Mother, daughter duo knew the dangers before deadly butt-lift gone wrong, prosecutors say

Paramedics had little idea of what was happening to her. After bringing her to a hospital, Rajpaul stopped breathing and died.

When a mother and daughter duo from Riverside administered a lethal dose of injectable silicone into 26-year-old Karissa Rajpaul’s buttocks at a home in Sherman Oaks in October 2019, killing her within hours of the procedure, the adverse results she showed almost immediately should not have come as a surprise, prosecutors said Tuesday, Feb. 20.

Rajpaul stopped breathing and began to lose consciousness after the pair — 53-year-old Libby Adame and 26-year-old Alicia Galaz — stuck two syringes into her backside, pressing the plungers several times to inject her with the liquid that was supposed to prompt the growth of fat cells in her butt cheeks, making them look fuller.

Paramedics who arrived at the home after a companion of Rajpaul called 911 had little idea of what was happening to her. After bringing her to a hospital, Rajpaul stopped breathing and died.

Adame and Galaz should have known Rajpaul’s death was possible, prosecutors said inside the Los Angeles courtroom where the first day of the pair’s murder trial played out Tuesday, because they had seen it happen before.

Galaz had been on hand for the death of another woman, Karina Arias, a little more than a year before, said Deputy District Attorney Lee Cernok. Arias died after getting the same procedure at a salon in South Gate, Cernok said. Security camera footage showed Galaz arriving at the salon that day; the footage also showed her waiting with an associate in the salon’s rear parking lot as paramedics rushed in the front, finding Arias unconscious and unsuccessfully attempting to revive her.

Cernok revealed the other woman’s death in her opening statements Tuesday as she sought to show the jury of 10 men and six women that both Adame, known as “La Tia” on social media, and Galaz should have known the risks that came with the butt-lifts they had performed on hundreds of women over nearly a decade across Los Angeles County.

Cernok accused the two of implied malice murder — that is, the risks of the procedure were so well known to the pair that they showed malice in injecting Rajpaul with the liquid. They have been charged with one count of murder, as well as three counts of performing medical operations without a license.

The women put all of their customers at risk, over and over, while reaping riches and social media fame at their expense, Cernok said.

“They kept going and going and going, to make money,” Cernok told the jury.

Attorneys for Adame and Galaz however, cast doubt on Cernok’s murder claims. They said the women could not be held criminally liable for Rajpaul’s death. They said California law does not outlaw butt-lift procedures.

Given that Rajpaul sought out the treatment — the operation that killed her was her third such session with Adame and Galaz — and consented to being operated on, they questioned the filing of murder charges.

“The facts are not in dispute,” said Michael Flanagan, an attorney for Adame, outside the courtroom Tuesday. “What’s in dispute is what the law says.”

In his opening statement, Flanagan described the operation that killed Rajpaul as a fatal accident, not a murder.

“Things went wrong,” he told the jury. “This is not a case of a cold-blooded killer.”

Whether they’re found guilty or not, the charges filed against both women in 2021 brought to light an underground culture of amateur butt-lifts sought out by women in the greater Los Angeles area. The procedures have roots in Mexico and in Central and South America. Sometimes known as “Brazilian butt lifts,” the popular body modifications carry extreme risks, according to U.S. regulators.

The potential harms of injectable silicone have been known for years. Such procedures are not approved for use in the United States. The FDA has warned against them since at least 2017.

“Silicone injections can lead to long-term pain, infections, and serious injuries, such as scarring and permanent disfigurement, embolism (blockage of a blood vessel, stroke and death,” the agency wrote. “NEVER get any type of filler or liquid silicone injected for body contouring or enhancement. This means you should never get breast fillers, ‘butt fillers,’ or fillers for spaces between your muscles.”

The horror of Rajpaul and Arias’ deaths was on full display for the jury on Tuesday.

Prosecutors showed the jury the autopsy photos of both women: Arias’ pale body laid out on a coroner’s examination table, puncture wounds visible above both butt cheeks.

Rajpaul’s autopsy, too, showed deep punctures above her butt cheeks where Adame and Galaz stuck syringes into her. Examiners cut into her skin to investigate the damage done to her muscle tissue by the needles, as well as to extract the liquid injected into her. The pale red liquid inside her was found to be silicone, Cernok said.

Adame and Galaz sat quietly in the small courtroom as both sides presented their arguments to the jury.

Clad in a pale gray fur coat, Adame shifted in her chair, looked back at the gallery at family members and whispered to Flanagan. Galaz, wearing a black and white coat emblazoned with newspaper-style prints, adjusted her hair, occasionally smiling at her attorney.

It was not clear Tuesday whether any criminal charges had been filed in the death of Arias. Cernok said her death had been under investigation by police when investigators heard of Rajpaul’s death. But an LAPD detective who investigated Rajpaul’s death in Sherman Oaks declined comment outside the courtroom.

Prosecutors said Galaz helped two other women administer the procedure performed on Arias at the South Gate salon.

After she died at a hospital, prosecutors said Arias’ cell phone was tracked back to Adame and Galaz’s luxurious mansion in Riverside. Later that night, Arias’ phone pinged a cell phone tower one last time before it was turned off.

The first witness called Tuesday was Rajpaul’s husband, Marco Gianuzzi.

Gianuzzi, who lived with Rajpaul in Reseda, at times teared up and spoke hesitantly from the witness stand, taking several gulps from a water bottle. He said he was present for the first two procedures Adame and Galaz performed on his wife. Gianuzzi said he objected to both.

Knowing he opposed her continuing to get butt lifts, Gianuzzi said he believed his wife hid the third procedure from him. On Oct. 19, 2019, he got a call from police informing him his wife had died.

In cross examination, Flanagan asked whether Gianuzzi actually liked the affects he saw in his wife’s buttocks after she got the lifts done. He adamantly said he didn’t.

“She was beautiful to me like this — natural,” Gianuzzi said. “I actually dislike big butts.”