Carlos Chaves, Mall Surgeon

Sure, an unlicensed doctor was performing liposuction at a hair salon. Stranger still: Clients kept showing up.

Even before the police raided Switch, the hair salon seemed out of place -- wrong for quiet, upscale Town & Country Mall, and especially wrong in the mall's quietest and most upscale end, nestled in the elbow between Neiman-Marcus and Saks. Money hangs heavy in the air there, and the refined hush is that of a museum or research library. Only a few shoppers glide past, elegant and rare as swans. These privileged beings outfit their pre-K daughters in DKNY separates at Neiman's, then check out the Kate Spade handbag collection at Saks; they are dead serious about their mall shopping, dead serious about choosing precisely the right makeup or gown or shoes, about presenting themselves and their families as tasteful, cultivated and beautiful. Buy this, this corner of the mall whispers to them, and you will be fabulous, you will be transformed.

Switch, though, didn't whisper. Its sign glowed in red neon; a beat-heavy dance mix, the stuff of nightclubs, pulsated from its speakers; a sign facing the mall atrium trumpeted low prices. If Switch belonged in Town & Country Mall at all, you figured, it was down at the livelier JCPenney end, where the promises are shouted rather than whispered, and those promises are not just of transformation, but of transformation at a bargain price.

On the morning of Tuesday, October 5, Liz Mihalco kept her appointment at Switch -- an appointment not for transformation itself, but to discuss transformation. Like many of Switch's customers, she greeted the receptionist in Spanish. She was directed past the stylists to the back of the salon, to the back rooms used for massages and facials and other, more private, services.

"The doctor": Even in his mug shot, Carlos Chaves looked the part.
Houston Police Department
"The doctor": Even in his mug shot, Carlos Chaves looked the part.
More Low Rider than W: Nellie Eleftherton, Chaves's assistant.
Houston Police Department
More Low Rider than W: Nellie Eleftherton, Chaves's assistant.
A full-service salon: In its ad, Switch offered cuts, color and lipo.
A full-service salon: In its ad, Switch offered cuts, color and lipo.
Bagged, tagged and stored in an HPD freezer: Fat from one of Chaves's clients.
Houston Police Department
Bagged, tagged and stored in an HPD freezer: Fat from one of Chaves's clients.

Back there, Mihalco talked with salon worker Nellie Eleftherton. Like the shoppers who glide past Switch, Eleftherton had obviously put thought into her appearance, but her style was less W than Low Rider. She wore a minidress and sandals; her hair was big and showy, permed and blond-streaked; her unnaturally full lips formed a pillowy bowtie worthy of a cartoon character or porn star.

In Spanish, Eleftherton asked Mihalco who'd referred her, and what procedure that person had undergone; Mihalco's answer must have been good enough, because she was then introduced to "the doctor." And 40-year-old Carlos Chaves looked the part: His salt-and-pepper hair was cut well, and he wore his green scrubs with the authority of a surgeon.

Surgery was what Mihalco had come to discuss. Chaves showed her a book of before-and-after photos of previous clients: eyelids, implants, lipo. Mihalco told him that she'd had four children, and asked him to look at her waist. He recommended "liposculpture," a procedure he said would take an hour, could be done there in the salon with local anesthetic and drugs for her nerves, and would cost $2,000, payable in cash. They set up an appointment for 4 p.m. the following Tuesday -- not earlier, he said, because he'd be performing lipo on another patient, one who was more seriously obese, and he expected that procedure to take three hours.

As you might expect, Chaves isn't exactly a doctor -- at least, not a doctor licensed to practice in Texas or anywhere else in the U.S. But likewise, Mihalco wasn't really a would-be liposuction client: She's an undercover officer with the Houston Police Department.

At the appointed time, Mihalco returned to Switch, this time with hidden police backup. She was given pills, and after she handed over $2,000 in unmarked bills, she signaled for the raid to begin. About a dozen officers rushed into Switch, herding its stylists and customers, some with suds or chemicals in their hair, to the front of the salon.

The spectacle proved irresistible. Local TV news stations dispatched camera crews; mall employees poured out of their stores, hanging over the upstairs balcony railing to watch the minidrama. Police handcuffed Chaves and the salon's bald owner, Victor Rodriguez. The pair hid their faces as officers led them through the mall promenade, and later that night the TV screen was dominated by Rodriguez's smooth scalp. But Rodriguez was not arrested, only taken in for questioning. Eleftherton and Chaves, though, were both arrested. Eleftherton was charged with improper disposal of biohazardous waste; Chaves, with practicing medicine without a license and distributing a controlled substance.

