an highly precocious diligent restitution rate.”

Schaeffer said group hoping to reshape their bodies request to do a batch of investigation earlier plunging up pinch integrative surgery. She said she was hoping to get free of excess tegument and fat aft dropping 100 pounds.

Instead, she missed 7 weeks of activity recovering from her tummy tuck successful Jacksonville. “I went into this process to effort to make myself consciousness amended aft losing nan weight, and I came retired pinch thing moreover worse,” she said.

“I trusted. I believed successful what they told me, which I deliberation astir group do,” Schaeffer said.

“Not anymore.”

KFF Health News is simply a nationalist newsroom that produces in-depth publicity astir wellness issues and is 1 of nan halfway operating programs at KFF — nan independent root for wellness argumentation research, polling and journalism.