After outpatient cosmetic surgery, they ended up in the hospital or alone in a recovery house

After outpatient cosmetic surgery, they ended up in the hospital or alone in a recovery house

Lisa Farris feared a bad infection would quickly worsen from a recent liposuction and tummy tuck. So she called the cosmetic surgery center and asked if she should go to the emergency room, she claims in a lawsuit.

The nurse who answered the call at the Sono Bello Center in Addison, Texas, told her to "under no circumstances" go to the emergency room — even though Farris was leaking "a large gush of foul fluid" from the incision, according to records from the malpractice lawsuit she filed against the plastic surgery chain in 2024.

The nurse told Farris that she "just needed to reinforce her bandage to contain the leaking fluid and give her time," the lawsuit documents say.

“Fortunately, Ms. Farris went to the emergency room where she was diagnosed with sepsis due to her surgical complications,” a medical expert on her legal team wrote in a court filing. If left untreated, sepsis can lead to death.

Sono Bello officials declined to discuss malpractice lawsuits filed against the company, citing patient privacy laws. But in court filings, the company disputed Farris' claims. The case is scheduled to be heard early next year.

The Farris lawsuit is one of dozens of medical malpractice cases filed in the last three years that accuse cosmetic surgery chains of failing to provide appropriate care to patients in the days and weeks following their procedures - in many cases by allegedly failing to promptly treat painful infections and other serious complications - including in four patients who died, a KFF Health News investigation found.

In some cases, patients who traveled hundreds of miles or more for seemingly routine surgeries allegedly suffered painful complications while recovering in hotel rooms or unlicensed "rest homes" that lacked adequate medical staff and supervision, according to court documents.

While complications such as infections can occur after any surgical procedure, issues related to post-operative care are blamed as the cause of injuries in over two-thirds of cosmetic surgery cases examined by KFF Health News.

The surgical companies involved - some, like Sono Bello, funded by private equity investors - offer elective procedures such as liposuction and "mommy makeovers" to patients who pay thousands of dollars out of pocket or on credit. Advertisements promise life-changing body reshaping techniques with minimal risk and quick recovery times.

Medical malpractice lawsuits lagged behind the growth of these companies. Lawsuits accuse the chains of hiring doctors who lacked sufficient training or had troubled pasts, and of using pressure sales tactics and misleading advertising to downplay safety risks, according to court documents. The companies deny these allegations and have had some lawsuits dismissed.

Patrick Schaner, a plastic surgeon and medical director of Sono Bello, highlighted that the company has performed more than 300,000 cosmetic surgeries with minimal complications. “That context is very important,” he said in an interview.

Schaner said Sono Bello surgeons are “good at what they do” because they perform a large number of procedures. “We are doing a great job of putting safety protocols in place,” he said.

Many patients who file lawsuits blame disfiguring injuries on what happened after their surgeries, such as doctor's visits where medical staff allegedly failed to recognize or dismissed evidence of worsening surgical complications, court records show.

A nurse at a Sono Bello center outside Chicago allegedly failed to alert doctors when Mary Anne Garcia, a patient who had undergone liposuction at the center about three weeks earlier, showed up with her aunt. Garcia was dizzy and so weak that she needed a wheelchair to get back to the car, according to a lawsuit her estate filed in September.

Instead of telling Garcia to go to the emergency room, Sono Bello's nurse told her to "drink more fluids and try to eat something," the complaint states.

Garcia died the next day of cardiac arrest, according to the lawsuit. Sono Bello has not yet filed a response to the lawsuit in court.

“It was terrible”

Susan Easley, 59, a veteran U.S. Agency for International Development executive who worked on AIDS projects in Africa for two decades, died last year in a short-term apartment in Washington, D.C.

According to a lawsuit filed in November, her son Gavin found her body on May 13, 2024, four days after she underwent AirSculpt liposuction and fat transfer surgery at Elite Body Sculpture in nearby Vienna, Virginia.

“It was terrible,” Gavin Easley said in an interview with KFF Health News. "My mother was the epitome of kindness, caring and unconditional love. She was the most incredible woman I have ever known," said Easley, 29, who runs an organic farm in Arkansas with his wife.

The lawsuit alleges that surgeon Dare Ajibade Easley administered an excessive amount of the anesthetic lidocaine during the 6½-hour procedure and failed to recognize persistent vomiting afterwards as a sign of toxicity. She called the clinic to report her condition, but her concerns were dismissed, the lawsuit says.

“When she called to report complications, they didn't take it seriously," said Virginia attorney Peter Anderson, who filed the lawsuit. He said Easley showed "clear signs and symptoms" of problems.

