Cosmetic surgeries may be particularly risky in Georgia where doctors can perform in-office surgeries with little oversight and few safety requirements, according to a joint investigation by The Atlanta Journal-Constitution and Channel 2 Action News.

In 2013, Dr. Nedra Dodds performed liposuction and fat injections on 37-year-old April Jenkins, who screamed during the surgery, “It’s tearing. It’s burning.”

Jenkins ended up dead.

“Ms. Jenkins’ surgery should have been stopped,” said Brent J. Savage, a Savannah attorney who filed a lawsuit against Dodds on behalf of Jenkins’ estate. “Instead of stopping it when she cried out, a rag was put in her mouth to muffle her screams.”

Nathaniel Johnson III lost his medical license after a fraud conviction and the death of a liposuction patient. But police charged him last year with performing cosmetic surgeries again on unsuspecting patients.

Now, former patients represented by attorney Susan Witt allege that Dr. Windell Boutte, who has a high-volume cosmetic surgery practice in Lilburn, is a risky choice. Boutte's website says she is a "Doctor to the stars!" and videos that were posted online show her dancing to music during surgeries with her patients' bodies exposed in the background.

Like many doctors in Georgia, all three physicians did their procedures in their offices.

Savage said his experience in the Dodds’ case raised questions about state oversight.

“In-office cosmetic surgeries are fraught with danger and pain,” Savage said. “They don’t use proper anesthesia and it is very difficult to keep the areas clean and sanitary. It is insane not to have it regulated by the State of Georgia just like they regulate any hospital operating room.”

In Georgia, however, there are virtually no limits on who can do cosmetic surgery, where they can do it, and how they advertise.

“Unfortunately there are all these [doctors] that you don’t know what their training is and they set up in their offices and no one is looking over their shoulder,” said Dr. Felmont “Monte” Eaves III, a board-certified plastic surgeon at Emory University and medical director of the Emory Aesthetic Center. “The people who need supervision the most are the ones that get the least. It’s a terrible irony.”

Read more at myAJC.com.