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The ugly road to beauty
'Goodnight, sweetheart'
Hernandez stood by Lisa's side and held her hand as a doctor placed her under general anesthesia.
He promised her that a cardiologist would be in the room during surgery in case something went wrong, and he said he would come back later to check on her.
"And it's not because the press is here," he said. "We do this for all of our patients."
Lisa looked into his eyes and felt safe.
"Goodnight, sweetheart," Hernandez said. "See you when you're chesty."
Eight surgeries
The operating room was stuffy, the climate regulated by a ceiling unit that provided little cool air.
Lisa lay sedated on the operating table, her arms extended like a crucifix. Villarreal cut through her scalp, from ear to ear, and then peeled it over her face like an orange. It was the first step before he tightened the underlying muscles with sutures and pulled the skin up for her facelift.
A fly buzzed around Lisa's exposed, bloody face.
The surgeon and surgical nurse tried to swish it away, then instructed another nurse to kill it. She walked around the room with a bottle containing a reddish liquid and looked for the fly. She never found it.
A lone fly in an operating room may seem trivial, but it has the potential of spreading disease if it lands on open flesh, medical experts note. It also can be a red flag to unsanitary conditions.
"Even if that fly hasn't landed on her, what else is not sterile?" said Joe Johnston, a trauma surgeon at University Hospital in San Antonio.
In a five-hour span, Lisa would get a facelift, breast implants, an arm lift and cosmetic eye surgery.
Lisa was Villarreal's third operation of the day. He had performed a tubal ligation reversal on one patient and liposuction on another before it was Lisa's turn.
Calling for help
Back in her room, Lisa woke up in the middle of the night, turned around to inspect her bed and noticed the blood. Her sheets were sticky and wet and she desperately wanted them changed.
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She didn't find out until the next day that no cardiologist was present during her surgeries.
"What do you mean the cardiologist wasn't there?" she asked a reporter. "He'd (Hernandez) better have a good explanation for this."
Hernandez later told her that the cardiologist was nearby and, if he was needed, he could be there in 10 minutes.
She seemed satisfied with the answer. When Hernandez was in the room, Lisa was sweet and pleasant. She often called him affectionate names such as "honey" or "sweetheart." And he reciprocated.
When he wasn't around, she expressed concern and frustration.
"If I was to say anything negative, and I don't want to say anything negative, but the whole communication thing is horrible," she said.
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