A 45-Year Sentence for Unlicensed Cosmetic Surgery | What the Port St. Lucie Verdict Means for Med Spas

Forty-five years. That is the sentence a Florida judge imposed in June after a jury convicted a former physician assistant of eleven felonies tied to cosmetic surgeries performed at a now-closed Port St. Lucie practice. The procedures included liposuction, fat injections, Brazilian butt lifts, and breast augmentations. The number should stop every med spa owner, physician assistant, and supervising physician in the state. Not because the underlying conduct was ordinary. Because of how prosecutors got there.

They took a licensing violation and built a racketeering case on top of it.

A Florida judge sentenced former physician assistant Adley Dasilva to 45 years in June 2026, after a jury convicted him of eleven felonies including racketeering and aggravated battery for performing unlicensed cosmetic surgeries.

Key Takeaways

• A Florida jury convicted former physician assistant Adley Dasilva of eleven felonies, including four counts of aggravated battery under Fla. Stat. § 784.045 and four counts of practicing medicine without a license.
• Prosecutors added organized fraud under Fla. Stat. § 817.034 and racketeering under Fla. Stat. § 895.03, which is how a licensing case became a 45-year sentence.
• Physician assistants act only within delegated authority under Fla. Stat. § 458.347; surgery beyond that delegation is treated as unlicensed practice of medicine.
• Port St. Lucie is in the Southern District of Florida's footprint, where parallel federal exposure under 18 U.S.C. § 1343 and § 1347 is a live risk in med spa cases.
• Two co-defendants had not been tried at sentencing. Anyone in that position needs separate counsel now, before the state converts leverage into charging decisions.

What Actually Happened

According to CBS12's sentencing report, Adley Dasilva, a former physician assistant who owned Cosmetica Plastic Surgery and Anti-Aging in Port St. Lucie, was sentenced on June 19, 2026 to 45 years in prison after a jury convicted him of eleven felonies: four counts of aggravated battery causing great bodily harm, four counts of practicing medicine without a license, felony theft, organized fraud, and racketeering.

The timeline matters. Investigators began looking at the practice in 2022, and the state health department suspended its license that same year. The business registration was revoked in 2023. In June 2024, four people associated with the practice were arrested after the physician associated with the practice came forward, along with four patients who reported severe health issues after their procedures. Police said the operation began as a legitimate practice with a doctor, and that staff later took over and performed procedures without the doctor's knowledge. The defense has said it will appeal, and two co-conspirators had not yet gone to trial as of the sentencing.

The architecture of the charges is the story: each surgery generated its own aggravated battery count, its own unlicensed practice count, and the business itself became the racketeering enterprise.

How a Licensing Case Became a Racketeering Case

The architecture of the charges is the story here. Each surgery generated its own aggravated battery count and its own unlicensed practice count. The business itself became the vehicle for organized fraud under Fla. Stat. § 817.034 and racketeering under Fla. Stat. § 895.03, with the practice treated as a criminal enterprise and the procedures as the pattern of racketeering activity. Money collected from patients under false pretenses supported the theft count. Consent from the patients was no obstacle, because consent obtained by misrepresenting credentials does not defeat a battery charge.

Stacking is what turns a scope-of-practice violation into a de facto life sentence for a middle-aged defendant. Aggravated battery is a second-degree felony carrying up to fifteen years per count. Florida RICO carries up to thirty. Any white collar defense attorney will recognize the method, because it is the same one federal prosecutors use in healthcare fraud cases under 18 U.S.C. § 1347: identify the predicate transactions, then charge the pattern. Once the pattern charge is in the case, the plea calculus changes completely.

The statutes stack: aggravated battery at fifteen years per count, Florida RICO at thirty, with organized fraud layered on top. The pattern charge is what changes the plea calculus entirely.

The Statutes, the Scope Rules, and Who Else Is Exposed

A physician assistant's authority in Florida exists only within delegation from a supervising physician under Fla. Stat. § 458.347. Surgery performed outside that delegation is not a paperwork problem. It is practicing medicine without a license under Fla. Stat. § 458.327, and where a patient is hurt, it is battery. Florida law separately addresses office procedures and aesthetic services performed in physician-supervised settings under Fla. Stat. § 458.348, which is where legitimate med spas live and where sloppy supervision structures create criminal risk.

Supervising physicians should read this case carefully. Here, the doctor came forward, and that decision shaped everything that followed. A physician who signs supervision protocols and never looks at what happens in the clinic is betting a license and possibly liberty on employees. Where insurance or financing is billed, federal healthcare fraud exposure under 18 U.S.C. § 1347 enters the picture. Where payments, advertising, or patient recruitment cross state lines, wire fraud under 18 U.S.C. § 1343 follows. And where drugs or devices are sourced outside licensed channels, 21 U.S.C. § 331 and § 333 give federal prosecutors their own independent path into the case. Physician federal investigation defense is its own discipline for a reason: the state case is frequently just the first case.

Investigators began looking at the practice in 2022. The health department suspended the license that year. The business registration was revoked in 2023. Continuing to operate after each step converted a regulatory dispute into evidence of intent.

