♪ but i don't forget too well ♪ [ cheers and applause ] ♪ this is "nightline." >> juju: tonight, if looks could kill. >> my biggest fear is death. >> juju: a deadly infection linked to some cosmetic surgery clinics in mexico.

>> this is part of the phenomenon of medical tourism. severe, life-threatening infections. >> juju: going abroad for procedures like mommy makeovers. >> i added it up and i spent about $5,000, here it would have been about $18,000. >> juju: cheaper doesn't always mean safe and risks are everywhere. >> is this something that could happen in the u.s.? >> absolutely. support rulings. two major decisions impacting millions. one striking down president biden's student debt relief program. the other a case that pits gay rights against the first amendment that could have far-reaching implications. and bretman this social media star breaking barriers, gracing magazine covers. >> every brown queer kid deserves their own cover. i think they deserve to be seen in that way.

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are turning deadly. here's abc's janai norman. >> reporter: it's not even light outside yet. and acela santos has her bag packed, ready to go. marta reyes and daughter sunny also started their drive before the sun came up. these women are setting out on very similar journeys with two very different destinations. separated by an international border. >> so i can't sleep. i'm kind of nervous. about the surgery.

>> hey, there. don't be nervous. you'll be fine, you'll be fine. >> reporter: we're in a country where so many are obsessed with plastic surgery. in a world obsessed with the fountain of youth. globally, cosmetic surgery rakes in more than $45 billion a year. music stars like lado and caddi b singing about surgery. ♪ so classic that ass to is on fat it's not ♪ >> reporter: to reality stars. >> liposuction 360 in a professional mini bbl. >> reporter: nene leeks and larsa pippen, on the hunt for the best bargain. many times that search lead eds them outside the u.s. >> i think my tummy tuck procedure in mexico, i added it up. i spent about $5,000. here it would have been about $18,000. >> reporter: but cheap doesn't

always mean safe. can you explain what fungal meningitis is? >> think about a dime-sized or quarter-sized lesion eating into the substance of the brain. eating it. >> reporter: now a lethal fungal infection is putting dozens of women in danger, and the cdc and the world health organization are sounding the alarm. >> what we're seeing more in this outbreak than anything else is women -- this is part of the phenomenon of medical tourism. these are severe, life-threatening infections. >> reporter: at least six american women have died. all after plastic surgery in mexico. this entire outbreak appears to be a symptom of a much bigger problem, an entire industry rife with loopholes, leaving patients vulnerable. so is looking good really worth the risk? is this something that could happen in the u.s.? >> absolutely. >> my biggest fear is death.

i haven't seen nobody walk home yet from this. >> reporter: we're in texas at the brownsville airport a few miles from the mexican border and the city of matamoros. more and more americans are taking the trip over the border for so-called mommy makeovers. anything from a facelift to tummy tucks to brazilian butt lifts. matamoros is one of mexico's chief ports of entry for tourists. it can also be very dangerous. earlier this year, four americans were kidnapped on the way to a cosmetic surgery. two died. >> we're going to change the shape of the nose. checking that we're in the right position. my name is dr. franco, plastic surgeon. i have more than 35 years of

experience. >> reporter: dr. 49 cojicome has worked in matamoros for years, building one of the most respected plastic surgery clinics in the area. he says nearly 80% of his patients come across the border from the u.s. >> this incision, we're going to find a space between the muscles. >> reporter: 280 miles away on the u.s. side of the border, another surgeon is also getting ready to glove up. >> i'm thomas genevieve, board certified plastic surgeon. i'm from the east coast, but i live in the great state of texas. >> reporter: ballpark it. how many surgeries do you do a day? >> in busy months, 25 surgeries a week, 100 a month. >> reporter: acela santos is a school teacher and mother of three. for her this surgery is a key

step toward a more confident future. >> after kids, your body gets messed up. i've already tried the exercise routine and lose weight, but the skin is still there. even if i lose the weight, it's still loose. the only way to fix it is through surgery. >> reporter: she lives here in san antonio, just a few hours from the mexican border. >> it's better to pay the extra $3,000 or $4,000 and be safe than go over there and then something bad happens. >> reporter: this surgery, liposuction, a tummy tuck, a brazilian butt lift, will cost her about $15,000. >> the reason this is dangerous is because this is called the triangle of death here, which is on the buttocks. >> reporter: dr. genevieve says one of his most popular surgeries is the infamous bbl. >> believe it or not, this is the most dangerous operation in america right now besides cardiac. i'm going to shape her butt. you can see the flatness here.

