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At a minimum, Chaves was working out of Houston and Miami, both serious cosmetic-surgery towns, and rich markets for plastic surgeons. The cities' high rates of cosmetic procedures are often attributed to heat and humidity, and the skimpy clothes those demand. But there's more to it than that: Miami and Houston are both wide-open cities, places where it's easy to start fresh, to imagine yourself improved, richer or more powerful or prettier. They are cities of self-made men and women, Gatsby-like characters who reshape themselves to fit their dreams. How could they not love cosmetic surgery, which allows them, literally, to assume a new shape?
But in unlicensed cosmetic surgery, Miami clearly has the edge over Houston. Houston's unlicensed practitioners are usually dentists offering cut-rate services to Mexican immigrants. Miami attracts more unlicensed doctors -- Argentines catering to an Argentine clientele, Bolivian doctors to Bolivians, and so on. Among the unlicensed, cosmetic surgery is a popular specialty. "It's not an uncommon crime here," says Ed Griffith, a spokesman for the Florida State Attorney's office. "Not our most common, but not uncommon." (To capture the public's attention in Miami, a case has to be as lurid as the recent saga of Reinaldo Silvestre, who hideously botched several surgeries. One patient, a former Mr. Mexico and runner-up for Mr. Universe, had hoped to have his pectorals enhanced. Silvestre used the wrong implants, and the bodybuilder woke up with female breasts.)
Spanish-speaking immigrants provide a ready market for unlicensed doctors, Griffith explains. Not only are they more willing to venture outside normal American medical channels, they often prefer a doctor from their homeland, licensed or not. And Spanish-speaking immigrants are less likely than American-born Anglos to report unsatisfactory experiences to authorities. Sometimes the immigrants aren't legal residents; sometimes they're just unfamiliar with the American legal system; and sometimes, Griffith says, class bias prevents complaints. The patients tend to be working-class or poor, and assume that doctors walk on water.
Cosmetic surgery confers a similar advantage to the unlicensed doctor: Dissatisfied patients often hesitate to discuss their problems. Complaining about a botched tonsillectomy is one thing, but you have to be extraordinarily angry to go public about lopsided breasts or a penile implant gone wrong.
In Miami, Beatriz Diaz was angry enough to complain.
In the fall of '97, Sandra Marti was giving Beatriz Diaz a facial. Salons everywhere encourage intimacy; it somehow seems reasonable that if you trust someone with your hair or skin or nails, you can trust her with your secrets. And at this salon, in Kendall, just outside Miami, Beatriz Diaz trusted Sandra Marti enough to confide in her. Diaz was entering her forties and had endured her last pregnancy a decade before; now, she told Marti, she'd like to shore up her appearance with cosmetic surgery -- collagen injections for her lips, a tummy tuck and breast implants to take her from a B cup to a C.
Marti recommended a clinic: Christian people, she told Diaz, who are real good. Diaz made an appointment in November.
The clinic turned out to be a house at 6271 Coral Way. That fact didn't jar Diaz. In Miami, it's not unheard-of for legitimate clinics to operate out of houses, and certificates and diplomas were hanging on the walls. Besides, the clinic's sound system was playing Christian music; Diaz liked that.
She was greeted by Mayra Vazquez, a Spanish-speaking woman just turned 50. Diaz told her what she'd come for, and Vazquez agreed to handle the collagen injections herself, right away. But once they were immersed in the procedure, Diaz worried that Vazquez was handling the needle awkwardly; Vazquez responded that she was nervous. Diaz decided to cut her some slack.
Mayra Vazquez had described her husband, Alfred, as a doctor, and after the injections, Diaz spoke to him. He advised her to have the tummy tuck and breast-implant surgeries one at a time, and he scheduled her for an examination by his partner, whom he called "Dr. Chaves."
Both Alfred Vazquez and Carlos Chaves performed the exam; they advised Diaz that she'd need liposculpture before the tummy tuck. Diaz agreed to pay $1,600 for the procedure, and on the appointed day, her trusted cosmetologist, Sandra Marti, escorted her back to the house at 6271 Coral Way. Alfred Vazquez gave Diaz some pills and took her to an upstairs room, where he assisted Chaves.
Diaz isn't sure what drugs Vazquez gave her, but she remembers their effects: She was conscious but unable to move. She could see Chaves and Vazquez injecting her with a liquid, then using syringes to remove her fat. And she could hear them talking. Somehow, she grew convinced that they didn't know what they were doing. She was terrified -- but, paralyzed, couldn't escape or even protest. "They were torturing me," she remembers. And: "It was terrible, terrible, terrible."
That night Diaz was sick with an allergic reaction and fever. She called the Coral Way office and was told that both doctors were out of town. Four days later, when Alfred Vazquez called to schedule an appointment to remove her stitches, he told her that an allergic reaction was normal.