In back of the salon, police found Chaves's previous lipo client, and paramedics hustled her into an ambulance, to be checked out at Ben Taub. (Emergency-room doctors said she was fine and released her.) The room where the woman had been also contained syringes, bloody cloths and the piece of evidence that disgusted even the most hardened cops: two plastic bags of human fat, between seven and eight pounds of it.

Sergeant Doug Osterberg, the lead investigator on the case, had seen some strange cases in his 24 years as a Houston cop. But this -- this, he says, was special.

Special, yes; it's not every day you hear about lipo in the mall. But perhaps the strangest thing about the case of Carlos Chaves is that it isn't an isolated News of the Weird incident, a blip on the screen, an investigation of a lone wacko. What's strangest of all is that Carlos Chaves may simply be ahead of the curve -- on the cutting edge, so to speak, of cosmetic surgery. Like Switch in Town & Country Mall, he seems only a little out of place, only a little more dangerous and shameless than some legitimate cosmetic surgeons.

Chaves may not be licensed in the U.S., says his Houston criminal-defense lawyer, Kent Schaffer, but he is a trained surgeon. He attended medical school in Bolivia, at the Universidad Mayor de San Andreas, and has practiced for 12 years, including stints in both Bolivia and his native Colombia. Another of Chaves's lawyers, Victor Gutierrez of Miami, notes that Chaves has performed cosmetic surgeries, legally, all over South America, some of them under the supervision of noted plastic surgeons in Brazil. Gutierrez says he has talked to people who had work done by Chaves in other countries, and those people, he says, are highly satisfied customers.

In 1995 Chaves moved to Miami, where he has friends and family, but he remains a Colombian national. According to Gutierrez, Chaves applied for a physician's assistant license, and the State of Florida accepted his educational credentials; it's only the English-language tests that gave him trouble. According to Florida records, Chaves is instead licensed in two less demanding areas: to perform massage therapy, and to give facials.

Immigration lawyers say they've heard hundreds of similar stories, of immigrant doctors forced into other employment. It's extremely hard for a doctor, trained and licensed in a foreign country, to continue practicing his profession in the U.S. To be licensed in Texas, a doctor must pass a demanding battery of medical tests, be competent in English and undergo three years of residency training in the U.S. -- at low pay and long hours, even if a similar residency was previously served in another country. Furthermore, the U.S. requires that immigrant doctors practice at least two years in underserved parts of the country, undesirable places such as Appalachia; the penalty for working in a more desirable place is a whopping $250,000.

Immigration lawyer Clarissa Guajardo Shaw says that most foreign doctors don't even attempt to practice medicine in the U.S. The last time she talked to one of her clients, formerly a doctor, he was making piñatas.

Wellington Smith also deals with immigration issues; as part of the Texas Doctors Group, in Austin, he recruits physicians. He says that when practicing doctors immigrate to the U.S., they end up "driving taxicabs or working in used-car lots." But becoming certified to practice here? "I've never seen it."

The powerful American Medical Association lobbied for those tough standards in the mid-'90s, in part to preserve members' earning power. More doctors means more competition; why allow immigrants to undercut prices when HMOs are already slashing American doctors' incomes?

Competition is particularly fierce in cosmetic surgery, the profits of which have been relatively safe from penny-pinching HMOs. Few health plans cover cosmetic surgery, but consumers are willing to pay its hefty costs out of their own pockets. According to the American Society of Plastic Surgeons, in 1998 the average breast-augmentation surgery in Texas cost $2,850; the average face-lift, $4,000 to $5,300, depending on whether the surgeon used an endoscope.

Not only are the procedures cash cows, but the market is booming. The ASPS reports that more than a million people had cosmetic surgery in 1998, more than twice as many as in 1992, and that number is considered highly conservative. The future looks more profitable still, as baby boomers continue to age, bulge and sag, and as people grow ever more likely to believe that cosmetic surgery is safe and socially acceptable.

Naturally, lots of doctors want to get in on a good thing -- and not only those who trained long and hard in the field. The most demanding certification body, the American Board of Plastic Surgery, requires at least three years of training in general surgery and two in plastic surgery, but legally, any licensed doctor can perform cosmetic surgery, and its practitioners include dermatologists, gynecologists, ear, nose and throat specialists, family practitioners and even dentists. Many doctors tout their certification by groups such as the American Board of Cosmetic Surgery, the American Society of Liposuction Surgery or the American Board of Facial Plastic and Reconstructive Surgery; but despite their impressive-sounding names, those groups require little in the way of specialized training. In some cases their only membership requirements are that doctors pay a fee and attend a weekend course.

Such distinctions are lost on the surgery-seeking public. Do prospective patients ever ask about credentials? "Never," says John K. Long, a Houston M.D. certified by the American Board of Plastic Surgery. "Never, never, never."