that's got a little bit more curve. >> a brazilian butt lift may seem benign, low-risk. turns out it's by far the riskiest procedure in plastic surgery, and potentially the most fatal. >> 700 here, 1,100 here, but it kind of equalized. >> reporter: he prides himself on his experience. he says he's never had a patient die because of one of his surgeries. being so close to the border, genevieve says he does get patients to went to mexico and now need help fixing botched surgeries. you're four hours from the border. do you get patients who come in here and find out your price and are like, wait a second, i could drive across the border and pay quite a bit less? >> we do. and if it's good, you got lucky. if you made it and you didn't get weird stuff happening to you, infections, bleeding, then congratulations.

>> i am now five days post-op. >> reporter: the latest tiktok rage is all about the ubiquitously titled "mommy makeover." >> plastic surgeons love to talk about and use the terms "having a little work done" or "having a mommy makeover." going for medical tourism vacation. it sounds so cute, doesn't it? well, complications and fatalities are not cute. okay? >> reporter: and now the usual risks of traveling for plastic surgery are coupled with an illness that's much more mysterious and more dangerous. >> you know, my life is more important than anything else. and i won't go to get surgery ever again. >> reporter: elandra had surgery in mat toe morose in march, a bbl and liposuction. now the mother of two has been living in a phoenix hospital for nearly two months, being treated for fungal meningitis. >> the doctors told me i could

have died within 24 hours. because this is a fatal infection. >> reporter: we reach out to both clinics involved. we've received no response. mexican officials have closed both of them. k-3 where elandra went, and riverside surgical center. the cdc has issued an alert telling anyone who had procedures under epidural anesthesia between january 1st and may 13th of this year that they need to go to their local emergency room and get tested for meningitis. what are your greatest fears at this point? >> fears? death. and i only say that because i have not seen one lady who leaves. i have not seen no girl go home yet. >> our thanks to janai. you can see the full episode of "if looks could kill" on "impact

on nightline" now streaming on hulu. turning now to two landmark decisions handed down by the nation's highest court, one delivering a major blow to president biden's student debt relief program, and the other a first amendment ruling with broad implications for some businesses and their customers. today, the supreme court handing down two historic decisions. >> this decision is devastating. but not the end of the road for debt cancelation. >> reporter: in both cases the conservative majority putting its stamp on two divisive issues with a 6-3 vote. the court first ruling that business owners that sell custom expressive products can refuse services to any customer whose message they might oppose, including same-sex couples, citing their first amendment rights. the case was brought by evangelical christian web designer lori smith. >> the court affirmed today that the government cannot force

anyone to say something it doesn't believe. >> reporter: justice neil gorsuch writing for the conservative majority, "the first amendment envisions the united states as a rich and complex place where all persons are free to think and speak as they wish, not as the government demands." in dissent, justice sonia sotomayor warning about the broad scope. "a website designer could equally refuse to create a wedding website for an interracial couple, for example." the court also striking down president biden's student debt relief program. now the 43 million americans who borrowed more than $400 billion from the federal government will have to resume payments in october. >> i can't say i'm shocked. i can say that i'm furious. >> reporter: the conservative majority saying biden didn't have legal authority to implement such a sweeping program without congressional approval. today the president vowing a plan "b." >> a new path consistent with

today's ruling to provide student debt relief to as many borrowers as possible. >> reporter: regardless of today's court decision, many believe the extreme cost of college is unsustainable for so many families. coming up, bretman rock, the social media trailblazer and their journey to stardom. we love our house. the outdoor space is great. but we do have invasive weeds. i think they got in the house. i think you're right. tv: he shoots... tv: ...and of course, water. this particular rose bush... stay away from my family! why are you so strong?! at least geico makes bundling my home and car insurance easy. we save so much. do you want me to get the spray stuff? get the spray stuff! where is it?! it's up here! for bundling made easy go to geico.com. my most important kitchen tool? my brain. so i choose neuriva plus. unlike some others, neuriva plus is a multitasker

