Rogue ‘beauty treatments’ claim victims from Salinas to Miami.

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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.”