Instead, patients appear to pay attention to ads, on billboards or in print. You see those ads everywhere: here in the Houston Press, in the Houston Chronicle, Semana, Texas Monthly and, in their highest local concentration, HoustonHealth & Fitness. Sometimes the ads depict a serious-looking doctor in scrubs or talking to a patient, but more often, and more memorably, they show the surgeon's former patients, usually women and usually striking ones -- models, dancers and beauty-pageant winners. They beam bleached smiles or pout, the better to show off their plump lips. They wear diamonds and expensive evening dresses (short ones, to show off their slender thighs). Their perky noses, smooth foreheads and tiny waists read as carefully chosen accessories, signs of good taste. The message is that of the mall: Buy this, and you can be transformed.

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.

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.

Remarkably, Diaz then scheduled her next surgery, and paid $2,000 for it.

This time, though, Chaves and Vazquez said they couldn't proceed that day because of Diaz's high blood pressure. The next day she returned to the office and demanded her money back. She didn't get it, and furious, she filed a report with the Florida Agency for Health Care Administration.

It seems worth noting that though Diaz may have harbored qualms about the abilities of Chaves and the Vazquezes, she continued to submit herself to their care. It wasn't their medical practices that finally prompted her to complain; it was a consumer issue, the clinic's failure to refund her money. Diaz may have believed that the house on Coral Way was a legitimate medical facility, but her mind-set was that of the mall, where you can return an item and get your money back, no questions asked.

Two other dissatisfied patients also filed complaints against Chaves and the Vazquezes: one man was unhappy with Chaves's surgery to remove a cyst from his forehead, and his girlfriend suffered swollen lips after Mayra Vazquez gave her collagen injections. The three complaints led to a health-department investigation, and eventually, the case was turned over to the cops.

At 7 a.m. on May 26, 1998, Miami-Dade police officer F. Carollo knocked on the door of Chaves's middle-class house in northwest Miami. Chaves answered, confirmed that he was Dr. Chaves, the cosmetic surgeon, and was promptly arrested. At the police station he stated that he'd performed numerous surgeries without a Florida medical license, and was sorry for the crimes.

He was charged with the unlawful practice of medicine, as well as petty and grand theft for accepting fees for services he couldn't legally render. Released on bail, he wasn't supposed to leave the state of Florida. And he certainly wasn't supposed to continue his surgical career in a Houston hair salon.

Beatriz Diaz says that her cosmetic-surgery ordeal has left her emotionally fragile, that she has been using Xanax and Zoloft to control the resulting panic attacks. She says Mayra Vazquez's collagen injections left her lips swollen unattractively for months before wearing off, and the aftermath of the liposculpture was worse: Not only did Diaz suffer infections, she was left with eight "holes," pits where the needle had removed fat. She says she has spent $10,000 to have another plastic surgeon repair the damage.

Diaz's lawyer, Jared Gelles, believes that she has a good civil case for battery: Because Chaves and Vazquez falsely led her to believe they were licensed doctors, she didn't truly give her consent for surgery. But Gelles worries that even if Diaz prevailed in court, she might never collect any money. She hasn't yet filed a lawsuit.

As ugly as Diaz's story is, though, it's probably best to think of Chaves in the context of other cosmetic surgeons. Even legitimate doctors often have dissatisfied patients -- that's why they carry malpractice insurance -- and cosmetic surgery inspires more dissatisfaction than most other medical procedures.

According to the American Medical Association, plastic surgeons attract a disproportionate number of malpractice claims. All sorts of unpleasant things can, and do, go wrong: Implants leak or slip or even protrude through skin; the tissue around them hardens; and all too often, liposuction can kill. There's no central registry of deaths due to liposuction, but a California State Senate study put the death rate at one in 5,000, shockingly high for a surgery that's not medically necessary. Another estimate, delivered at the Global Summit on Aesthetic Surgery, put the number of liposuction deaths in 1997 somewhere between 67 and 100.

No statistics seem to exist on the number of botched cosmetic-surgery procedures, but in a recent Newsweek article, New York's Dr. Gerald Pitman, one of the nation's most respected liposuctionists, estimated that as many as one in ten cosmetic surgeries has to be redone.

Last year a Fort Lauderdale Sun-Sentinelinvestigation found that since 1986 at least 34 Floridians had died after undergoing cosmetic procedures in a doctor's office. Surgeries in a doctor's office are riskier than those performed in a hospital. The offices may not be set up with crash carts for emergencies, or they may not be adequately staffed. But the most important difference is this: Hospitals screen the doctors they allow to operate, and oust surgeons whose practices they consider risky. In a doctor's own office, no such scrutiny applies.

