Main: Libby Adame in court in Los Angeles County in October 2025 (KABC). Inset: Cindyana Santangelo (Facebook).
A 55-year-old woman in California may spend the remainder of her days behind bars for killing a 58-year-old actor after administering silicone oil injections during an illegal butt augmentation procedure earlier this year.
A jury in Los Angeles on Thursday found Libby Adame guilty of second-degree murder and practicing medicine without a license in connection with the death of Cindyana Santangelo, who had appeared in shows such as “Married with Children,” “C.S.I. Miami,” and “E.R.”
Santangelo was the second of Adame”s “clients” to die under her care during an unlawful injection procedure. In March 2024, the fake doctor was convicted of involuntary manslaughter and practicing medicine without a license in connection with the 2019 death of 26-year-old adult film actor Karissa Rajpaul. Adame’s daughter, Alicia Galaz, was convicted of the same charges over the 2019 procedure.
Police at the time emphasized that the mother and daughter “had no medical training.”
A judge in Ventura County, California, in April 2024, sentenced Adame to four years and four months in prison while Galaz was sentenced to just under four years over Rajpaul’s death. However, both were released less than a year after sentencing after successfully arguing that they should be credited for time already served, including the time they spent under electronic monitoring following their initial arrests, People reported.
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In closing arguments, prosecutors argued that Adame had been explicitly warned about the dangers of such procedures after she was found guilty of killing Rajpaul. The presiding judge in that case had explained to Adame that she was “on notice of the dangers that could result” from continuing to perform the illegal procedures, emphasizing that such behavior would likely result in a murder charge, Los Angeles NBC affiliate KNBC reported.
“Did she know better?” Deputy District Attorney Lee Cernok asked before responding to his own question, saying the answer was “a resounding yes.”
Santangelo’s husband, Frank Santangelo, took the stand during the trial, telling jurors that his wife died inside their Malibu home after being injected by Adame, the Los Angeles Times reported. He also testified that Adame fled from the residence the moment she saw his wife start convulsing.
Adame testified in her own defense at trial, claiming that someone had administered an injection to Santangelo’s buttocks shortly before she went to the home as a consultant working for medical providers who could legally perform the procedure in Mexico, per KNBC. She claimed the victim’s backside was already bandaged when she first arrived and that the site of the injection was “too high” to have been her work.
As Law&Crime previously reported, Rajpaul died on Oct. 15, 2019, following a “buttocks augmentation procedure” inside of her home in Encino, California. Authorities said Adame had been using surgical grade silicon that had been cut with other dangerous chemicals.
“This cosmetic procedure involved injecting an uncontained, liquid silicone substance directly into the buttocks to make the buttocks look fuller,” police said following her arrest. “The consequence of injecting uncontained silicone into the body is that it can enter the blood stream and create embolisms which can result in serious illness or death.”
During the procedure at Rajpaul’s home, medical complications reportedly arose that led to Adame and her daughter calling for emergency assistance and then rushing out of the home before authorities arrived.
“The suspects fled the scene without identifying or informing the paramedics of the cosmetic procedure for proper lifesaving protocols to be initiated,” police said. “As a result, the victim died in an emergency room with tending physicians unaware of the silicone injection.”
The Los Angeles County Coroner’s Office ruled Rajpaul’s manner of death a homicide, finding that the cause of death was “acute cardiopulmonary dysfunction” and “intramuscular/intravascular silicone injections.”
Adame is facing 15 years to life in prison when she is sentenced on Nov. 5.
