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‘Plastic and Lies’: Murder Charges Expose Vast Underground Butt-Injection Operation

A mother-daughter team in Los Angeles was charged for a fatal cosmetic surgery procedure. Now, dozens more women claim the two had botched their procedures
Illustration by Patrycja Podkościelny for Rolling Stone

I n 2016, newlyweds Marco and Karissa moved to Los Angeles, seeking sunny skies and the chance for a happy life together. The couple had just gone through a miscarriage, and Marco hoped the pleasant climate would help Karissa’s depression. “She was very weather dependent,” he says. “She needed always sunlight and warmth.” Today, Marco almost spits the name of the Golden State. “I hate California. I’ll never go back there to that shitty fucking place.”

According to Marco, who asked to be identified by his first name only, the people Karissa met in L.A. lured her into the pursuit of a luxurious Hollywood lifestyle — and the enhanced physical appearance that goes with it. “She got influenced by the allure of the stupid L.A. parties,” he says. “She started to follow those fucking Kardashians, all those plastic bitches. I told her those are fake, they don’t exist. It’s just plastic and lies.”

By the fall of 2019, he had repeatedly tried to talk Karissa out of changing how she looked. But just like when she’d started stripping at Los Angeles parties, and later, when she began traveling to Nevada to work at legal brothels, he found that convincing his wife to do — or not do — anything was a losing proposition. “She was very stubborn, and if she wanted to do something, she would’ve done it,” Marco says.

She started having cosmetic surgeries, plumping up her lips and soon afterward, her butt. On Oct. 15, 2019, Karissa Rajpaul invited two women, Libby Adame, 51, and her daughter Alicia Galaz, 23, to a friend’s home for a buttocks augmentation procedure. That friend, who spoke to Rolling Stone on the condition of anonymity, said he and Karissa had met on Instagram and had been on a few dates before that day. He says he also tried to talk Karissa out of going through with the injections, making her promise she would only have an evaluation, not the procedure, at his house. “I told her, ‘Look, you’re doing something very dangerous, something you should do only with doctors supervising in a medical room or a hospital,’” he said. “She told me, ‘Oh, no, don’t worry, I already did it twice.’ I’m like, ‘Are you crazy?’”

Adame and Galaz arrived around 2 p.m. and took Karissa into a bedroom, where they proceeded to inject what police would later describe as uncontained liquid silicone into Karissa’s buttocks, piercing the muscle and entering her bloodstream. Around 30 minutes later, according to an official report, Adame and Galaz yelled for the host to bring a glass of sugar water, and he entered the room to see Karissa sitting on the bed, pale and struggling for breath. In his telling, he went to check on her and found her close to fainting. “I was like, ‘OK, what’s going on with this person? Why is she so weak? She’s passing out,’” he recalls, and says they told him she just needed some sugar. “I ran, I got her some chocolate, Coca-Cola, whatever. I told them, ‘Look, you guys should take her to a hospital.’ They were like, ‘Oh, no, she’ll be fine.’ Of course, she wasn’t fine. She wasn’t responding. She just looked very, very low. When she started passing out, I gave her mouth-to-mouth. I yelled, ‘Call 911! You need to call 911 right now. This is crazy. You’re fucking insane.’” The women did finally call 911, he said, and opened the gate for paramedics before leaving the property. 

Adame and Galaz — neither of whom had medical licenses — had taken all their equipment with them, according to the man who was there, so emergency responders did not know what had happened to Karissa, whom official documentation describes as unresponsive when they arrived. “I knew they injected her with something,” the man said. “That’s what I told the paramedics when they got here: ‘She had some kind of procedure done on her.’”

Emergency medical staff intubated Karissa and attempted to stabilize her blood pressure. Less than three hours after getting the injections, Karissa was pronounced dead. She was 26 years old. The medical examiner found silicone oozing from her puncture wounds internally, in the muscle of the buttocks. The autopsy report said she had died from acute cardiopulmonary dysfunction caused by the silicone injections; it determined the manner of death to be homicide. “When the police officer came back that night and told me what happened to her, I was completely shocked,” said the man whose house she’d been visiting. “It’s such a shame for anybody to die that way. It’s such a bad tragedy.”

“It wasn’t her fault,” Marco says. “She was really a nice girl, and she didn’t deserve this. She obviously did a mistake and I accept that, but she paid — the price, it’s too much.”