This spring Florida stiffened the state laws that govern such surgeries; among other restrictions, the state limited doctor's-office liposuction to nine pounds of fat, a limit critics say is almost twice as high as it should be.

In California, state legislator Liz Figueroa has crusaded to reform the state's cosmetic-surgery practices. Last month the governor vetoed one of her bills that would have allowed consumers to check doctors' records on the Internet, but signed into law measures that, like Florida, place limits on cosmetic surgeries performed in doctors' offices. At the same time, California passed laws on cosmetic-surgery ads. Surgeons can no longer claim to be "board certified" without specifying which board has approved them; nor can they use misleading before-and-after photos and scientific claims that can't be substantiated.

In Florida and California cosmetic surgery is moving toward the hospital, away from the shopping mall. But no such laws are being debated in Texas, and in Houston, the city that invented both the atrium mall and the silicone breast implant, the two still seem destined to converge.

Town & Country Mall was less than thrilled about its position in the movement's vanguard -- backroom surgery doesn't fit well with the mall's upscale image -- and expressed its official disapproval of Switch and Chaves last month after the police raid. According to the mall's general manager, Robert Nguyen, unlicensed cosmetic surgery constitutes a violation of Switch's lease, and the mall asked the salon to leave. Switch hired a lawyer and expressed its desire to stay at Town & Country.

But by early November the salon was gone. The red neon sign had disappeared; the dance music had stopped thumping. Only one trace remained: WALK-INS WELCOME, the window still proclaimed, the ghostly white letters formed by glue that refused to be scraped away.

According to mall scuttlebutt, the salon's owner, Victor Rodriguez, maintained that he had done nothing wrong, that he'd only sublet space to Chaves and didn't know anything about surgeries. That line of argument seems thin: Bald, gruff Rodriguez was a frequent presence at the salon, seen there often by mall employees. Could he really not have known what Chaves was doing? And could he have missed Switch's own ad in Buena Suerte?

Rodriguez declined to explain himself, but in the process, revealed something of his character. "How much money you have for me?" he asked. "How much money you offer?" Told the answer was none, he replied, "Then no story for you." At the mall, everything has its price.

On October 15 Carlos Chaves appeared before Harris County's 248th District Court. He was wearing the orange jumpsuit issued to prisoners of the county jail, but still, he carried himself erect, like a doctor, and his hair looked freshly trimmed. He listened stoically as a woman in a leopard-skin blouse translated into Spanish the charges against him: delivery of a controlled substance, unlawful practice of medicine.

The judge set his bail at $55,000, but Chaves remains in the Harris County Jail. His lawyer Schaffer explains that had Chaves bonded out, he'd immediately have been shipped back to Miami.

Because Chaves is here, the State of Florida has agreed to delay the trial of him and his co-defendants, Alfred and Mayra Vazquez. Both Vazquezes were charged with practicing medicine without a license and grand theft in the third degree; Alfred was additionally charged with petty theft. Both are out on bond.

It's hard to say how the Vazquezes have been occupying their time as they await trial. Alfred's lawyer declines to comment on the case, and the lawyer listed by the court as Mayra's says that the listing was an accident, that he has never even met her. Dial the number that the Vazquezes told police was their home phone, and you reach an answering machine that, in English and Spanish, offers to take messages for "Aesthetic and Beauty Alternative Medical Corporation." Or you get a woman who speaks little English, but enough to say the Vazquezes will be back in the morning. Or you get a man who answers the phone "Aesthetic and Beauty" and claims that the number belongs only to a business, that he has never heard of the Vazquezes.

Chaves, of course, remains in the Harris County Jail. At press time, Ted Wilson, the prosecutor handling Chaves's case, expected to send one charge, practicing medicine without a license, before a grand jury early this week. The other charge, distributing narcotics, will have to wait for a lab analysis of the pills given to the undercover cop.

In the meantime, an HPD freezer holds the case's most unsettling pieces of evidence: the two bags of human fat that cops seized in their raid. Says Sergeant Osterberg, "The guys in the property room are probably not real happy about it."

Of course, nobody ever wants fat; the question is how to get rid of it. Carlos Chaves offered an answer -- at the mall! in an hour! -- that should have seemed obviously too good to be true. But in the mall, and in cosmetic-surgery ads, nothing is ever too good to be true; transformation is just around the corner, and safety isn't something you have to worry about. Instead of asking questions, clients booked appointments and paid in cash. What Chaves did was almost certainly dangerous and illegal, but he obeyed the first rule of mall success: He offered customers something they wanted.

Research assistance in Miami provided byMiami New Timeswriting fellow Victor Cruz. E-mail Lisa Gray at lisa.gray@houstonpress.com.

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