A medical board took steps to carry out a new law related to so-called Brazilian butt lift procedures, but one top regulator said a growing danger still needs to be addressed: liposuction.

Board of Medicine Chairman Steven Rosenberg said Florida consumers must have a better understanding of dangers associated with liposuction, and physicians need to "really think twice about providing those services."

Medical doctors are not required to be board-certified to provide plastic surgery. While hospitals can put requirements on physicians, patients seeking liposuction can have the work done outside hospitals.

Most plastic surgery procedures are done on an outpatient basis.

"We can determine what procedures can be done and how they should be done. And that's something the board has, and probably will address further," Rosenberg said. "But when it comes to who is qualified to do procedures, the Board of Medicine unfortunately has its hands tied."

That means patients need to be better informed about the physicians they are seeking out to provide the services, Rosenberg said at a Board of Medicine meeting in Tampa.

Rosenberg's warning about liposuction came as the Board of Medicine amended disciplinary rules to fine physicians $5,000 a day for failing to register their offices if they perform Brazilian butt lifts, a type of procedure that involves injecting fat into buttocks. The assessment is accompanied by a potential 12-month license suspension or probation. The board is authorized to revoke licenses for repeated offenses.

The fine was set in a law (SB 732) that was passed by the Legislature this year to crack down on rogue health-care clinics that provide Brazilian butt lifts. Liposuction is part of that procedure.

It's the second time in as many months that the board chairman warned about dangers associated with plastic surgery.

Rosenberg's remarks Friday came on the heels of the board considering two disciplinary cases related to liposuction-only procedures.

The board approved levying a $20,000 fine against Jan V. Karlin for liposuction on 63-year old diabetic patient identified by the initials "R.C."

The patient's bowel was perforated multiple times during the suction-assisted lipectomy procedure performed on June 24, 2014, according to the Department of Health which investigated the incident. The patient subsequently died.

Karlin, who has been licensed in Florida since 1973, told the board he did not know what he did to cause the injuries.

The board also hit Nagy Farag with a $5,000 fine for liposuction he performed on a patient's legs in mid-September 2013. The patient saw Farag nine times between Sept. 27, 2013 and Oct. 23, 2013, when she was admitted to the hospital with an infection that causes skin tissue to die, according to the state.

Farag also is required to be evaluated by a board-approved evaluator and have his practice locations reviewed by a health-care risk manager.

The board also hit Farag with a $22,546.69 bill to reimburse the state for its costs of prosecuting the case.

Meanwhile, the board on Friday also agreed to amend its rules to fine physicians who don't comply with a new law meant to abate the state's opioid crisis by requiring doctors to offer non-opioid alternatives to patients.

Christine Sexton reports for the News Service of Florida.