In September, nearly two years after her death, the Los Angeles Police Department announced that Adame and Galaz had been charged with Karissa Rajpaul’s murder, as well as three felony counts of practicing medicine without certification. Authorities say they recovered tens of thousands of dollars in cash from a search warrant executed at the two women’s home. According to medical records obtained by Rolling Stone, as well as half a dozen on-the-record sources, Karissa was far from the only person whom Adame and Galaz harmed with their procedures. 

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Alicia Galaz (left) and Libby Adame have both been charged with murder. Los Angeles Police Department

Deputy Chief Alan Hamilton, who runs operations at LAPD’s Valley Bureau, revealed to Rolling Stone that since the arrests, nearly 100 people have come forward to report they or a loved one had suffered injury or disfigurement following a procedure by Adame and Galaz. Police believe the two used Adame’s notoriety to recruit clients through Instagram and word of mouth. Another police source who spoke with Rolling Stone said Adame is believed to have been performing illicit home cosmetic procedures since at least 2012.

Investigators believe the two women were running a national, perhaps international, illegal cosmetic-surgery operation in which dozens of people were physically harmed. “We’ve already verified that we have victims in other states, and we are working on verifying that we have victims from other countries, as well,” Hamilton says, adding that people have come forward from Miami to Toronto and that new reports are “a daily occurrence.” Several of the people Rolling Stone reached out to for this article claimed to know additional former clients of Adame and Galaz who were too afraid to speak out about their experiences, because they feared reprisal. The full scope of Adame and Galaz’s impact therefore remains to be seen.

Pinched here, plumped there — Hollywood has long had a love affair with plastic surgery. And thanks to the Kardashification of the American aesthetic, it’s soaring in popularity. Cosmetic procedures are up 22 percent since 2000, according to the American Society of Plastic Surgeons, with buttocks improvements in particularly high demand. In 2019, more than 28,000 people got a fat-grafting procedure known as the Brazilian butt lift (compared with 8,500 in 2012). On TikTok, the tag #bbl has 3.3 billion views, where users document their experiences traveling to Miami and other destinations to get the procedure.

The BBL, in which fat is removed by liposuction from one part of the body and injected into the buttocks, may be the fastest-growing cosmetic procedure nationwide, but it’s also the deadliest. One industry organization estimated a BBL mortality rate of one in 3,000. A 2017 survey found that three percent of surgeons doing BBLs had had a patient die from the procedure. According to Dr. Arthur Perry, a surgeon who has served on the New Jersey State Board of Medical Examiners and refuses to perform BBLs, that mortality rate indicates the procedure is inherently unsafe and in need of more research. “When you hear of a death by a board-certified plastic surgeon doing a Brazilian butt lift, that frightens me the most,” Perry says.

The black-market cousin of the BBL is injections, sometimes called butt shots, where a practitioner injects filler like liquid silicone into a client’s buttocks instead of using their own fat. The procedure is banned by the Food and Drug Administration, with the agency even issuing a warning in 2017 against getting butt or breast injections of liquid silicone — which is only approved for retina surgery — or dermal fillers typically used to correct wrinkles in the face. “No injectable filler is FDA-approved for large-scale body contouring or body enhancement,” the agency said. “These kinds of uses can lead to serious injury, permanent scarring or disfigurement, and even death.” As with a BBL, the gravest risk of injections is that some of the material could accidentally enter the bloodstream if the needle hits one of the enormous blood vessels running through the buttocks. If this happens, the material can move like a blood clot through the body, traveling to the heart, lungs, or brain, where it can cause a stroke or block arteries in an embolism that can lead to sudden death. Since the procedure isn’t typically performed by a qualified medical professional, a client also can’t be sure that they’re really getting the filler they think they are. Horror stories abound of people who have been injected with bathroom caulk, motor oil, even peanut butter.

In a BBL, the majority of the fat dies off as a matter of course, and fillers can shift around in the body. Both can change the shape of the butt, leading some customers to return for more treatments. Others have described feeling “addicted” to the procedure, going back for more any time they notice a dent or dimple.

