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So maybe it shouldn't have been surprising when Channel 13 reporter Patrick Nolan discovered that Switch had been advertising Carlos Chaves's services. In a quarter-page ad that ran in Buena Suerte, a Spanish-language version of the Greensheet, large type proclaimed the salon's October special: a $29.95 permanent. In smaller type, Switch announced it was now offering other beauty services: permanent makeup, cellular regeneration, sensual-looking lips (explained as "relleno de labios," or stuffed lips) and something called "mesoterápia," mesotherapy, with which you can "eliminar grasa sin esfuerzo" -- eliminate fat without effort. Furthermore, to repair expression lines and scars, to raise your nose and cheekbones or enlarge your chin, the salon offered "cirujia sin vistury," surgery without a scalpel. (That last translation is tricky, since "vistury" is not a Spanish word. The writer apparently misspelled "bisturí" -- perhaps the salon's smallest lapse in professionalism.)
The ad pitches Chaves's treatments not as medical procedures, but as proud offerings of a full-service salon. In the context of other cosmetic-surgery ads, the concept doesn't seem that shocking; surgery comes to seem like any other image-enhancing commodity, not much different from a manicure or a Versace jacket. And if a dermatologist can legally perform a face-lift in his office, what's so shocking about lipo at the mall?
Kent Schaffer, Chaves's top-notch Houston defense attorney, says that really what his client was doing was no big deal. (Schaffer says this, of course, with the appropriate lawyerly stipulation: Even if his client was doing everything that prosecutors allege, it was no big deal.) Schaffer argues that doctors, eager to limit all forms of competition, have lobbied for too-strict definitions of "practicing medicine." Almost any form of health-related help could fit under that definition, he says, even giving a friend an aspirin.
Chaves performed "liposculpture," Schaffer explains, which is "not classical liposuction, not under general anesthesia, not potentially life-threatening -- a relatively minor procedure." Shaffer says that liposculpture is common in South America and is often used in the U.S. as a follow-up to major liposuction, to smooth out little lumps and bumps. Relatively small amounts of fat are sucked out with syringes, not vacuum devices. A trained surgeon performing a piddling procedure, the lawyer argues -- why all the fuss?
But Chaves's own prices indicate that his lipo surgeries were more than minor. At Switch, talking to HPD's undercover cop, he cited a cost of $2,000. In Texas last year the average cost of a single liposuction -- performed by a member of the American Board of Plastic Surgery, the most trained and presumably most expensive group of plastic surgeons -- was only $1,461.
And according to plastic surgeons, "liposculpture" is simply a fancy word for liposuction, which is always dangerous. Whether done with a needle or a vacuum, says surgeon Long, the procedure requires completely sterile conditions. The most infamous liposuction deaths in Texas -- the two involving Hugo Ramirez, then a licensed gynecologist -- were blamed on infections contracted while Ramirez performed the procedures in his office. A doctor's office is obviously not as good as a hospital, but a hair salon is another matter entirely. Long can't imagine being able to properly sterilize surgical instruments in a beauty parlor. Sometimes, he says, he's even worried about haircutters' combs.
Long is also alarmed by Chaves's telling the undercover officer that liposuction on her stomach would take about an hour. "In my office, for me to put three liters of fluid in takes at least an hour," he says. "I'm sorry, hon, I'm really good and quick, but I can't possibly do even thighs in an hour."
Rod Rohrer, a Dallas M.D. certified by the American Board of Plastic Surgery, echoes Long's alarm: "The thing is, there's a big-time danger you can get a devastating infection, even if it's a 'small' procedure. And what if he sticks one of those needles in a bowel or lung? To say that it's not invasive shows how idiotic he is. Liposuction is not like an oil-and-lube job. You're taking someone's life in your hands."
Besides, notes Rohrer, suctioning out seven or eight pounds is not a small job. "Seven pounds," he says, "is a lot of fat."
At first Houston police believed that their mall doctor was Alberto Carlos Chaves, of Colombia. But they soon discovered he was actually Carlos Alberto Chaves, of Florida, and that he was out on bail, having been arrested in Miami for practicing medicine without a license.
Obviously it's not easy to keep track of Chaves. Police believe that he commuted to Houston once a week, on Tuesdays, and that he'd worked out of Switch at least since May. In the raid they confiscated a datebook that showed more than three dozen clients since summer. It also showed appointments as far back as 1991, but it's not clear where all of those appointments were kept. In the days after the arrest, the cops investigated tips that Chaves had worked out of other Houston salons, at other malls; they suspect, too, that he may have made similar weekly barn-storming stops in other cities, but so far they have no hard evidence.