The Early Mistakes That Compound Exposure

Continuing to operate after the health department suspended the license, and after the business registration was revoked, is the single most damaging fact pattern in this case. It converts a regulatory dispute into evidence of intent, and it is exactly the kind of fact that supports an organized fraud theory. Handling patient complaints informally, overstating credentials in titles and advertising, and letting unlicensed staff absorb clinical functions are the others.

For employees and associates, the trap is assuming that having worked there is not a problem. Prosecutors sort people into witnesses and defendants early, and the federal witness vs. target distinction has a direct state analog. Two people in this case are still waiting to learn which they are, with the principal already sentenced to 45 years. That is the worst possible negotiating posture to face without counsel.

A Florida RICO defense begins with the enterprise and pattern elements. If the pattern collapses, the exposure collapses with it. The cooperation calculus must be run early and honestly.

Defense Strategy When Charges Are Stacked

A Florida RICO defense lawyer looks first at the enterprise and pattern elements, because they are the force multiplier. If the pattern collapses, the exposure collapses with it. Medical causation on the battery counts is a second front: great bodily harm is an element, not an assumption, and it requires expert testimony. Severance, role differentiation, and the timeline of who knew what about the suspension are all live issues for the remaining defendants.

The cooperation calculus has to be run early and honestly. After the principal draws 45 years, the state's leverage over everyone else in the case increases, and so does the value of moving first. That is a decision to make with a pre-indictment defense lawyer who has run both tracks, litigation and negotiation, and who can position a client before the state finishes writing its theory of the remaining cases.

Why Timing Matters Right Now

An appeal is coming, two co-defendants are untried, and charging decisions about anyone else connected to the practice, from staff to marketers to suppliers, remain open. This is the stage where representation changes outcomes. Once the state locks its theory, the options are pleading to it or trying the case against it. South Florida federal criminal defense work teaches the same lesson every year: the clients who fare best are the ones whose lawyers were in the room before the decisions were made. Anyone connected to a med spa under investigation in Florida, in any role, should be having that conversation with a federal investigation defense attorney now.

Common Questions

Can a physician assistant legally perform surgery in Florida?

Only within authority delegated by a supervising physician under Fla. Stat. § 458.347, and cosmetic surgical procedures of the kind at issue here fall outside any lawful delegation in a med spa setting. Surgery performed outside delegated scope is treated as practicing medicine without a license under Fla. Stat. § 458.327.

Why was this charged as racketeering instead of just unlicensed practice?

Because the state alleged a pattern of criminal activity run through an enterprise, which Fla. Stat. § 895.03 punishes by up to 30 years. Adding racketeering and organized fraud under Fla. Stat. § 817.034 multiplied the exposure far beyond the underlying licensing violations and transformed the plea leverage in the case.

What happens to the supervising physician when staff perform procedures without authorization?

It depends on what the physician knew and how supervision was structured. Board discipline is likely, and criminal exposure follows where there is knowledge, participation, or billing involvement. In this case the physician reported the conduct, which is one reason the case developed the way it did.

I worked at a med spa that is under investigation. Am I at risk?

Potentially. Prosecutors sort witnesses from defendants early in these cases, and the distinction often turns on role, knowledge, and who speaks to investigators first and how. Get separate counsel before giving any statement, even if you believe you did nothing wrong.

Could a case like this become federal?

Yes. Interstate payments or advertising can support wire fraud charges under 18 U.S.C. § 1343, billing insurance implicates the federal healthcare fraud statute under 18 U.S.C. § 1347, and drugs or devices sourced outside licensed channels can be charged as misbranded under 21 U.S.C. §§ 331 and 333.

Connected to a Med Spa Investigation in Florida?

AMC Defense Law represents med spa owners, physician assistants, nurse practitioners, physicians, and staff in state and federal investigations throughout Florida and nationwide. Whether you have received a target letter, a grand jury subpoena, or a knock on the door from investigators, early counsel preserves options that disappear quickly. Consultations are confidential. Call AMC Defense Law at 561-542-5494 or email amc@amcdefenselaw.com.

About the Author

Aaron M. Cohen, Esq. is the founding attorney of AMC Defense Law (The Law Offices of Aaron M. Cohen, P.A.), a criminal defense firm based in Boca Raton, Florida. With more than 30 years of experience, Mr. Cohen represents individuals and entities in complex federal and state criminal investigations and prosecutions nationwide. He is admitted to practice law in Florida, New York, New Jersey, and the District of Columbia, and is admitted in the United States District Courts for the Southern, Middle, and Northern Districts of Florida, the District of Columbia, the Southern and Eastern Districts of New York, the District of New Jersey, the Eastern District of Michigan, and the Southern District of West Virginia, as well as the United States Court of Appeals for the Eleventh Circuit. Mr. Cohen is available pro hac vice in federal districts nationwide for clients requiring experienced criminal defense counsel in complex or sensitive matters.

Disclaimer: This article is for general informational purposes only and does not constitute legal advice. Reading this article does not create an attorney-client relationship with AMC Defense Law or Aaron M. Cohen. Every case turns on its specific facts. If you are under investigation or have been charged, retain qualified counsel immediately.