State: Florida’s Cosmetica doing illegal BBLs, liposuction

(Getty Images)

(Getty Images)

Adley Da Silva is a licensed physician’s assistant. Kiomy Quintiana, his wife and sales manager at Da Silva’s Cosmetica Plastic Surgery & Anti-Aging, has never held a medical professional license in Florida.

And a state inspector says Da Silva, who has had only two days of training, did illegal Brazilian butt lifts and other liposuctions at Cosmetica in Port St. Lucie, and helped Quintiana perform a cosmetic surgery there. The inspector said a Da Silva butt lift and breast augmentation left the patient with gaping wounds and a life-threatening skin infection.

The inspector alleged those and other violations in three emergency orders posted last week: an emergency suspension order (ESO) on Da Silva’s physician assistant license (spelled “Adley Dasilva” on the license and discipline paperwork); an ESO on Cosmetica’s office surgery registration; and an emergency restriction order (ERO) on Aventura Dr. Ernest DiGeronimo, who was supposed to be Cosmetica’s physician supervising physician and designated.

In addition to Quntiana being allowed to perform a cosmetic surgery that involved inserting an instrument under a patient’s abdominal skin, Da Silva’s ESO states at least two other unlicensed people were allowed to assist Da Silva during butt-lift surgery.

Also, the Cosmetica staff “refused to allow the inspector into the operating room to check the crash cart, equipment and supplies. Therefore, the inspector was unable to determine if the required emergency medication, equipment and supplies were present and were biomedically inspected and maintained.”

As of Thursday morning, Adley Da Silva’s Instagram page still said he was a “Lipo Expert.”

In response to an Instagram direct message from a Miami Herald reporter, Da Silva wrote: “We have already secured our legal counsel and we will fight back. [against] all the false allegations.”

The home page of Cosmetica’s website claims certification by the American Board of Plastic Surgery, but a check of that website shows certification only for doctors, and DiGeronimo isn’t board-certified. DiGeronimo’s predecessor at Cosmetica, Dr. Luis A. Viñas, was board-certified, but he left in March.

What follows are from the emergency orders, state license profiles and state corporate records:

Who’s supposed to be doing surgeries at Cosmetica?

In 2019, Da Silva took Silva Cosmetics from West Palm Beach to Port St. Lucie and changed the company name to Cosmetica Inc. The facility became licensed for office surgery under Cosmetica Plastic Surgery & Anti-Aging on Dec. 4, 2019.

Office surgeries are classified as Level I, II or III based on the level of sedation. For a Level II or III surgery in the office setting, the surgeon must have privileges at a licensed hospital. Failing that, the surgeon must have undergone board certification training, which requires at least a combined eight years of general residency and plastic surgical residency and an oral exam; or board qualification training.

Also, the surgeon in Level III procedures must know the principles of general anesthesia.

“Mr. Da Silva was registered as “recovery personnel” at Cosmetica,” Da Silva’s ESO says. “Mr. Da Silva has never been a licensed medical doctor in the state of Florida and has never been registered to perform or assist in surgeries at Cosmetica.”

Da Silva’s only training in liposuction or blepharoplasty, his ESO says, was a two-day course in VASER liposuction in Bogota, Colombia.

“Mr. Da Silva has not completed any residencies or similarly rigorous training programs in either general surgery or plastic surgery,” his ESO said.

IMG_9845.PNG Ashley Da Silva's Instagram page
A Friday, June 10, screenshot of Adley Da Silva’s Instagram page, which declares the physician assistant is a “Lipo Expert.” Emergency orders say his only training of her as far as liposuction was a two-day course in Colombia. Instagram

From December 2019 through this past March, Dr. Luis A. Viñas was the only registered surgeon at Cosmetica. DiGeronimo took over Viñas’ roles on March 7. But DiGeronimo was also the designated surgeon at his own office in Aventura. The inspector said twice that surgical logs place him in Aventura and Cosmetica, about 100 miles apart, at the same time. Once, they said he started a surgery at Cosmetica only 40 minutes after he finished in Aventura, possible only if DiGeronimo covered the distance at 150 mph.

Neither doctor was at Cosmetica on Jan. 5 when TM came for a “Surgical Package.”

