Erin Schaeffer’s hopes for a slimmer figure after weight loss turned into a nightmare just days after a cosmetic procedure at Sono Bello, a national surgery chain. The 37-year-old training manager for UPS says she woke up with fluid leaking from an open stomach wound, triggering a severe infection that landed her in a Florida hospital for a week.
More than a year later, Schaeffer bears physical and emotional scars. In a lawsuit filed in Duval County Circuit Court, she accuses Sono Bello’s Jacksonville branch and Dr. Manuel Herrera—an obstetrician-gynecologist (OB-GYN)—of negligence, claiming Herrera lacked proper training to perform the tummy tuck and liposuction that left her in “excruciating pain.”
“I literally felt like I was skinned alive,” Schaeffer recalled.
Sono Bello and Herrera have denied the allegations. In a joint court filing, they refuted claims of inadequate training, with Robert Centeno, Sono Bello’s East region medical director, emphasizing in interviews with KFF Health News and NBC News that the chain’s surgeons undergo “very rigorous training.”
Backed by private equity, Sono Bello is part of a booming cosmetic surgery industry targeting Americans willing to pay up to $20,000—often via high-interest medical credit—for procedures like “Mommy Makeovers” and liposuction. The U.S. body-contouring market, valued at over $22 billion in 2024, has drawn scores of chains, but a joint investigation reveals a pattern of lawsuits alleging disfiguring injuries, including 12 wrongful death cases against such chains in the past seven years.
Court records and interviews highlight troubling practices: hiring doctors with minimal cosmetic surgery training, downplaying infection risks, using high-pressure sales tactics, and offering financial incentives for surgeons to operate on high-risk patients (e.g., those with obesity, which elevates complication risks). Regulatory oversight is scarce, with no national database tracking cosmetic surgery complaints—unlike the FDA’s system for drugs and devices.
Schaeffer’s ordeal began in March 2024, when she returned to Sono Bello for a mini-tummy tuck (marketed as AbEX) and additional liposuction, having been satisfied with a prior liposuction there. The procedure, performed under local anesthesia (touted by Sono Bello as safer with faster recovery), left her in unbearable pain. “I begged the doctor to stop,” she said. “I can’t handle the pain.”
Days later, she developed a fever, severe swelling, and eventually, leaking wounds. Sono Bello staff initially dismissed her symptoms as normal, but when Herrera examined her, he admitted she needed hospital surgery—yet couldn’t arrange it, as he lacked local hospital privileges (he is credentialed 140 miles away in Orlando). “I was in utter shock,” Schaeffer said.
Sono Bello spokesperson Mark Firmani noted the chain doesn’t require local hospital privileges for its doctors, though many have them. Centeno framed Schaeffer’s experience as rare, citing that “over 90% of patients” report comfort during procedures and positive outcomes.
Herrera, who remains with Sono Bello, is a board-certified OB-GYN who completed the chain’s 6–8 week fellowship in aesthetic procedures. He previously acknowledged limited prior experience in body sculpting. Critics, including established plastic surgeons, argue such short training is insufficient for complex surgeries.
Sono Bello is not alone. Chains like Mia Aesthetics and Goals Aesthetics have faced dozens of malpractice lawsuits, including wrongful death claims. Many cases are settled confidentially or dismissed due to arbitration clauses in patient contracts, which consumer advocates say favor providers.
Patients often describe aggressive sales tactics. Schaeffer said a Sono Bello agent pressured her to put money down during her first visit, and she met her surgeon only briefly a week before the procedure. “It was a hard sell,” she said. “She didn’t want me to leave without putting money down.”
Traditional plastic surgeons condemn such practices. “Patients need time with their doctor to understand risks—you can’t do that an hour before surgery,” said Scott Hollenbeck, president of the American Society of Plastic Surgeons.
High-risk patients, including those with obesity (BMI 30+), face elevated complications, yet chains like Sono Bello incentivize surgeons to operate on them. Court records show Sono Bello uses “surgical value units” to boost pay for procedures on higher-BMI patients. For example, a 79-year-old Nevada patient with a high BMI underwent surgery that earned her surgeon extra pay but led to severe sepsis and $2.6 million in medical bills, according to a lawsuit.
Centeno defended the practice, stating higher-BMI patients “require additional work” and that denying care based on BMI would be “discriminatory.” But medical experts warn obesity increases infection and complication risks.
Schaeffer, now paying $420 monthly for a procedure that left her injured, urges caution. “I trusted what they told me, which I think most people do,” she said. “But people need to research before diving in.”
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