Free Last Dance, Last Chance by Ann Rule

seemed to be time to be with her family.
    Anthony considered himself to be from a higher class than the Ragos. After all, his father was a distinguished surgeon much beloved by the community, and their home was definitely upscale. Country clubs and private schools had never been part of the Ragos’ world.
    Anthony continued to be critical of Debbie. It was almost as if he deliberately set out to tear down her self-confidence. She could never be thin enough for his tastes, and he reminded her of that repeatedly while still wanting her to cook whatever he fancied. Anthony worked out at Gold’s Gym almost compulsively, and with his new fail-proof toupee he looked better than ever.
    He wasn’t home a lot. He had the long commute to Warsaw to take over his elderly benefactor’s patients, and at the same time he was struggling to get his own clinic going.
    And his Wednesdays were sacrosanct. Nothing interfered with his research.

6
    B y 1994, Dr. Anthony Pignataro was moving rapidly toward the specialty he aspired to—that of a plastic surgeon. But for every success he had, there were red flags and censure raised. He chose to ignore them for the most part. He always had a smoothly crafted explanation for any negative event in his life.
    In 1994, he was sued by a patient for an allegedly negligent face-lift and blepharoplasty (eyelid lift) that caused the seventy-one-year-old patient to seek further surgery to correct Anthony’s mistakes. Anthony blamed the problem on the patient, insisting that she had failed to follow his postoperative instructions. He also said she had gotten a second opinion from a competitor who spitefully encouraged her to sue. The lawsuit was eventually settled by a $75,000 payment from his malpractice insurance to the patient.
    Also in 1994, Anthony was investigated for the first time by the New York State Department of Health/Office of Professional Medical Conduct. He advertised for clients enthusiastically, something physicians rarely did then. Not only that, despite the fact that it was not true, his ads said he was “Board-Certified in Otolaryngology.”
    He claimed that he was affiliated with “Cosmetic Plastic Surgeons International.” Debbie said later that Anthony had formed some sort of alliance with a plastic surgeon in Canada and then had used that man’s name to become “international.” Anthony referred eye-lift and skin care patients to the Canadian doctor, whose face-lift patients were referred back to Anthony.
    His operating room in the basement of his office was finished to his satisfaction, and Anthony advertised that his facility provided “state-of-the-art care in outpatient surgery.” He sent coupons to hair salons in his area, offering them $100 for every patient they sent to him for a hair transplant. He was not yet using his snap-on-snap-off technique; instead, he was taking hair grafts from the back of the patient’s head and transplanting them to the balding area.
    “This was a long and laborious technique,” he recalled. “The state of the art had advanced. Minigrafts and micrografts had become the standard. Minigrafts are four to eight hair grafts, and micrografts are one-to three-haired grafts.”
    It took about a thousand of these per session, and Anthony and his transplant team, mostly office help and licensed practical nurses, would take five or six hours to manage this. Now, he invented what he called the Micrograft Implanter. He was pleased with it because it worked “even in untrained hands,” and it cut down on the time needed, allowing him to operate on even more patients.
    He felt so relaxed doing hair transplants that he sometimes sent out for pizza to eat during the surgery. One patient, as easygoing as Anthony, joined him in eating the slices of pizza.
    But Anthony’s advertising brought an investigator from the State of New York, a physician who questioned him about the plastic surgery he was performing in his office. He was cagey when he answered