Shatarka Nuby just wanted to be pretty.
She longed to fill out her jeans, to look curvier in her bikini, so she sought out a man with a syringe who said he could sell her the body she wanted for $1,000.
In her bedroom in South Florida, witnesses later told police, Nuby handed Oneal Ron Morris a wad of cash and stretched out on her stomach. Morris plunged a syringe filled with clear liquid into Nuby's hips and buttocks, the onlookers said. Her skin began to rise under the needle.
Nuby underwent treatments for four years and, in time, fell ill. She died in March at age 31.
Morris, 31, now awaits trial on charges of manslaughter. Police say that, using the alias "Duchess," he gave injections to multiple women in South Florida — pumping their buttocks and other body parts with silicone, mineral oil or Fix-A-Flat tire sealant and sealing the wounds with Super Glue.
Nuby is one of hundreds of people who have turned to a black market version of cosmetic surgery, sometimes with lethal consequences. Her official cause of death: respiratory failure triggered by a massive migration of industrial-grade silicone.
Some see the injections as a quick fix to a body image problem. Others are strippers or sex workers who seek more feminine bodies, or transgender men who can't afford hormone therapy.
"Too often, these are acts of desperation," said Harper Tobin, policy director at the National Center for Transgender Equality.
Since 2002, authorities across the country have investigated more than a dozen deaths related to illegal buttocks injections. Eight people were convicted of practicing medicine without a license or similar offenses. Two others were convicted of negligent homicide or manslaughter.
In a high-profile case out of Philadelphia, Padge Victoria Windslowe, 42 — the self-proclaimed "Black Madam" — was charged in July with third-degree murder.
In September, a Mississippi judge charged Morris Garner, 52, with depraved-heart murder in the death of an Atlanta woman. Investigators say a silicone-like injection caused the blood clots that killed Karima Gordon, 37.
"Until recently, this has been sort of a dark secret," said Dr. Malcolm Roth, president of the American Society of Plastic Surgeons. "If you have a back-alley procedure done and live to tell the tale, you'll never be able find the person who did it."
The practice is an illegal variation on a growing trend sometimes called the Jennifer Lopez effect: the search for the perfect posterior. According to the society of plastic surgeons, Americans spent more than $26 million last year on legal buttocks augmentation.
As the legal market grows, so do less-legal options.
Dr. Angel Coz was on the clock at Detroit's Henry Ford Hospital in January 2011 when a young woman came in. Her chest hurt. She was coughing up blood.
X-rays showed silicone scattered across her lungs, like stars in the Milky Way.
She had gone with her girlfriends to a "pumping party" in a hotel room, she told Coz, where they negotiated a group discount on silicone injections. The shortness of breath hit immediately after the shots.
"People don't know what they're getting into when they go into that hotel room," Coz said.
It's impossible to say how common the practice has become, but Kimberly Smedley's case suggests it's widespread.
Over nine years, prosecutors said, the Atlanta woman ordered 4,920 pounds of centistoke dimethyl siloxane fluid, often an additive for furniture polish. She called the fluid medical-grade silicone and dispensed it from a Poland Spring water jug at $500 to $1,600 a shot.
"It's illegal," Smedley wrote in a text message to a client, according to court records. "I'm not a doctor and I'm not a nurse."
Smedley said she made $200,000 over nine years. Bank records indicate her profits were closer to $1.3 million, prosecutors said.
In February, Smedley, 46, pleaded guilty to illegally transporting liquid silicone from Atlanta to at least four states. She was fined $25,000, sentenced to three years in prison and ordered to pay $8,106.02 in restitution to one victim's hospital and insurance company.
"My initial reaction was, 'Boy, this must be unique,'" said Rod Rosenstein, a U.S. attorney in Maryland who prosecuted Smedley. "But we obviously came to learn that this wasn't the case."
In July authorities charged Windslowe of Philadelphia with third-degree murder in the death of an aspiring hip-hop dancer from London. Prosecutors said Windslowe, a transgender woman who calls herself "the Black Madam," ran a silicone injection business out of airport hotels.
Claudia Aderotimi, 20, read about Windslowe's services online, according to charging documents, and flew to the United States in 2011 for the procedure. She paid Windslowe $1,800 for injections to her buttocks and hips. The chest pains started immediately, prosecutors said.
Aderotimi died days later.
Windslowe was already in jail when charged with Aderotimi's death. Police had arrested Windslowe at a pumping party, where they found a line of women waiting to be injected.
Silicone has been a central part of plastic surgery since the 1960s, when it was first shaped into implants and injected freely into cheeks, breasts and hips. Medicine has since shown that silicone can migrate. The Food and Drug Administration banned direct injections of silicone in 1992.
"The body recognizes microscopically that silicone doesn't belong there," Roth said. "When you inject things, they don't stay in one place."
The buttocks have a high blood-vessel count. Silicone injected there has a higher likelihood of entering the bloodstream, hurtling resin particles throughout the body. In the lungs, silicone can cause major artery blockage. In the brain, strokes. Everywhere else, tumors.
Doctors can try to remove silicone particles, Coz said, but there's no magnet or vacuum to catch every piece.
For transgender men, risking the procedure is often a result of frustration, said Tobin of the National Center for Transgender Equality. Patients pay thousands of dollars for cosmetic surgery and hormone therapy, and sometimes expect immediate or dramatic results. Procedures are not always covered by health insurance.
"Transgender people can suffer real distress," Tobin said. "They're distraught about their appearance corresponding with their mental image of themselves."
Shatarka Nuby was not transgender. The mother of one girl just wanted fuller curves. She paid Morris thousands of dollars for cup after cup of silicone — in all, 10 rounds of injections, police said. Her buttocks and hips swelled. Sometimes, after the needle slid out, she ran downstairs to her grandmother to show off her new body.
Last November, Nuby wrote to the Florida Department of Health. She was worried, she said. Her skin was turning hard and black.