AirSculpt is a brand of Elite Body Sculpture, a Miami Beach-based chain founded by plastic surgeon Aaron Rollins. The company, which is backed by private equity investors, has around 30 offices across the country. Neither the company nor Rollins responded to repeated requests for comment on patient lawsuits. In court filings, the company denied the allegations.

According to the company, Ajibade has since moved to Texas, where he works for Sono Bello in San Antonio. Neither the surgeon nor the Virginia surgery office, which is also a defendant in the case, responded to calls for comment. The defendants have not yet filed an answer in court.

A booming business

Sono Bello, with more than 100 centers nationwide, bills itself as “America’s No. 1 Cosmetic Surgery Specialist.”

Patients filed seven malpractice cases against Sono Bello in September — each in a different state. In an interview, Marcy Norwood Lynch, Sono Bello's executive vice president and chief legal officer, speculated that the increase in cases was related to KFF Health News and NBC News' coverage of the company. There may be “a consistency” between the reporting and the filing of the lawsuits, she said. The company has denied the allegations in court.

KFF Health News examined a sample of more than 100 medical malpractice cases filed against multistate surgical chains between early February 2023 and November 2025. Malpractice lawsuits alone do not prove that care is substandard, although many medical and licensing boards view them as a tool for assessing medical quality.

Heather Faulkner, a plastic surgeon and associate professor at Emory University School of Medicine in Atlanta, said surgeons need to recognize signs of infection quickly before it progresses and leads to serious, even life-threatening, illness.

At Emory, she said, surgeons are required to be present at their patients' first visit after cosmetic surgery. “Ultimately the doctor is responsible,” she said. “The patient needs to be seen by the person who performed the surgery and know how to recognize that something is wrong,” Faulkner said in an interview.

Patients who sue cosmetic surgery chains often argue that they were treated by nurses or other staff who they say lacked the training to identify and manage problems before they needed emergency wound care.

Schaner, Sono Bello's medical director, said the company has a telephone messaging system that ensures patients can contact their surgeon or other company doctors. While nurses treat some patients, "the final decision-making rests with the surgeon," he said.

Five patients treated at Sono Bello centers who sued the company in 2025 said surgical wound complications were dismissed after medical staff, including surgeons, saw images of the injuries, court records show. The cases are pending.

Schaner said Sono Bello sometimes lets patients submit photos of wounds, but the images are “not the only means of triaging” patient injuries or complications.

Joshua Kiernan sued Sono Bello after undergoing liposuction at the Columbia, South Carolina branch on May 28, 2024. On June 8, 2024, he tripped and fell in the parking lot of a gym, causing drainage around the cut in his stomach, the lawsuit says. On June 17, 2024, Kiernan visited the office and complained of “redness and pain” around the incision, according to his lawsuit.

Surgeon Stancie Rhodes did not examine him in person, but had an office staff member take a photo "so she could view it from another part of the office," the complaint says.

The surgeon sent back a message saying the photo "looked good" and Kiernan was instructed to take Tylenol for the pain and check in with the office a week later, the complaint says.

Two days before his appointment, Kiernan required emergency hospital treatment for “abdominal hematoma and infection,” according to the lawsuit.

Kiernan underwent six surgical procedures and incurred more than $325,000 in medical bills to treat his condition, the lawsuit says. In court filings, Sono Bello denied the allegations.

"Surgical care doesn't end with the last stitch," said Mark Domanski, a Virginia plastic surgeon who believes the chain clinics are generally more adept at marketing than at providing top-notch care to patients. “It involves post-operative visits with the surgeon who performed the procedure, who is there to respond to the patient's concerns and questions, especially if things are not going well,” he said.

Rest houses

Many patients who travel for cosmetic surgery, either to save money or because treatment options are not available in their area, are unable to return home immediately.

Yet there is little agreement about where and how long patients should recover and what medical services should be available to them.

Scott Hollenbeck, past president of the American Society of Plastic Surgeons, said laws or regulations in most states do not provide precise requirements.

“This can lead to large differences in supervision, staff qualifications and medical support available,” he said.

The Plastic Surgery Society has warned of a cottage industry of recovery centers that often charge patients hundreds of dollars a night during recovery, even though they may lack medical staff capable of treating possible surgical complications.

Court records in Florida show that patients staying in convalescent homes and hotels have died or suffered untreated complications, especially in South Florida, where authorities have struggled to regulate unlicensed facilities for a decade or more. A local lawmaker recently filed a bill to curb them.

Hollenbeck said patients recovering in a hotel or other facility need to find out in advance what “level of care” is available. He said ads promoting "luxury" accommodations or a "convenient location" did not make a hotel "clinically qualified to provide convalescent care."

