Whalesca Castillo faces charges of manslaughter, criminally negligent homicide and unauthorized practice of medicine after authorities say she injected a silicone substance into the butt of a 43-year-old Philadelphia woman at an apartment on Seward Avenue in the Bronx on June 17, 2017.
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Authorities say Leslie Ayala had an embolism when Castillo injected silicone into her buttocks and thighs, and the death was ruled a homicide last month.
Castillo pleaded not guilty on Thursday as she was arraigned in Bronx criminal court on a grand jury indictment. Her attorney, Robert Osuna, said "any loss of life is a tragedy."
"Ms. Castillo, like every other American citizen, enjoys the presumption of innocence and that presumption remains with her up and until she is proven guilty beyond a reasonable doubt," Osuna said in a statement Thursday.
Castillo has previous arrests and served two prison terms for unlicensed silicone injections and had been under investigation since Ayala's death.
The New York Times reports that Castillo, who does not have a medical license, served a year in prison in 2011 and nine months in 2014 on charges relating to operating an illegal medical clinic.
Court papers from her earlier arrests show Castillo charged $1,500 for each procedure.
Castillo pleaded guilty to federal charges related to performing plastic surgery without a medical license in September 2011. After being released on probation, she was caught doing unlicensed injections again in 2014 and sent back to prison.
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Buttocks enhancement surgery, known as the "Brazilian butt lift," has become increasingly popular in recent years thanks in part to the visibility of well-endowed stars like Kim Kardashian and Nicki Minaj.
Liquid silicone injections are not approved by the Food and Drug Administration for cosmetic surgery, but unlicensed silicone injections can be a cheap alternative to approved procedures involving fat transfer or silicone gel implants.
Experts say that even the FDA-approved fat-transfer procedure for butt enhancement is more dangerous than other cosmetic surgeries.
The American Society of Plastic Surgeons estimates that the Brazilian butt lift has a death rate as high as one in 3,000 patients.
The society says 20,300 of the procedures were performed in 2017. The number of butt lifts has more than doubled in the past five years, the society says.
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Reliable numbers for unlicensed silicone butt injections are difficult to ascertain, but deaths linked to the procedure have been reported in locations including Atlanta and Capitol Heights, Maryland .
According to the court filings, Castillo discouraged patients from seeking medical treatment when they experienced pain or bleeding after their procedures.
One client texted Castillo complaining of leaking blood and liquid from her buttocks and legs, court documents said. Castillo replied: "Buy some crazy glue and put it on."
(The Associated Press contributed to this report)
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