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INDIANAPOLIS — Tammy Brewer said her daughter Shacare Terry struggled with weight her whole life.

“She’s been having a hard time because she just wasn’t like a normal kid sometimes and always wanted to be better but got picked on because of her size and things like that,” said Brewer. “Being a big girl at a young age is always not good.”

That’s what convinced the 31-year-old mother of a toddler to travel first to Mexico in December for bariatric surgery and then again last month to the Dominican Republic for two body sculpting surgeries.

“She was just excited for her new journey,” said Nicole Baker, Shacare’s aunt. “She talked about the liposuction and the tummy tuck and just the excess skin you have from weight loss.”

Noted Indianapolis plastic surgeon Dr. Greg Chernoff said that such follow up surgeries so soon after the weight loss surgery pose risks for patients.

“Most of them aren’t surgical candidates metabolically because going through that surgery creates a lot of imbalances metabolically and most them we won’t even talk to for up to two years after their surgery,” he said.

Just four months after her first surgery and the week before Easter, Shacare was on her way to the DR for more work.

“A friend of hers, the girl who also had surgery, said they had took $20,000 down there each because they were told to bring cash, so she did say that, that she had $20,000 and her surgery was 17 and to stay in the recovery home was 1500,” said Baker. “The person who went down there with her who had the surgery was essentially her caretaker. She made a post that she was hired to take care of two girls.”

Brewer said her daughter had previous surgical implants that Shacare wanted removed by the doctor in the DR.

“She had some butt implants put in before and no one here would do it and he said he can take these out and such and such and he needs more money,” said Brewer. “He wanted, I think, four or five thousand more dollars.”

After just two days in the DR, Brewer said her daughter seemed lethargic and sedated during Facetime calls, so she hopped on a plane to rush to Shacare’s side.

“Mind you, I didn’t know nothing about them, I didn’t speak Spanish,” said Brewer. “I called the U.S. Embassy because my concern was, ‘Can you go check on my daughter because I think she needs a higher level of care than what they’re giving her?'”

Brewer said when she arrived at the clinic where Shacare was hospitalized, she believes her daughter was already dead.

“I know they screwed up,” said Brewer. “I guess he just knew about plastic surgery. I don’t think he knew about if anything else goes wrong.”

An autopsy performed in the DR found that Shacare died of pulmonary edema, cerebral edema and respiratory failure. The family said the young mother also had sepsis and staff said they were going to put her on dialysis.

“She had a blood transfusion the day before surgery so that she could be prepared for surgery,” said Baker. “The friend noticed it was yellowing of eye whites and the side of her face was yellow so it appeared like she had jaundice or something.”

Dr. Chernoff said he will occasionally see patients who consult for his services and then tell him their research indicates a similar surgery can be performed overseas at a lesser cost.

“The internet has become such a double edge sword for all of us. Every day I see patients who have read an article who now know more than I do after 30 years,” he said. “If one or two or especially three physicians have told you the same thing and it goes against what you want to do, maybe you should listen to these physicians.

“You don’t necessarily want the lowest price when it comes to someone cutting on your face or your body. As with anything in life, you get what you pay for.”

Chernoff said patients should engage surgeons who are board certified and operate out of a hospital or a clinic connected to a hospital.

“Complications can arise during surgery and if you go out of the country and something goes wrong, what do you do then? You need to know that your treating physician is local and available to treat you 24/7.”

When asked what patients should do if they are considering leaving the United States for plastic surgery, Tammy Brewer echoed Chernoff.

“Research, research, research,” she said.

“And stay in your own country,” said a relative.

The family will have its own autopsy conducted Wednesday on Shacare. They have also established a GoFundMe account to finance a potential legal challenge to the doctor who performed her surgery.