Easley, whose mother lives in Washington, D.C. died, said he was struggling to understand what happened after a medical transport service took her from the surgery center in Virginia to a makeshift apartment.

He said his mother, who was born in a small village in Uganda before immigrating to the United States as a teenager and joining the U.S. Army, "had so many plans" for the future.

Susan Easley had been medically cleared for a new mission in Africa. After that, she planned to retire and, among other things, open a farm in Tanzania, according to her son.

The lawsuit alleges that the surgery center discharged her early due to signs of a dangerous condition called “systemic local anesthetic toxicity,” caused by an overdose of lidocaine.

Susan Easley called the surgery center that day and reported "multiple episodes of nausea and vomiting," but there was "no evidence" that anyone told her to go to the emergency room, the lawsuit says.

“I don’t know what they said to her,” Gavin Easley said. "That's a terrible thought for me. I have no idea how to get to the bottom of this mystery."

“Avoidable death”

Some lawsuits target decisions made by support staff who help monitor patients after surgery.

That's a critical point in the case of Mary Anne Garcia, the Illinois woman who died after her aunt drove her to Sono Bello's office in Oakbrook Terrace, Illinois, on June 4, 2024.

Garcia “felt sluggish, dizzy and nauseated,” the lawsuit says. She also had a rapid heartbeat and low blood pressure, according to the complaint. But registered nurse Lucia Raddatz did not notify the surgeon or urge Garcia to undergo emergency care, even though Raddatz had to help her back to the car in a wheelchair due to Garcia's "severely weakened condition," the lawsuit says.

The lawsuit filed on behalf of Garcia's estate names Raddatz and Sono Bello as defendants. An emergency room doctor hired as an expert witness in the case said that if Garcia had gone to the emergency room on June 4, "she would have received treatment that would have prevented her death," court records say. Sono Bello did not comment and has not yet filed a response in court.

Established plastic surgeons say they are often called upon to treat patients who come to the emergency room with complications because surgeons who work for the chains may not have local hospital privileges or be unavailable for consultations for other reasons.

“There is not a single colleague of mine who has not dealt with the complications of these types of facilities or medical spas more than once,” said Charles Pierce, president-elect of the New Jersey Society of Plastic Surgeons.

“Angry and betrayed”

Doctors at a hospital in Austin, Texas, expressed frustration while caring for Anna Palko, a 33-year-old mother of four, according to a malpractice lawsuit she filed in November against surgeon Rambod Charepoo and his employer Mia Aesthetics. The Miami-based cosmetic surgery company, which operates in about a dozen cities, including Austin, touts itself as offering the highest quality plastic surgery at affordable prices.

A doctor at St. David's Medical Center in Austin wrote in Palko's medical records: "Unfortunately, the patient experienced post-operative complications with a physician who is known in our emergency department for similar post-operative complications associated with cosmetic surgery performed by MIA (sic) Aesthetics," the lawsuit states.

Palko is one of five Texas women who sued Charepoo and Mia Aesthetics for malpractice between mid-July and late November this year, court records show.

Four women allege that the surgeon and company failed to adequately treat infections that occurred after surgery, while the fifth alleged other complications. Mia Aesthetics was dismissed from a case. The surgeon and the company have denied the allegations in court filings, court records show.

Charepoo was also the subject of a lengthy investigation by the Texas Medical Board, which licenses doctors.

In August 2021, the panel alleged that the surgeon "failed to meet standards of care" in the treatment of six patients, including one whom he "put at risk" by allowing the patient to leave the surgical center in a private vehicle toward the emergency room after the person "suffered significant hypotension and hemorrhagic shock."

In October 2024, the medical board found that Charepoo had failed to meet standards of care for five of the six patients. The board required him to have a surgical supervisor oversee 20 of his surgeries per quarter for two years. The board also ordered him to take medical training courses, pass an exam and pay a $4,000 fine.

Charepoo is fighting the order in court. Charepoo, Mia Aesthetics and attorneys representing Charepoo and the company did not respond to requests for comment.

In January, he sued the Texas Medical Board, saying the punishment was "both excessive and unjustified" and should be invalidated. The medical board declined to comment on the lawsuit, which is pending in Travis County District Court.

When patient Palko heard about the surgeon's problems, she was shocked. She said she chose Mia Aesthetics because the ads promised highly qualified doctors.

“I felt so disgusted, angry and betrayed,” Palko said in an email sent through her attorney.

Have you had liposuction, a “mommy makeover,” a tummy tuck, a Brazilian butt lift, or another type of cosmetic surgery? We would love to hear about your experiences. Click here to contact our reporting team.

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