Dire warnings aside, not everyone who wants cosmetic surgery can afford to pay a board-certified surgeon the tens of thousands of dollars it can cost for an already risky BBL. Trans women, for example, who often lack access to health care and may feel unsafe seeking certain treatments, have historically turned to below-board silicone injections to build curves. More recently, several men have died getting unregulated silicone injections in a trend known as “pumping,” popular among some gay men who want to make themselves look bigger. Cardi B has said that when she was 22, she paid $800 to have fillers injected into her buttocks in an apartment in Queens. “In the club, it’s like you’re almost invisible if you don’t have a big ass like that,” she said in a 2016 interview, adding that she regrets getting it. “I don’t really know what’s in my ass right now,” she said. “I could die. Who knows?”  

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Materials confiscated by LAPD during the arrest of Galaz and Adame Los Angeles Police Department

Below-board injection outfits have drawn criminal charges and jail sentences in recent years. In 2014, Mississippi woman Tracy Lynn Garner was sentenced to life in prison for “depraved heart murder” in the death of Karima Gordon, a Georgia woman on whom she performed illegal silicone injections after a third person referred Gordon to her, saying that Garner was a nurse when she actually had no medical training. Garner has since died in prison. In Philadelphia, Padge-Victoria Windslowe, who calls herself the Black Madam, got a 10- to 20-year prison sentence in 2015 for third-degree murder in the death of a 20-year-old British woman whose heart stopped after being injected with nearly a half gallon of silicone. Windslowe, who charged $1,500 to $1,800 for her procedures, claimed during her trial that she got into the business to help fellow transgender people the way injections had helped her. “Being transgender, for so many years … I was imprisoned in my mind,” she said in court. “When someone helped me with those injections, I basically felt like an ugly duckling turned into a swan.” In 2017, a Miami woman, Oneal Ron Morris, got 10 years in prison for injecting customers’ buttocks with a mixture of cement, mineral oil, superglue, and Fix-A-Flat tire mender. 

Even if a person avoids instant death from an injection, serious complications can develop years later, from open wounds leaking fluids, to infections leading to sepsis or necrosis. Some complications can cause nerve or organ damage or even require the amputation of limbs. If someone experiences issues after a black-market procedure, they may struggle to find care. According to Dr. Perry, some doctors may even be hesitant to treat people who come showing issues from a black-market procedure, because of the liability the patient’s condition could bring. “Plastic surgeons are not thrilled to take care of these things,” he says. “Not because they don’t care about the patients, but unfortunately, [if] you have this procedure [done] by someone else, then you go to the emergency room and you get a plastic surgeon, and now you’re that plastic surgeon’s patient, guess who gets sued?”

Adame has a reputation as a prominent figure in the local party scene. She has more than 11,000 followers on her private Instagram account, is nicknamed “La Tia,” and favors dresses that hug her exaggerated hourglass curves. She wears her long, dark hair parted in the middle and cascading over her shoulders. One woman who asked to remain anonymous told Rolling Stone she initially knew of Adame as a socialite and social media figure. “Girls that I used to work with would post about her parties, and I was intrigued,” the woman says. “From what I know, she used to reside in Huntington Park. That’s where all her lavish parties would start. Then, she’d be over up in the Hills somewhere.” 

Public records indicate Adame has lived in several places in Huntington Park and the neighboring city of South Gate, and former clients allegedly got injections from Adame in Bell, a small city between Huntington Park and Interstate 710. This section of southeast Los Angeles County lies roughly 15 miles east of LAX. It’s cordoned off to the south by the 105 freeway and by the concrete banks of the Los Angeles River to the east. The population is more than 90 percent Latino, with many people speaking primarily Spanish. (Hamilton told Rolling Stone the LAPD is adding Spanish-speaking personnel to its investigation to help interview the dozens of people who have come forward nationwide with complaints about Adame and Galaz.) Roughly 20 percent of families live below the poverty line, and many have jobs as essential workers like grocery-store clerks, janitors, and restaurant employees.  

Adame’s reach was not limited to Southeast L.A., however. Karissa Rajpaul used Adame’s reputation to reassure the friend she was with in suburban Sherman Oaks, on the northwest side of the Hollywood Hills, the day she died. “She told me that woman is famous for doing those things, that she had tons of customers she deals with,” he tells Rolling Stone. “She told me, ‘Everybody knows her. She’s an Instagram celebrity.’” 

She used her status online to recruit clients, police have said. According to Deputy Chief Hamilton, in the best cases, Adame and Galaz took peoples’ money for procedures that did nothing. In the worst instances, he says, they disfigured people — or, in Karissa’s experience, killed them. “Some people now have permanent limited mobility, some people have permanent wounds — scars that have not healed,” Hamilton says. “And quite frankly, some of these issues, I don’t know if they can be repaired by even a qualified medical professional.” 

