Defendant appeared in court in Bay Area cosmetic butt injection death

Vivian Gomez was arrested in May and charged in the the death of San Jose social media influencer Christina Ashten Gourkani. Prosecutors allege Gomez administered illegal butt-enhancing injections that led to Gourkani's death.

On April 19, Christina Ashten Gourkani, a 34-year-old social media influencer from San Jose known for her resemblance to Kim Kardashian, met a woman at a Burlingame hotel room to receive buttock-enhancing injections.

Gourkani, who had undergone cosmetic procedures before, quickly fell ill and was rushed to a hospital, San Mateo County prosecutors say, and died the next morning after suffering from an infection and a pulmonary embolism.

The Florida woman who administered the gluteal injections, Vivian Gomez, has been charged with involuntary manslaughter, practicing medicine without a license and great bodily injury associated with practicing medicine without a license. She appeared briefly in San Mateo County Superior Court on Wednesday afternoon but did not enter a plea as expected; proceedings were pushed back to July 11 to allow more time for an autopsy report to be released. If found guilty, Gomez could face up to eight years in jail.

The District Attorney's Office and Gomez's attorneys are still awaiting the results of an autopsy, which would confirm the contents of the injections. Prosecutors believe they contained silicone and led to Gourkani's death.

"Our client is quite distraught," said Gomez's attorney, May Mar, after Wednesday's hearing. "She is an esthetician by trade and cosmetologist. Did she cause the death of the victim? Yes or no? That's why it comes down to that autopsy report, among other things."

It is the latest in a string of incidents around the country where people were injured or died after unlicensed administration of buttock-enhancing injections. Botched butt injections made headlines last year in New York City, where a 53-year-old woman was dumped and later died at a Bronx hospital with unusual injection marks on her buttocks. Earlier, a woman died in Atlanta a day after getting injections of silicone that later reached her lungs, and in Philadelphia, a 20-year-old student died after receiving a butt injection at a hotel.

It's not clear how many unlawful cosmetic injections are performed each year, nor how many people are harmed or killed by them. This is largely because the procedures are performed by individuals without medical licenses who typically don't report injuries or deaths to authorities.

Organizations such as the American Society of Plastic Surgeons track outcomes from a different butt-enhancing procedure known as the Brazilian Butt Lift, or BBL — which involves transferring fat from other parts of the body to enhance the buttocks. BBLs are done legally by licensed plastic surgeons but are one of the riskiest types of plastic surgeries, with an estimated 1 in 13,000 BBLs resulting in death.

With illegal silicone butt injections, victims often don't know who to report injuries to or may be afraid to tell authorities that they’ve undergone an illicit procedure.

But there's growing concern over illegal buttock-enhancing silicone injections, and the number of people who’ve received the illicit injections could be in the hundreds or thousands.

In a 2017 warning to consumers about the dangers of injectable silicone, the U.S. Food and Drug Administration said it was "alarmed by the increasing trend of injectable silicone being used for body contouring purposes."

The agency has worked with the Justice Department to bring criminal charges against at least five people in the last seven years in Miami, Puerto Rico, Boston and Atlanta for performing illegal buttock-enhancing injections that led to injuries or deaths of patients. In the Atlanta case, one woman died 36 hours after receiving a buttock-enhancing silicone injection that migrated to her heart, lungs and brain, according to the FDA and Justice Department.

Silicone injections are not cleared by the FDA for body contouring or enhancing purposes. When injected into areas with many blood vessels, such as the buttocks, silicone can travel through those vessels to other parts of the body and block blood vessels in the heart, lungs or brain — causing a stroke or death. Injectable silicone can also cause scarring, disfigurement and the formation of a painful gravel-like substance that stays permanently under the skin.

Prosecutors elsewhere in California have also brought at least two cases in the last four years against people who gave cosmetic injections without a license, including a mother-and-daughter duo in Los Angeles County who are awaiting trial on murder charges after giving buttock-enhancing silicone injections to a woman who police say died as a result of the procedure in 2019.

Last month, a San Jose couple were arrested and charged with practicing without a medical license at a "med spa" where they gave clients Botox and lip fillers. There were no major injuries or deaths reported, said Ann Huntley, the Santa Clara County deputy district attorney handling the case.

The unlicensed administration of cosmetic injections is likely more widespread than the number of cases that are brought to regulators’ and prosecutors’ attention, said Huntley, who is part of the district attorney's consumer protection unit that is investigating several other similar cases.

"My suspicion is that, like any other black market service, there's a lot more of it going on than the one or two cases we actually hear about," Huntley said.

Chronicle reporter Gabe Castro-Root contributed to this report.

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