A Brazilian Butt Lift, breast surgery and something that wasn’t done

“TM” planned for one-stop surgery shopping on Jan. 5 at Cosmetica — Brazilian butt lift, breast augmentation, abdominoplasty and umbilical hernia repair, which pushes the pouch of belly lining back through a hole in an abdominal wall and stitches it into place .

The man doing the surgeries? DaSilva.

She “believed that Mr. Da Silva was a licensed medical doctor, as Cosmetica staff members referred to Mr. Da Silva as “doctor” several times in her presence,” his ESO says. “Mr. Da Silva performed Patient TM’s surgery on Jan. 5, 2022 under general anesthesia with intubation, a Level III surgery.”

And helping Da Silva wasn’t Viñas, but Fernando Gabaldon. Gabaldon’s Instagram page says he’s an experienced plastic surgeon in Venezuela. Cosmetica’s website features him more prominently than Da Silva, although he’s called “first assistant.” Gabaldon is certified by the American Board of Surgical Assistants, but holds no licenses in Florida.

Afterward, TM had “severe pain and gaping wounds which would not heal” even through post-op appointments with Da Silva in January and February. Her de ella “abdominal skin de ella began to necrotize.”

“A necrotizing soft tissue infection is a serious, life-threatening condition that requires immediate treatment to keep it from destroying skin, muscle, and other soft tissues.” Johns Hopkins Medicine explains.

His ESO criticized Da Silva for poor wound care that featured “superficial” wound dressings, opioids for pain and antidepressants. He didn’t refer her to a board-certified plastic surgeon or a specialist in wound care. His referral for hyperbaric oxygen therapy came only after TM suggested it.

When TM got to Fantastic Wellness Center Med Spa in West Palm Beach for the hyperbaric therapy, a nurse referred her to a plastic surgeon. He saw TM who, the ESO said, “still had open wounds on her abdomen and flank, her breast implant was displaced and her umbilical hernia was present and untreated.”

Da Silva “apparently did not perform the umbilical hernia repair.”

A visit from a Department of Health inspector

The Florida Department of Health inspector who visited Cosmetica on March 11 to talk to Da Silva about reports of unauthorized plastic surgeries was told he was in surgery. Cosmetica seated the inspector in a room with closed circuit televisions showing various parts of Cosmetica, including the entrance to the operating room.

The inspector saw several Cosmetica staffers, including Quintiana, Da Silva’s ESO says, “going in and out of the operating room without surgical attire, such as gowns, gloves, face masks, and/or shoe coverings while the surgical procedure was in progress, in violation of Cosmetica’s policies and procedures manual.”

When Da Silva came out, he told the inspector that he did a blepharoplasty that morning and would do liposuction that afternoon. After saying he was supervised by a physician, he admitted there wasn’t a physician there that day.

This is when Cosmetica staff kept the inspector out of the operating room. But the inspector checked out surgical logs and patient charts.

Some anesthesia charts listed Viñas as a surgeon for procedures done on days he wasn’t there. Five operative reports didn’t have a surgeon listed. The operative report for TM, whose surgery was Jan. 5, 2022, was dated April 29, 2022, the day after the Department of Health hit Da Silva with a subpoena for TM’s records.

That report also lacked necessary information such as the breast implant serial numbers, how much supernatant fat was removed (there is a 1,000 cc limit in Florida) or why the umbilical hernia repair wasn’t done.

An anesthesia chart for a Level III surgery had Da Silva and “Dr. Maricz” as the surgeons. There’s no Dr. Maricz licensed in Florida.

“The vast majority of the records reviewed contained either conflicting or incomplete records,” Da Silva’s ESO said. “The frequent and repeated errors and inconsistencies in Cosmetica’s records are indicative of either gross negligence or intentional concealment.

“The inspector requested credential files for the staff members present at Cosmetica. After waiting for approximately three hours, Cosmetica staff failed to provide the files.”

This story was originally published June 16, 2022 8:48 AM.

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Since 1989, David J. Neal’s domain at the Miami Herald has expanded to include writing about Panthers (NHL and FIU), Dolphins, old school animation, food safety, fraud, naughty lawyers, bad doctors and all manner of breaking news. I have drinks whole coladas. He does not work Indianapolis 500 Race Day.

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