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A Miami surgeon has racked up related to his reported mishandling of aesthetic procedures, including gluteal fat grafting -- also known as a Brazilian butt lift or BBL.

According to the most recent complaint filed, a woman was hospitalized after Julio A. Clavijo-Alvarez, MD, placed drains improperly for her recovery and failed to document the complications in a follow-up visit.

In the complaint, the Florida Department of Health alleged that Clavijo-Alvarez saw a patient in 2021 at the New Life Plastic Surgery clinic in Miami for a Brazilian butt lift and placed a Jackson-Pratt (JP) drain under the rectus abdominis muscles, under the peritoneum, and inside the abdominal cavity.

According to the complaint, "the prevailing professional standard of care required Respondent to refrain from placing a JP drain" in any of these areas. The next day, the patient presented first to Jackson West Medical Center in Doral with back and abdominal pain, and then was transferred to Jackson Memorial Hospital in Miami, where the drain in her abdominal cavity was removed.

A few days later, the patient returned to meet with Clavijo-Alvarez, who documented their meeting, but reported that the patient had had no pain post-BBL, the complaint alleged, and failed to record the subsequent hospital stays, which the Department of Health alleges was a violation of Florida statute.

Pat Pazmiño, MD, a plastic surgeon and owner of Miami Aesthetic, told 番茄社区app that in the normal course of liposuction, water and epinephrine are injected into the layer of fat between the skin and muscle to help limit bleeding and create working space for the surgeon. After liposuction, a drain is placed in that layer for any remaining water to escape, which helps the patient heal more quickly and comfortably.

"If you can think of the abdomen kind of like a five-story building, we're only supposed to be working in the attic. The drain [in this case] ended up on the second floor," said Pazmiño, who often reviews complaints as an expert for the Florida Department of Health. "So it was really way too deep, and there's no use for a drain there. ... That's not an appropriate place for a drain."

Clavijo-Alvarez had two other complaints filed against him from 2021 and 2022. The first centered on findings from an inspection of a different clinic where Clavijo-Alvarez was working called Jireh Cosmetic Center Corp in Miami Lakes.

Pazmiño said it is common for surgeons to move between clinics or for clinics to change names.

Only a few months prior to the complaint about the BBL drains, the Department of Health found that "on one or more occasions," Clavijo-Alvarez didn't perform or document a preoperative examination, didn't provide the patient in writing with information about his hospital staff privileges, did not obtain informed written consent from the patient on risks of the procedure and anesthesia, and removed more than the established limit of supernatant fat from a patient during liposuction.

The clinic, the complaint alleged, had items missing from the crash cart and employed a nurse without post-anesthesia care unit experience to monitor patients recovering from anesthesia.

In the 2022 complaint, also from New Life Plastic Surgery, another inspection found blank, pre-signed prescriptions from Clavijo-Alvarez for oxycodone and diazepam in an "unsecured area" of the clinic, which the Department of Health alleged was grounds for disciplinary action by the medical board.

The Florida Department of Health filings serve to further cement South Florida as a hotspot for dangerous and sometimes deadly Brazilian butt lifts, though the events occurred before the state's legislators in May 2023 with additional safety measures for BBLs.

These complaints follow a the family of a woman who died in 2021 from a pulmonary fat embolism after her surgeon, working out of Seduction Cosmetic Center in Miami, reportedly presented her with false paperwork and punctured her abdominal wall and internal organs during a BBL.

Clavijo-Alvarez's physician profile lists his Florida medical license as "Clear/Active" and does not note any discipline on his license beyond the public complaints, which could include fines, suspension, remedial classes, or revocation as a result of hearings before the medical board.

Pazmiño had not reviewed all three complaints against Clavijo-Alvarez, but said the clinics' practices with respect to the allegations, "really raises concern as to how closely they are paying attention, and to what they're prioritizing. ... It's very troubling when you see a lot of different breaks with the standard of care."

Clavijo-Alvarez, Department of Health general counsel, and the Florida Board of Medicine did not respond to requests for comment from 番茄社区app.

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