Salford mum died after poor care following Brazilian Butt Lift in Turkey
Demi Agoglia died in Istanbul, three days after her operation
Last updated 11th Dec 2024
A mother-of-three from Salford died after she was subjected to a catalogue of poor care when she underwent "Brazilian butt lift" surgery in Turkey, an inquest has heard.
Demi Agoglia, 26, was said to be "conscious about the way she looked" and was insistent on undergoing the BBL procedure which sees fat taken from elsewhere on the body and injected into the hips and buttocks.
She died in a hospital in Istanbul on January 8 just three days after the operation.
On Wednesday, Bolton Coroner John Pollard ruled the medical cause of death was a microscopic fat embolism in which tissue leaks into the bloodstream.
Concluding Ms Agoglia died as a result of misadventure contributed to by neglect, he said: "I find there was no proper informed consent in this matter, there was no proper pre-operative care and advice, and no proper post-operative care.
"All of this meant the care in total fell well below the standard expected of this type of treatment and the lack of care contributed significantly to Demi's death."
Mr Pollard told Ms Agoglia's family he would write to Health Secretary Wes Streeting, adding: "I do feel something further needs to be done to stop this frankly barbaric medical practice being conducted to such low standards that would certainly not be tolerated in the UK."
Bolton Coroner's Court heard that Ms Agoglia, from Little Hulton, had struggled with her mental health and was on medication for ADHD and bipolar disorder.
Her mother, Christine Tydd, told the hearing she told Ms Agoglia she was a "good looking girl" and did not need the operation, shortly before her daughter travelled to Turkey on January 4 with her partner, Bradley Jones.
She said: "She was conscious about the way she looked. There was no changing her mind."
Landscaper Mr Jones said he also did not want Ms Agoglia to have the surgery, but she had booked the trip months earlier through a company named Comfort Zone Surgery after "she had seen some celebrity" advertising the procedure.
The couple stayed in a shared villa in Istanbul before they were taken by taxi to hospital.
Following the operation Ms Agoglia was "shaking" and appeared "very, very cold", said Mr Jones.
Staff from Comfort Zone were called to the villa after Ms Agoglia complained of a tight chest and they checked her blood pressure but did not inspect the area of the operation or check her heart rate and pulse, the inquest heard.
Ms Agoglia collapsed at the villa the following day and was taken back to Avrasya Hospital where she died.
The surgeon who conducted the operation later told Mr Jones they had done everything they could.
It later emerged that the Comfort Zone staff who were called out to the villa were not qualified nurses.
Giving expert evidence, Harley Street consultant plastic surgeon Dr Omar Tillo noted the "completely bizarre" actions of the Comfort Zone staff who tried to feed pieces of cucumber to Ms Agoglia after she collapsed.
He said: "The lack of proper care and response, particularly the failure to address post-operative complications, are likely to have played a significant role in Demi's tragic outcome."
Dr Tillo said the BBL procedure is performed in the UK "within very strict rules to do it safely".
Pathologist Dr Usha Chandran carried out a post-mortem examination on January 25 and ruled the cause of death was "unascertained" because she found no evidence of microscopic fat embolism.
But Mr Pollard pointed out that deterioration of the body can take place when there is such a delay between the death and the post-mortem examination.
Dr Tillo agreed with Mr Pollard that it would seem "almost incredible" that the death of a young, physically fit woman was not linked to the BBL operation she underwent.
Dr Chandran told the hearing: "I'm really disturbed by Demi's death and I feel all these cosmetic procedures are given a lot of importance by celebrities... and are being done in shoddy clinics."
The inquest heard that the coroner's office had sent multiple emails to the Turkish hospital and the surgeons involved to obtain statements but had received no response.
Mr Pollard said: "Most inquests are sad by their very nature. This inquest is especially so as it involved the death of a young woman with considerable mental health issues who, despite the fact she was pretty and her partner did not think she needed any improvement, insisted on having a BBL surgery.
"I found that she went to Turkey presumably because the process was quicker and cheaper than the UK.
"We know little or nothing of the perioperative situation because the Turkish authorities refused to co-operate with the coronial process.
"I do find the post-operative care varied from woeful to completely non-existent.
"When she showed obvious symptoms of serious illness it was not immediately recognised by her partner, understandably, or the unqualified members of staff.
"By the time she got to the hospital it was frankly too late and she was in an irrecoverable state.
"I think it was indicative of the poor level of care that at all times she was transported not in an ambulance but in a taxi, it was always the same taxi.
"I heard extremely helpful evidence from Dr Tillo who clearly spelt out all the failures and failings he was able to assess from the evidence and the sparse documentation available to him."
No record of any intensive care unit admission or of any tests and scans carried out had been produced, the inquest was told.
Following the inquest, Ms Agoglia's sister, Chloe, 23, said: "I just wouldn't recommend anyone going to Turkey for any possible surgeries, or to research more about it if they are even thinking about it.
"She was so beautiful and just didn't need any surgery at all. She only went for the sake of her being so down in herself and not feeling good enough.
"Our Dem hasn't just left her family behind, she's left the most beautiful little boys.
"Forever and always in our heart Dem. We really did give this our all. Sleep tight Dem."