A Deadly Pattern Repeats
Adame never had medical training, court records show, yet she and her adult daughter, Alicia Galaz, performed cosmetic enhancements across Southern California for years. They catered to women chasing Instagram-ready results, the coveted “hourglass” figure at a fraction of what board‑certified surgeons charge.
However, in 2019, Karissa Rajpaul died after receiving silicone injections from Adame and Galaz in Encino; the procedure was filmed on Rajpaul’s own phone. Forensic testimony revealed the industrial‑grade silicone entered Rajpaul’s bloodstream, blocking her lungs and killing her within hours. Adame and Galaz were arrested and charged in 2021.
Both women were convicted in 2024 of involuntary manslaughter and unlicensed medical practice. Adame received a four‑year sentence, while Galaz was given three years. However, a judge ruled that the duo earned credit for time served during the three years before they went to trial.
While still on probation for the 2024 conviction, Adame continued to engage “in the business of providing injections for cosmetic purposes,” Judge Sam Ohta of the Los Angeles County Superior Court said during her sentencing hearing for Santangelo’s murder.
Inside the Fatal Procedure
During Adame’s trial, prosecutors introduced video from Santangelo’s Malibu home as evidence. The footage showed her husband calling 911 as his wife had trouble breathing; in her opening statement at trial, Cernok said Adame had fled the scene. Paramedics found Santangelo unresponsive, and she died a few hours later at a hospital in Thousand Oaks.
Toxicology and autopsy reports confirmed Santangelo died from a silicone embolism, which is caused when microscopic oil droplets travel through the bloodstream, lodge in the heart and lungs and suffocate tissue. Investigators narrowed the source to the injections Adame performed that day. Dr. Othon Mena, assistant chief medical examiner of Ventura County, testified that he classified the death as a homicide because it appeared to result from a medical procedure done by someone without a medical license.
Adame’s defense attorney, J. Michael Flanagan, argued at trial that his client did not perform the fatal injection, claiming she was at the home as a "consultant" for doctors in Tijuana, Mexico. Flanagan also said Santangelo already had bandages on her buttocks from a procedure performed by someone else.
Medical Experts Weigh In
Dr. Catherine Hannan, a board‑certified plastic surgeon in Washington, D.C., told A&E Crime + Investigation that the tragedy of Santangelo and Rajpaul’s deaths exposes the prevalence of illegal body injections. These types of medical procedures can also be extraordinarily expensive, Hannan says.
For instance, her medical practice charges between $10,000 to $12,000 for a procedure known as a Brazilian butt lift, which entails taking fat from one part of a patient’s body and injecting it into the buttocks, Hannan says.
“In Los Angeles, the amount is two to three times that,” she continues. “I really think it comes down to cost. So even though there are board-certified surgeons on every corner in Beverly Hills, people get desperate.”
Yet, she’s performed corrective surgery on patients who received illegal butt injections. “I’ve had to take out silicone caulking, the stuff you seal your bathtub with, from someone,” Hannan says. “It’s impossible to remove all of it once it is in the body.”
Black-market butt injections also thrive because the procedure doesn’t require medical incisions of body tissue such as breast implants, Indiana‑based plastic surgeon Dr. Barry Eppley says.
“Anybody can stick a needle into somebody and inject a substance," he tells A&E Crime + Investigation. "Needles and syringes can be found anywhere, and you can buy a lot of injectable things off the internet, overseas and whatnot.”
So, when individuals are offering cosmetic procedures for between a few hundred dollars to a few thousand dollars, “the most vulnerable parts of society will pay for it,” Eppley says.
However, unlicensed practitioners are not medically trained to know the dangers. For instance, an embolism is caused when the needle goes too deep and pierces the muscle underneath the fat in the buttocks.
“We go more superficial, and stay out of the muscle,” Eppley continues. “That's the technique. All it takes is somebody going a little deeper than you should be, and then you get an emboli.”
Hannan concurred with Eppley. “Our plastic surgery societies and some state medical boards require physicians to perform the injections under ultrasound guidance to visualize the placement of the fat,” she says. “Most undertrained, self-proclaimed cosmetic surgeons do not have the training or experience to do this."
