Maria Olivia Aguirre-Castillo was in search of beauty. The Castroville woman could have opted for a nip here, a tuck there, perhaps a little Botox to get rid of the expression lines in her brow. Her butt, she seemed to think, needed a little plumping. At 46, she might have felt the years creeping up on her.

In her mind, at least, there was work to be done. And so, investigators say, on the morning of November 17, 2005, Aguirre-Castillo met with “a friend” in Castroville for some help.

The friend wasn’t a plastic surgeon, not someone who could have safely put silicone implants into Aguirre-Castillo’s buttocks or harvested fat from one area of her body and injected it where she wanted it. The friend wasn’t even a doctor. Or a nurse. But that didn’t stop Aguirre-Castillo.

Monterey County Sheriffs Department detectives say Aguirre-Castillo was injected multiple times into the folds of skin where the top of each thigh meets the buttocks with a syringe filled with some kind of filler, leaving multiple half-inch red bruises on her butt.

Though final test results were not available at press time, preliminary reports say the substance was Mazola corn oil, the same kind of cooking oil found in grocery stores everywhere and used in kitchens every day. The injections left multiple cyst-like lumps of thick gelatinous goop embedded deep into the skin of her buttocks.

Around 10am, according to investigators, Aguirre-Castillo was back at her Castroville home, where she began to feel the effects of the injected grease. She was hot, dizzy, and extremely thirsty. She then became confused and disoriented. Aguirre-Castillo fell to the floor and began convulsing.

American Medical Response responded to Aguirre-Castillo’s home and began life-saving procedures, then transported her to Salinas Valley Memorial Hospital (SVMH).

Once at SVMH, resuscitation procedures continued. For a week, Aguirre-Castillo remained comatose in the Intensive Care Unit, unaffected by her doctors’ efforts. Physicians ran blood tests, CT scans, EKGs. The areas around her heart, brain and chest cavity had become dumping grounds for excess fluid. Her lungs became swollen and engorged with pasty yellowy liquid.

Then, just before 2pm on Thanksgiving Day, Nov. 24, 2005, Aguirre-Castillo’s heart stopped beating, she stopped breathing, and she was pronounced dead. The coroner’s report attributes her death to “multiple organ failure due to systematic fat embolization due to massive subcutaneous fat necrosis due to injection of foreign material into buttocks.”

Dr. James Wells, the immediate past president of the American Society of Plastic Surgeons, did not treat Aguirre-Castillo, but he has read the Monterey County Coroner’s findings. He’s been board certified in plastic surgery since 1978, and before going into private practice in Long Beach, he taught at Johns Hopkins School of Medicine. He is currently a professor of plastic surgery at the University of California Irvine.

“Basically what happened was, after she was injected, the substance moved into her blood stream and then traveled throughout her body, affecting multiple organs like the lungs, brain and kidney, and there was no going back,” he says “That’s how she died.”

In the Monterey County Coroner’s Annual Report for 2005, Aguirre-Castillo’s manner of death was found to be an “accident.” The death was categorized as a “therapeutic misadventure.”

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As bizarre a notion as injecting one’s body with cooking oil might be, Aguirre-Castillo’s death was not an anomaly. Stories abound about people dying or becoming severely disfigured from the same kinds of underground beauty treatments.

“People are injecting just about anything these days,” Wells says.

The most common is industrial-grade silicone: caulking. As in the same kind of gummy, sticky substance used to seal a shower, to set a toilet, to seal up seams on siding or baseboards—the kind of over-the-counter product found in any home-improvement store.

Wells has had to perform complete mastectomies on women who had their breasts injected with industrial-grade silicone. “One man came in and had been injected in his penis with the same kind of thing. There wasn’t much we could do for him, either,” Wells says.

The deaths and maimings are multiplying.

In July of 2005, Patricio Gonzalez of San Diego died after receiving illicit silicone injections. A warrant remains outstanding for the arrest of Sammia “Angelica” Gonzalez, the woman suspected of administering the lethal injection to Gonzalez and at least nine others.

Similar cases exist in Houston, New York, and Georgia.

As widespread as the practice of rogue beauty treatments has become in recent years, South Florida has become a virtual hot spot for the back-alley procedures. Those in search of fixing a little of this or that go to so-called “pumping parties” and are injected with substances that boggle the mind: brake fluid, Super Glue, paraffin, saline, oil, or peanut butter, diluted so the material goes through the syringe more easily.

In 2003, two Florida juries convicted Mark Hawkins and Donnie Hendricks for their roles in the death of Vera Lawrence, a transgendered woman who wanted to enhance her buttocks. Hawkins and Hendricks each injected 12,000 cubic centimeters of industrial-grade silicone into each one of Lawrence’s buttocks, killing her.

Jeremy Middleton testified at the trials of Hawkins and Hendricks, saying he couldn’t walk or talk after the procedures he received, procedures that often cost $1,000 per injection. “I was injected with bad silicone,” Middleton testified. “It was supposed to be used for furniture.”

Cory Williams also testified about injections by Hawkins and Hendricks. Williams was injected in his hips. “It hurts the first few times,” he says, “but in your mind, you want to be beautiful.”

