Denis Furtado’s Instagram is filled with photos of women’s butts. That’s because he is known as “Dr. Bum Bum” and has built his entire career around enlarging them.

But things went awry for the Brazilian doctor last month when one of his patients, Lilian Calixto, became sick after he gave her butt-enhancing injections at his home. Furtado brought the 46-year-old to a hospital, but it was too late. The mother of two died, and Furtado disappeared.

A few days later, he was arrested. Now he has been charged with murder. His mother and girlfriend also have been arrested as suspected accomplices.

The public prosecutor’s office in Rio de Janeiro said this week that Furtado “had attracted women with the false promise of quick and immediate beauty” and was using his apartment to provide aesthetic procedures “in a very provisional and precarious way.” Furtado, who was not licensed to practice medicine in Rio de Janeiro, allegedly injected Calixto with 300 milliliters of PMMA, an acrylic glass filler substance sometimes used in plastic surgery. The prosecutor’s charge sheet said the substance is intended to be “used only in very small doses and in a restricted way.”

Niveo Steffen, president of the Brazilian Plastic Surgery Society, told Agence France-Presse that “you cannot perform plastic surgery inside an apartment.”

“Many people are selling a dream, a fantasy to patients in an unethical way and people, weakened, are often attracted to low prices, without considering whether or not the conditions are adequate,” he said.

Furtado has defended himself on social media, claiming that he has performed 9,000 similar procedures and that Calixto’s death was a “fatal accident.”

Plastic surgery is not uncommon in Brazil. In 2013, for the first time, more cosmetic surgeries were performed there than in the United States. In some cases, the government reportedly subsidizes the procedures.

Calixto had traveled more than 1,000 miles to visit Furtado, whose social media following had earned him minor celebrity status in Brazil. He has 650,000 followers on Instagram, where he has posted many before-and-after photos of women’s butts that received thousands of likes.

The BBC said that earlier this month, Furtado wrote on Facebook that using PMMA for butt enhancement is “a minimally invasive procedure, offering immediate and definitive results, using local anesthesia and therefore painless, without much need of rest after the procedure.”

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