Main: Libby Adame in court in Los Angeles County in October 2025 (KABC). Inset: Cindyana Santangelo (Facebook).
A 55-year-old woman in California faces a potential life sentence for the death of a 58-year-old actor following unauthorized silicone oil injections during an unlicensed butt augmentation procedure earlier this year.
On Thursday, a jury in Los Angeles found Libby Adame guilty of second-degree murder and practicing medicine without a license in the death of Cindyana Santangelo, who was known for her roles in “Married with Children,” “C.S.I. Miami,” and “E.R.”
Santangelo was the second “client” of Adame’s to die under her unlicensed care. In March 2024, Adame was convicted of involuntary manslaughter and practicing medicine without a license related to the 2019 death of 26-year-old adult film actor Karissa Rajpaul. Adame’s daughter, Alicia Galaz, also faced the same convictions for the 2019 incident.
Police at the time emphasized that the mother and daughter “had no medical training.”
In April 2024, a judge in Ventura County, California, sentenced Adame to four years and four months, while Galaz received just under four years for Rajpaul’s death. Both were released within a year after a successful appeal for time served, which included time under electronic monitoring after their arrests, as reported by People reported.
During closing arguments, prosecutors highlighted that Adame had been previously cautioned about the risks of such procedures after her conviction for Rajpaul’s death. The judge from that case had put her “on notice of the dangers that could result” from continuing illegal procedures, noting there could be murder charges, according to 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.”
During the trial, Santangelo’s husband, Frank Santangelo, testified that his wife died at their Malibu home following injections by Adame, as reported by the Los Angeles Times reported. He stated that Adame immediately fled after witnessing his wife begin to convulse.
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.
