A San Jose man has been arrested on charges of practicing medicine without a license after he allegedly performed an illegal, after-hours breast-implant operation in a San Jose chiropractor's office, slicing into a young woman's chest with only local anesthetic as she reclined in a dentist-style chair. The woman's breasts were mutilated.

Nguyen Nhu Quang, 62, was arrested Thursday and arraigned Friday. He was charged with the unlicensed practice of medicine, battery with serious bodily injury, mayhem and paying accomplices for patient referrals. Quang, who is not licensed to practice medicine in California, remained in custody late Friday on $1 million bail.

Also arrested Thursday were Dr. Thuan Moc Luu, 40, a licensed chiropractor and podiatrist who allegedly provided surgery space for Quang, and Minh Ly, a 58-year-old cosmetologist believed to have referred the woman to Quang. All were in custody as of Friday afternoon.

Prosecutors also issued an arrest warrant for Julie Thuy-Huong Trinh, 36, who allegedly operated a separate beauty business, recruited patients for Quang and served as his surgical assistant. Her attorney contacted prosecutors about her possible surrender, but she had not come forward by Friday afternoon, said Ann Huntley, deputy district attorney.

All four were charged with the unlicensed practice of medicine after an investigation by the California State Medical Board, the Santa Clara County District Attorney's Office and the state Department of Insurance.

The identity of the woman, who is 25 and lives in San Jose, was not released Friday.

``She wakes up every night hearing the sound of scissors cutting through her breast tissue,'' said her attorney, Warren Nguyen, who described Quang as a ``butcher.'' ``It was just torture the way she described it.''

Nguyen said the woman's saline breast implants were removed, but she is permanently disfigured. The woman has sued Quang, Luu, Ly and Trinh, as well as the manufacturer and distributor of the implants, in Santa Clara County Superior Court, Nguyen said.

In late June, the woman went to a beauty salon operated by Ly after seeing an ad Ly had placed in a popular Vietnamese magazine, Huntley said. She wanted a mole removed from her face at the time but also asked Ly about breast implant surgery mentioned in the ad. Ly referred her to Quang, Huntley said.

Cost of $3,200

Quang agreed to perform the operation for $3,200 and scheduled the operation for 6 p.m. July 1, Huntley said. When the woman inquired about Quang's office, Ly and Trinh told her that Quang was a noted cosmetic surgeon from the Los Angeles area who came to San Jose every week to perform operations, the woman's attorney said.

When she arrived at the chiropractic clinic on Senter Road, she was taken to a treatment room and asked to put on a gown. The operation was performed in a dentist-style chair, said Candis Cohen, a spokeswoman for the California Medical Board.

Quang injected the woman's breasts with what investigators believe was a local anesthetic, then performed the saline implant operation without another kind of anesthesia, Huntley said. Trinh served as his assistant, at times telling Quang where to make incisions. When the woman's boyfriend came to pick her up, Quang gave him a plastic bag of pills said to be antibiotics and painkillers, Huntley said.

But the pain didn't go away. When the woman returned for follow-up care, Quang told her the implant in her left breast had ruptured, and he performed another operation, again only using local anesthetic to replace it.

``She was in incredible, excruciating pain,'' Huntley said.

Nguyen, the woman's attorney, said Quang blamed his patient for not healing properly. In pain and suffering from an infection from the ruptured implant, she finally sought care at a local emergency room. Her implants were removed.

Usual practice

Breast augmentation surgery may be performed under general anesthesia or under a combination of intravenous sedation and local anesthesia, according to the American Society for Aesthetic Plastic Surgery's Web site. The average surgeon's fee for breast enlargement is about $3,300, according to the society, but hospital and anesthesia charges can add thousands to that amount.

Nguyen said Quang obtained the saline implants, made by Mentor Corp., from a distributor called Anna Beauty Institute, in the same complex as chiropractor Luu's office. The institute's office has since been closed and Nguyen said he was told the owner now is in Vietnam.

Luu's office, which was closed Friday, sits next to a bridal store in a strip mall with other law and doctors' offices. Mail is piling inside near the front door, and a red, neon sign still shines: Chiropractic and Foot Doctor.

The state Board of Podiatric Medicine said Luu's record shows no previous violations. But the board is investigating this case, and it's possible his license could be revoked, said the board's enforcement coordinator, Michelle Mason. Employees of neighboring shops said they were surprised the doctor had been arrested and didn't know whether illegal activity had occurred in the office.

One woman said she remembered seeing an advertisement for Trinh's cosmetic business posted on the window a couple of months ago and believed the doctor worked there one or two times a week and leased the space to other people.

Nguyen said Vietnamese people and others in immigrant communities are sometimes preyed upon because of their lack of knowledge about Western medicine.

``It definitely is a recurrent problem in the community,'' said Nguyen, who served on the city of San Jose's Human Rights Commission in the 1990s. ``People don't know how to report problems to the proper authorities. It's a sad thing when you have your own countrymen commit this kind of act.''