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my most important kitchen tool? my brain. so i choose neuriva plus. unlike some others, neuriva plus is a multitasker supporting 6 key indicators of brain health. to help keep me sharp. neuriva: think bigger. ♪ >> stephanie: bretman rock is 24 and fabulous. the filipino american trailblazer is striking a bold pose on magazine covers and

inspiring millions along the way with a powerful message about self-love and acceptance. here's "nightline" coanchor juju chang. >> just want to share my light with the world. as long as i'm share ambiguous light some way or another, i think that's my true calling, i think. >> juju: internet superstar bretman rock has gone global. the 24-year-old filipino american striking a pose at paris fashion week. strutting around new york city. or simply chilling at home in hawaii alongside his 58 chickens. bretman shares unfiltered humor. >> calling all my chickens to the picnic table, brrrr! they're coming. >> juju: and fierce personality, with almost 50 million followers. bretis man's memoir about

leaning into being unapologetically yourself. what's that mean, that tagline? >> that's what it means, embodying everything that makes you, you. >> juju: we dished about it while dishing up a childhood recipe. >> i could cook this with my eyes closed. >> reporter: at belao in new york city, launched by three filipino american nurses. that one-handed cracking, you know your stuff. >> i grew up in the restaurant industry, girl. >> juju: and over dessert, of course. oh my gosh, look at this. wow. >> wow. >> juju: this is colorful and delicious. >> it's lgbtq. >> juju: it is, it's rainbow. happy pride! >> and happy belated aapi. >> juju: bretman shares how it is being nonquoruming. >> i go by all the pronouns,

whatever i feel that day. >> juju: you're nonbinary? >> yes. >> juju: what does that mean to people who don't have a clear understanding? >> everyone who is nonbinary has their own definition. for me, i truly just think nonbinary is someone who doesn't conform on the spectrum of gender. i truly do think i fall straight dab in the middle between masculine and feminine. >> juju: somewhere in the middle, and with a wide range of interests. from weightlifting -- to makeup and beauty -- >> what i love about my feminine side is the fact that i have the freedom to explore it. and i was surrounded by people that let me explore that. >> juju: bretman proudly becoming the first openly gay person to grace the cover of "playboy" magazine in 2021. bretman eliminate greated to hawaii with his family at 7 years old. >> we had a five-bedroom house with 25 people in there. i was with my grandma, mom,

brother, sister in one room. >> juju: from humble beginnings to loudly and proudly representing. the lesson of feeling good in your own skin something the mega influencer said took time to learn. i've read that you didn't love your features growing up? >> my nose took me forever to love. then my skin color on top of that as well. you really just have to decide one day that you're beautiful. >> juju: that confidence on full display on the cover of "vogue" philippines' first-ever pride cover. i'm going to pull up a little prop. >> okay, girl. aahh! not her. >> juju: yes, her. >> oh my gosh. >> juju: what do you think? >> what am i -- what do i think? i don't think -- >> juju: when you see her, what do you think? >> i think about little bretman pebble, honestly. this was so -- oh my girl, juju

girl. >> juju: are you going to start crying? >> i don't cry. especially on camera. >> juju: girls cry, that's okay. >> every time i think of little bretman pebble. it's truly a love letter to my baby self in the philippines. brown and gay kids, we're not supposed to be cover girls, coverboys. that's not supposed to be possible, but i did it. >> juju: you made it possible, and that makes it possible in other people's minds. >> we're all supermodels. the biggest takeaway is every brown queer kid deserves their own "vogue" cover. they deserve to be seen in that way. >> stephanie: our thanks to juju. up next, alan arkin. celebrating the life and legacy of the versatile oscar and tony-winning actor. my most important kitchen tool? my brain. so i choose neuriva plus. unlike some others, neuriva plus is a multitasker supporting 6 key indicators of brain health. to help keep me sharp.

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♪ >> stephanie: finally tonight, honoring the life and legacy of allan arkin. >> you are the most beautiful girl in the whole world. >> stephanie: arkin won best supporting actor oscar for his role as the foul-mouth the grandfather in "little miss sunsh sunshine" in 2007. his career spanned decades, over 80 movies from "catch-22" -- >> in order to be grounded, i've got to be crazy. >> stephanie: to "argo." >> either sign here and take $10,000 for your toilet paper script -- >> stephanie: alan arkin was 89. that's "nightline." watch full episodes on hulu. we'll see you right back here at the same time on monday.