Hawkins—who was convicted of murder, the unlicensed practice of medicine and negligence—was sentenced to 30 years in prison for Lawrence’s death. Hendricks was sentenced to five years for his role in the murder.

In 1998, responding to the desperate need to weed out so-called black-market doctors, the Florida Department of Health opened an Unlicensed Activity Office. The only one of its kind nationwide, the unit exclusively investigates unlicensed practitioners who make a business out of injecting illicit substances into others. Since its inception, the department has investigated more than 4,000 cases. In Miami-Dade County alone, nearly 500 people have been arrested for such practices.

Even the Hollywood It-Crowd is in on the dangerous practice.

In late 2004, Diane Richie, the now-ex-wife of music legend Lionel Richie, was taken into federal custody for her role in the administration of illegal anti-wrinkle injections. Richie’s boyfriend, Daniel Tomas Fuente Serrano, was accused of using the Richies’ Beverly Hills home for what were dubbed “Hollywood House Parties.” At the time of the parties, the Richies were still a couple.

A Richie employee told investigators that 20 to 40 people went to the Richie estate to get injections from Serrano, also known as “Dr. Daniel.” While Serrano was licensed to practice medicine in Argentina, he was not recognized as a physician by the Unitied States. At some point after the parties, Serrano became a registered nurse in California.

Lionel Richie told investigators he believed Serrano was a doctor. Richie went on to explain that he, too, had received injections at the parties, often paying hundreds of dollars per shot.

According to court documents, the wrinkle-filler injections Serrano was delivering left one woman with a lump on her lip, while another developed holes in her face from the injections.

Diane Richie was later charged with aiding and abetting.

~ ~ ~

The lumps and bumps aren’t uncommon, nor is death.

Dr. Flor Mayoral is a dermatologist in Miami. He says he sees 10 to 15 patients a week who have been disfigured by underground injections. He describes lip-fillers that gave people parrot-like beaks. He says people who have had too much of the poison injected into their faces look hard, like cadavers.

Nevertheless, the search for beauty is intensifying, whether it’s on the straight and narrow or on the black market. According to the American Society of Aesthetic Plastic Surgeons (ASAPS), there were nearly 11.5 million surgical and nonsurgical procedures performed in the US in 2005, a 444-percent increase in just the past eight years. For nonsurgical procedures like Botox, Restylane and collagen injections during the same period, there’s been a 726-percent increase. There were just under 3.3 million Botox injections last year, and 1.2 million Restylane injections.

Marie Pletsch of Carmel has been practicing medicine as a board-certified plastic surgeon for 31 years. She says it’s all about availability—that prospective plastic surgery patients are simply taking advantage of what’s on the market. And, she adds, the reasons behind people choosing to go the illicit route instead of the traditional route are complex and not always about money.

“They’re looking for a filler, but not just any filler,” she says. “They want a permanent filler. Fillers we use aren’t permanent. Some are long-term, but they’re not permanent, which is good. If there’s a slight mistake with medical-grade injections, the stuff will be gone soon. But with the fake stuff, the industrial-grade stuff, if it’s permanent, then it’s also permanently harmful.

“We’re in an era where people want to determine what is done to them. They go into a beauty shop and tell the stylist how they want their hair done. That’s what we’re seeing in plastic surgery offices. They’re coming in and saying, ‘I want such and such’ instead of saying ‘These are my concerns; what do you suggest?’ No longer is the practitioner being used to advise them. Consequently—some of us say no—but there’s always someone else out there willing to do anything you ask them to do, like injections. And the profit margin is huge.”

While a silicone breast augmentation may cost $4,000 or $5,000 in the world of board-certified plastic surgeons, injections of industrial-grade silicone are a mere fraction of that. A legal collagen injection runs about $450. On the black market, the fake stuff can be as cheap as $50.

Allergan is the company that owns Botox. Their main office in Irvine was in a state of damage control earlier this month when Aguirre-Castillo’s death hit local newspapers.

“This was not ‘fake Botox,’ a spokeswoman says, “like your local papers and law enforcement are saying, ‘Why on Earth would anyone have Botox injected into their butt?’ It’s used to remove wrinkles, to relax muscles. I can’t imagine why anyone would ever think Botox was an appropriate thing to use in the buttocks.”

Later that day, Allergan issued a press release reminding people that the only safe Botox is registered Botox administered by a licensed physician.

Still, there are those who will seek beauty at any price, registered or not, administered by a physician or not.

Pletsch says the underground world of injections is one that’s gotten far out of control. “It’s in salons, spas. The state isn’t monitoring it, or isn’t monitoring it well.”

~ ~ ~

Dr. Mary McQuade is a psychiatrist in Carmel. She’s treated plenty of patients with what’s called “body dysmorphic disorder,” a condition that tells the brain there’s something wrong with the outside of the body. It’s not unlike an anorexic who doesn’t see the skin and bones looking back at them in the mirror.

“This is not a new disease,” she says, “it’s just that more people have access to beauty procedures nowadays. There are those who will always see what isn’t there. They have one problem fixed, but it’s still not right. They still don’t feel whole or right, and they spend all of their time thinking and worrying about it.”

