Prominent Brazilian plastic surgeon Denis Cesar Barros Furtado, also known as “Dr. Bumbum,” has been charged with murder after a patient died following a butt enhancement procedure. Furtado is accused of giving Lilian Calixto a fatal injection of polymethylmethacrylate in his Rio de Janeiro apartment in July. Calixto, 46, fell ill during the procedure and later died at a hospital.

Furtado had built his entire career around enlarging women’s butts. The surgeon had reached 650,000 Instagram followers posting before-and-after-surgery photos on the platform. His Instagram account was shut down in July. His Facebook page has more than 47,000 followers, but nothing has been posted since before the fatal procedure.

Calixto, a married mother-of-two, worked as a manager for HSBC. She traveled to the doctor’s apartment in the city’s Barra de Tijuca area from her hometown of Cuiaba, about 1,250 miles away, to receive the treatment. Furtado is not registered to practice medicine in Rio de Janeiro.

Prosecutors said Furtado injected 300 ml of polymethylmethacrylate, also known as acrylic glass fillers, into Calixto’s butt. According to court documents, the filler is only supposed to be used “in small doses and with restrictions.” The BBC reported earlier this month that Furtado posted on Facebook that using PMMA for butt enhancement was “a minimally invasive procedure, offering immediate and definitive results, using local anesthesia and therefore painless, without much need of rest after the procedure.”

Calixto became ill during the procedure, alarming the doctor enough that he transported her to a local hospital. The BBC reported the woman was “suffering from an abnormally fast heart rate” when she was transported to the hospital and suffered four heart attacks before she died. Furtado left the scene after he dropped Calixto off and later went on the run with his mother for four days.

Furtado was arrested on July 19 and charged with homicídio doloso, where a person acts with the intent to kill or takes the risk of killing as a predictable consequence of their actions. He faces 12 to 30 years’ imprisonment. Furtado has denied wrongdoing in the death.

His mother and girlfriend also have been arrested as suspected accomplices. Furtado’s mother faces charges for allegedly “continuing to practice medicine and operate with her son after her medical license was revoked.” Renata Fernandes, the girlfriend, was taken into police custody “on suspicion of taking part in the procedure.” His maid is also reportedly facing charges.