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MIAMI – Elsie Soto says she couldn't move her legs after she had liposuction and fat-transfer surgery last year at a clinic near here. But instead of sending her to a hospital, a nurse took Soto to her own house. Soto says she has no memory of being taken to the hospital two days later — on her mother's insistence — and needed two blood transfusions when she got there.

Joyce Wooten, left, says her surgery four years ago left her with lopsided ears and hanging skin. Michelle Cordi, right, sued because of wounds that didn't heal around her ears.

A 32-year-old single mother, Soto said she was tired of looking at all the beautifully toned people surrounding her in this popular beach town. She went to three area plastic surgeons before deciding to have her procedures done at Strax Rejuvenation and Aesthetics Institute. It was a simple matter of cost: The other estimates ranged from $10,000 to $12,000; Strax charged $5,000.

But after almost $50,000 in medical bills (including nearly $40,000 for her hospital stay) that insurance won't cover because the procedure was elective, three months out of work and continued pain down her left leg, Soto now says low-cost, high-volume cosmetic surgery clinics are not the way to go.

Strax, which has two locations in South Florida, boasts it is the busiest cosmetic surgery center in the U.S. Soto says that's part of the problem: She thinks she was just another patient whose problems got short shrift in what seemed like an assembly line of patients.

"On Sunday morning, everyone goes to Denny's and comes in and out, in and out, in and out," says Soto, a hospital purchasing aide. "That's how it was." Soto filed a complaint against Strax with The Joint Commission, an independent, not-for-profit organization that accredits most hospitals and many health care facilities, including Strax.

Strax says it is helping consumers by making cosmetic surgery affordable for the masses. Peter Mineo, an outside attorney for Strax, said in an e-mailed statement that Soto "suffered a bruise to her sciatic nerve," which he called a rare but well-known potential complication of fat-transfer surgery to the buttocks. He says Soto was told about the risk. The nurse treating Soto was violating company policy when she took Soto to her home, Mineo says, but called it a "very kind act." And Strax believes Soto's medical problems were quickly resolved, Mineo says. USA TODAY reviewed Soto's medical bills and a statement from her physical therapist.

By Jayne O'Donnell, USA TODAY

MIAMI – Her husband says he loved her the way she was, but Kellee Lee-Howard wanted a trimmer body. So she went to a clinic for "minimally invasive" liposuction.

Maria Shortall (left) and Kellee Lee-Howard.

James Howard woke up on Valentine's Day 2010 to find his wife lying dead on the living room couch.

Along with her husband, Lee-Howard, 32, left behind six children — ages 3 to 14 — and a trail of questions about the doctor here who isn't board certified in any medical specialty but performed a type of liposuction he trademarked and has been teaching other non-plastic-surgeons across the country.

Alberto Sant Antonio, whose office wasn't registered as a surgery center, had done the liposuction a day earlier. According to the autopsy report, Lee-Howard died of an overdose of the painkiller lidocaine from complications after "elective cosmetic surgery."

Lee-Howard told her husband she had learned of the Alyne Medical Rejuvenation Institute through an ad and that she'd found a "safe" way to lose weight by surgery.

After the procedure, she didn't feel well and went to sleep on the couch. The next morning, when their then-10-year-old son tried to ask her if he could play a video game, Howard noticed she wasn't breathing and "started screaming her name," trying to wake her.

There was so much lidocaine in Lee-Howard's body that it showed "a basic misunderstanding of the principles of pharmacology and patient safety," says Alberto Gallerani, a plastic surgeon here who is an expert witness in the Howard family's lawsuit against Sant Antonio. "It was just outrageous."

Reached at his office, Sant Antonio said he was "not at liberty to talk about the case." His attorneys did not return phone calls, but in July they filed a motion seeking to dismiss the case or require the Howard family's attorney to specify how Sant Antonio was negligent.