When Rolling Stone attempted to reach Adame and Galaz for comment, a phone number listed for their most recent residence — an ornate mansion in Riverside, according to public records — was out of service. A representative from the L.A. District Attorney’s Office said it is unclear whether Adame and Galaz have retained a lawyer, as neither has had their first court appearance yet. Adame did not respond to an Instagram message sent to her account. Galaz, who holds a current manicurist’s license in California, has more than 10,000 followers on her Instagram account where her bio shows a Lebanese and a Mexican flag. (She did not respond to a message sent to her account by press time.) In her booking photo, she is smiling placidly with manicured eyebrows, her dark hair pulled back in pigtails, her lips an emphatic bow. 

Laura Moreno didn’t even really think she needed butt injections. The Los Angeles-based singer of Mexican banda music felt she had a nice butt already. “I had my own,” she says. “I was not flat.” Besides, she was afraid of the procedure. Her friend suggested it, though, and leaned on Moreno, insisting it would be good for her music career. “She was like, ‘You will look prettier, you’re a singer, you will look good,’” says Moreno, who performs by the name Jaddie More. 

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Laura Moreno at the hospital in 2014 Courtesy of Laura Moreno

Moreno says that in early 2014, she went to see Adame, who some women she knew had already visited, which made her more comfortable. She met with her at a beauty salon, she says, where Adame charged her two or three thousand dollars, as she recalls, and injected her glutes with what she told Moreno was celulas madres — stem cells. The term made Moreno feel safe, like nothing bad was going into her body. The first visit, everything felt fine. After Moreno went back to the salon for a second treatment, performed by one of Adame’s colleagues, however, her left leg started hurting. “The pain was getting worse, and worse, and worse,” she says, so she went back a third time, seeing Adame again. “I told her I was feeling bad and my leg was hurting, and she injected me [with] something that she said was for the pain … and for the infection, if I had something.”

After she left Adame’s salon that January day, she met her then-girlfriend for a meal. In the restaurant, she suddenly felt sick. Very sick. “I didn’t even eat because I started throwing up everything and wanted to go to the bathroom and, like, nothing was in my body,” she says. As they hurried to leave the restaurant, she nearly fainted. “I saw everything black, black.” Her girlfriend helped get her back to their second-floor apartment. She wanted to take Moreno to the hospital, but that scared Moreno. “I have never been in a hospital. I don’t like hospitals. I don’t like doctors,” she says. “I’m like, ‘No, it’s OK. It’s going to pass.’ But it didn’t pass; I was just getting worse.” She asked for blankets because she felt cold, then ripped the layers off minutes later, sweating and asking for fresh air. She was in and out of the bathroom, evacuating everything inside her. By the time she agreed to go to the hospital, a neighbor had to carry her downstairs to the car. On the drive, Moreno felt drowsy, but her girlfriend begged her not to close her eyes. She was admitted to the hospital in septic shock, according to medical records she shared with Rolling Stone. The records also confirmed she’d had multiple gluteal injections. “The doctor said that if I would have [gotten] there 10 minutes later, I would have died,” she says. 

Sgt. James Corcoran at the Bell Police Department confirmed Moreno filed a police report following Adame’s and Galaz’s arrests, when authorities invited more victims of the women to come forward. That wasn’t the first time she’d tried, though — as she told Corcoran that day, Moreno had attempted to make a police report in January 2014, after she got out of the hospital, but says that officers had barely listened to her at the time. “They sent us always to another place, like, ‘You need to go to the court, you need to see a judge,’” she tells Rolling Stone. “They don’t give attention to something that for them [is] not big, but for us it’s something big.”

On Aug. 5, 2021, Adame and Galaz were arrested and each held on $2 million bail, according to a criminal complaint. Both were out on bond within two days. The LAPD didn’t announce the charges until late September, leading to confusion among some people who were alarmed to learn that the notorious La Tia was out of jail as quickly as it seemed she’d been inside. Videos circulated on Instagram in the days after the news broke, appearing to capture Adame out on the town, celebrating her freedom. In one, she’s seated in a restaurant bragging about the fact that news reports say she’s in jail, as a server presents her with a platter of steak.