McQuade says people who are affected by body dysmorphic disorders enough to continue to abuse their own bodies, despite the risks, rarely get the help they need.

“Those aren’t the people who go see psychiatrists,” McQuade says. “A psychiatrist will tell them what they don’t want to hear. As far as they’re concerned, they know the truth, and a psychiatrist will never agree with them.”

Dr. Wells agrees. “We’ve grown into a society of people doing something they have no business doing. But they’ll do anything to be beautiful to themselves. The problem is they never get to that level of being satisfied.”

Another problem, Wells says, is that people will inject themselves over and over again without side effects or disfigurement and figure everything’s fine.

“They read the stories and they think, ‘Wow, thank goodness that wasn’t me.’ Or they have friends who do it and see that nothing has ever happened to them, so they figure it’s an OK thing to do. That’s all well and good until something does go wrong, and then they’re afraid to seek help, embarrassed by their decision to be injected by God-knows-what to begin with.”

For some, there’s no going back, and they’re walking around with caulking or cooking oils embedded in their skin. Wells says it’s rarely too late to fix things that have already been done.

“Look for the warning signs: redness, swelling, a boil or abscess. You may not see anything for a few hours, a few days, a few weeks, even a few years,” he says. “But eventually, it’ll creep up. And it has to come out.”

Once it gets that far, or even before it does, Wells says it can be dealt with. “We’ll get the silicone or whatever is in there out, and we’ll get that person back to square one where they were before they started injecting, and then we’ll deal with it.”

But the best bet, Wells says, is to get good treatment from the outset.

“People, in their desire to seek the fountain of youth, will agree to have all kinds of things injected that will not be to their long-term benefit. Think about what you’re putting into your body and what you want to get out of it.

“Start out with a licensed MD. Get referrals and think about what it is you’re asking. Do your homework. It’s called informed consent, and it’s called responsibility.”

~ ~ ~

On March 13, after several months of investigation, the Monterey County Sheriff’s Department finally arrested Martha Mata Vasquez, a Salinas hairdresser, in connection with the injections given to Aguirre-Castillo and several others, including Aguirre-Castillo’s sister.

On March 21, Vasquez was formally charged with manslaughter, practicing medicine without a license, and an “enhancement” for causing great bodily injury for the weeklong coma suffered by Aguirre-Castillo before she died. If convicted of all of the charges plus the enhancement—which serves to lengthen a sentence for particularly bad behavior—Vasquez could serve as few as eight years in state prison for her role in Aguirre-Castillo’s death.

Since Vasquez’ arrest, cops say their phones have been “ringing off the hook” with new victims.

“We’ve identified about five victims so far,” says Monterey County Sheriff’s Department Investigative Sergeant Terry Kaiser.

Deputy District Attorney Steve Somers has been assigned to prosecute Vasquez. Somers says that while many victims have come forward, some can’t be included in the prosecution because the injections they received occurred outside of the statute-of-limitations period.

Cops don’t want that to play into whether or not victims choose to come forward, pointing out that while criminal prosecution may be unavailable to some victims, civil culpability may still exist.

“There’s a whole bunch more of them out there,” Kaiser says. “We know that. Some have come forward but don’t want to talk officially because they’re embarrassed. Some have never told their spouses or friends that they were getting the injections, and they just want to go on about their lives. That’s OK. We’re going with what we have.”

Investigators say Vasquez advertised her services at the New Image Hair Salon at Acosta Plaza in East Salinas, where she continues to work as a hairdresser. Vasquez was charging anywhere from $300 to $500 per injection.

“I don’t know what [Vasquez] told them the substance was. Something to get wrinkles out of their butts and to plump up the butt to get rid of dimples,” Kaiser says. “Who knows what has been injected into other victims: Vaseline, silicone, kerosene, or just about anything.”

Vasquez has hired Tom Worthington and Charlie Keeley, heavy-hitting Salinas lawyers familiar with high-profile cases, to defend her. Worthington has been practicing law for nearly 40 years. Keeley has spent most of her career working for the Monterey County District Attorney’s Office. They’re arguably the best local defense attorneys money can buy.

Keeley stood next to Vasquez when she was arraigned, entering “not guilty” pleas on her behalf. Such a plea is pretty much standard at such an early stage of the proceedings.

Worthington spoke later about his client.

“She’s scared,” he says. “She’s very upset. She’s devastated by the death of this woman, her friend. But she wants to face this thing head-on. She’s ready to deal with it.”

“It’s a tragedy all around,” Kaiser said later, “including the tragic death of an individual who tried to be more beautiful.

“The bottom line is, [Vasquez] was looking to make some money, and she hurt people in the process.”

Worthington says Vasquez has been candid with investigators, giving them specific details of her involvement from the get-go. He’s hopeful that that will later play in his client’s favor.

Somers isn’t ready to second-guess the case’s outcome but says what he really wants right now is public education.

“We’re really hoping people will understand what’s going on. We want people to come forward. We believe there have been a lot of people injected. Even if they don’t come to us, we want those people to see a doctor and get help. Someone died. It can happen again.”