The videos of the minor social media celebrity caused a stir among loved ones of her alleged victims. Karissa Rajpaul’s husband, Marco, was livid about the videos. “Seeing that fucking bitch, she’s enjoying life right now,” he says. “They’re sending me stories from instagram of La Tia. There’s videos of her saying, ‘I’m out of jail,’ eating expensive steak. She’s surrounding by all these people saying ‘Look at the stupid cops.’ She’s out having fun. It hurts me a lot that she’s out. She’s laughing as though she’s not [charged with] murder.”

Galaz’s first court date is set for December, and Adame won’t appear until February. Asked how authorities are monitoring the women to keep them from continuing to administer illegal injections or fleeing the country, the L.A. District Attorney’s Office replied, “There is no additional information to provide at this time.”

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Karissa Rajpaul with one of her pit bulls

Hamilton says the LAPD is partnering with federal authorities to assist in the investigation of potential trafficking of material substances, and other people who may have been involved. “There are commerce issues, and laws that have been broken both statewide and nationwide, and probably some internationally, which I’m pretty sure our federal partners will help us bring to ground,” he says. 

The woman who worked in Huntington Park says she knows people whose experiences with Adame date back nearly 10 years, but they are scared to speak publicly about it. “They’re all too afraid to even speak out because they’re saying that other people are being harassed by her and her people,” she says, adding that she managed to convince one friend to file a police report.

If they aren’t getting underground surgeries from Adame, she fears, it will be someone else. “Most people that I know have gone in for certain procedures,” she says. “It is unfortunately a big thing in the Latin community at the moment. It’s like the new favorite pair of jeans. It’s a trend that everybody’s following.”

The pursuit of unrealistic beauty standards has torn people away from loved ones and the lives they were building together.

When California sunshine didn’t alleviate Karissa’s mental-health struggles, Marco got them a pair of pit bull sisters, Stardust and Diamond. Karissa threw herself into caring for them. “It was giving her a lot of joy,” Marco says, his voice breaking. “They were her little babies.” 

She became a passionate advocate for the breed, attending events to promote a better understanding of the dogs. She made friends at the events, including people who introduced her to an agency that hired her to dance at private parties. Karissa’s stripping caused strife between her and Marco. “She started touring out with people that I didn’t approve of,” he says. They separated in August 2017, and he filed for divorce that fall, shortly before she began working at the Mustang Ranch, a legal brothel outside of Reno. He never followed through, though, he says, and court records show he filed to dismiss the divorce proceedings in February 2018. 

By then, Karissa was making money — lots of money, it seemed — between the parties and stints at the Mustang Ranch. “Face it, I wasn’t born to live a basic life,” she Tweeted that January from an account where she marketed herself as a “legal luxury courtesan.” She called herself Diamond, the same as one of her beloved pets. She posted pictures of gem-encrusted trinkets she said clients had sent her, along with invitations to book visits with her at the ranch. In one Instagram video, she fans out a stack of $100 bills in a car. 

By April 2019, Karissa had begun dabbling in cosmetic procedures. She posted on social media inviting clients to pay for her sessions. “Lip injections on Wednesday … Cash App pinned,” she tweeted at the time. An Instagram story highlight from that summer shows her bare-bummed on a high bed as a woman wearing purple exam gloves leans over her backside. 

Around that same time, in April or May 2019, Marco believes Karissa connected with Adame. “Somehow through friends of friends she came into contact with this fake witch doctor that would perform these type of injections for less money,” Marco says. “And she was not lucky enough.” 

With Adame’s and Galaz’s arrests coming nearly two years after Karissa’s death, Marco wants to know what took the LAPD so long. “Until one month ago, when La Tia was arrested, she was still performing all these procedures on all these other girls after she killed my wife,” he says. The LAPD believes she did perform illegal procedures after Rajpaul’s death. As for the wait, Deputy Chief Hamilton says they were building a case. “You don’t necessarily want to tip your hand on other investigations,” he says. 

Karissa’s loved ones want justice for her murder and to see the pattern of botched surgeries end. “She’s gone because of two individuals that wanted to make a quick dollar taking advantage not only her, but of a bunch of women,” says Kary Quirarte, a fellow animal lover and Karissa’s friend for more than five years. “We’re still grieving.… I feel like, unfortunately, [Karissa] had to be sacrificed for their practice to be done or them to go to prison if they do, so no other person would go through it.”

Additional reporting by Nancy Dillon