Two women underwent cosmetic procedures at a Miami medical spa, trusting they were in good hands. The spa’s owner, a fellow Italian, had told them he was a doctor, verified by friends who adored him.
Nearly a year later, both Miami women are still recovering from what they’ve alleged to medical authorities as botched treatments. One had to undergo emergency surgery to combat a life-threatening infection; the other required a surgeon to reconstruct the left side of her face, which had become paralyzed.
The two women also learned Enrico Guarino, who performed their procedures with local anesthesia and a laser, did not have a license to practice medicine in Florida.
Paola Berreti had sought to remove excess fat around her knees, while Maria Cantone went in for a facelift. They said Guarino treated them at Guarino Academy, a medical spa he founded near the Miami Design District.
“I thought that it could be a quick fix, less invasive, and then it turned out to be a nightmare,” Beretti said in an interview with the Herald.
“I wasn’t able to go out because people said, ‘What’s going on, Maria? What happened to you?’” Cantone said.
Guarino regularly bills himself on Instagram as an “internationally trained aesthetic physician.”
But Guarino only holds a nursing license in Florida, which the state’s health department sought to revoke or suspend in 2024, saying he lied about his academic credentials.
Beretti and Cantone filed complaints with the Florida Department of Health, which, emails show, has begun investigating Guarino. A third woman, Tatiana Magarik, is suing Guarino and EvoSkin LLC, the medical device company that has the same address as his academy – 4300 Biscayne Blvd., Suite 303. Guarino, 60, is listed as EvoSkin’s manager in state corporate records.
Guarino “negligently applied a laser beam” to Magarik’s neck, causing severe burning and dead tissue, her suit alleges.
Magarik declined to speak to the Herald. But her lawyer, William Dean, said she had not been “looking for magic,” when she sought treatment from Guarino, who had been referred to her by an anesthesiologist.
“Dermatologists do important work, and plastic surgeons do incredibly important work as well,” Dean said. “Unfortunately, people want to lie, people want to embellish, people want to be something that they’re not.”
Guarino did not respond to a detailed list of questions from the Herald. Peter Suarez, Guarino’s lawyer, wrote in an email that his client “respectfully declines to comment due to a pending administrative matter,” and, therefore, they would not “be addressing the specific allegations or questions.”
Device not listed in FDA database
Cantone, 53, and Berretti, 52, received a laser treatment called the Endo One Dual-Wavelength Diode Laser.
The Endo One is an Italian-manufactured, “FDA-cleared” laser that can be used for non-surgical face lifting, dermatology procedures, body sculpting and dental health, according to EvoSkin’s website.
What makes the laser attractive to “aesthetic-conscious patients” is its “non-surgical laser lift,” only requiring local anesthesia to be administered, an article authored by Guarino on EvoSkin’s website said.
Although a product named “XLase Plus” is listed in the Food & Drug Administration’s medical device database under EvoSkin, the Herald did not find any references to Endo One in the FDA database. The FDA’s database contains devices registered by their manufacturer; a device’s registration does not mean it has the agency’s approval.
Neither Suarez nor EvoSkin responded to the Herald’s inquiries about whether the FDA had cleared Endo One.
Video clips of Guarino performing the Endo One procedure — which involves repeatedly stabbing the skin with a thin, cylindrical rod, releasing a red laser — are posted regularly on his and EvoSkin’s Instagram accounts. The two platforms have more than 6,000 followers combined.
“Dr. Guarino not only teaches the Endo–One technique worldwide — he uses it daily to deliver natural, transformative results for his patients,” read an October 2025 Instagram post on Guarino’s account.
Guarino’s Instagram profile describes him as a “surgeon-inventor” trained in Italy with over two decades of experience in regenerative and aesthetic medicine. According to his LinkedIn, he attended the Università La Sapienza di Roma from 1986 to 1998, where he obtained a medical degree.
The Herald could not independently verify Guarino’s medical school credentials in Italy, but Florida law requires physicians to have a valid medical license to practice in the state.
Questions about nursing credentials
Florida health department records show Guarino has been a licensed registered nurse since February 2022. But his status as a registered nurse has also come into question, according to a Department of Health administrative complaint filed against Guarino in April 2024. In the complaint, the health department alleges Guarino “knowingly misrepresented” that he attended and graduated from the Siena College of Health in Lauderhill despite not completing the requirements to graduate.
Siena College of Health was shut down in 2023 following an FBI investigation that found the nursing school was implicated in a scheme distributing more than 7,600 fake nursing diplomas.
The DOH complaint ultimately recommended the Florida Board of Nursing issue a “permanent revocation or suspension” of Guarino’s license, or impose another disciplinary action “that the Board deems appropriate.”
The Board of Nursing did not respond to the Herald’s inquiry about whether it had imposed any disciplinary actions against Guarino. A health department spokesperson, in an email to the Herald, said, “The Department cannot comment on any complaint, investigation or plans to take action against a licensee until 10 days after probable cause has been found.”
The Department of Health’s website still lists Guarino as a registered nurse until his license expires in April 2027. Under the “Actions Taken” tab on the disciplinary portion of his online profile, the department lists no other measures other than the administrative complaint it filed April 23, 2024.
Under some circumstances, registered nurses may be able to administer laser treatment, but only under the supervision of a licensed physician, according to Florida law. Neither EvoSkin nor Guarino Academy, which Guarino announced on social media as opening in July 2024, has a licensed physician listed on its website, and neither company appears in the Florida Department of Health’s database as licensed to administer laser-related procedures.
Just registering a laser does not authorize the person to “use that laser on humans for any medical, health, cosmetic, or other purpose,” according to the health department.
‘I trusted him’
Beretti, a salesperson for a wine company and former model, said she had long had a “fixation,” on her knees, including a “fat part” under her kneecap. She had previously heard about Guarino from one of her clients in 2024 and had met him at a spa opening where he did a demonstration.
“He’s very charming; he’s very talkative,” Beretti said.
She went to Guarino Academy July 31, 2025, to undergo an “‘Endolift’ fat-melting and skin-tightening procedure,” according to Beretti’s complaint with the health department.
Beretti said Guarino had sold her on the idea that the procedure, using the Endo One laser, would be an “easy treatment,” a simple fix that she could recover from before her 52nd birthday, less than a week away.
Previously, she had undergone liposuction with a different practitioner, whom she had researched thoroughly. But she said she trusted Guarino, a known person within the Italian community in South Florida that some of her friends had raved about.
Before the procedure, she had some hesitations, including when Guarino asked her to pay $2,000 for the treatment by Zelle, a transaction reviewed by the Herald. She had further hesitation when she realized the procedure would take place in the same room she had the consultation with Guarino, rather than an independent operating room.
“But I was thinking, ‘Who am I to judge him?’ He’s a doctor, he knows better than what I’m supposed to know, right?” Berreti said. “… I trusted him.”
Procedures with the Endo One should only take around 30 to 60 minutes, according to EvoSkin’s website; Beretti said the treatment took about two hours, two hours of painful “ragging in and out” of her knees.
By the time Beretti had arrived home, she had bled through the gauze around her knee and returned to the clinic to receive extra wrapping, according to WhatsApp messages exchanged between her and Guarino that the Herald reviewed.
In the following days, Beretti’s right knee swelled severely, according to her health department complaint. She contacted Guarino, who saw her again Aug. 4. He told her the swelling was edema and advised her to use arnica — an over-the-counter homeopathic cream – which did not alleviate her symptoms, Beretti said.
Beretti, unable to walk because of the painful swelling, managed to drive to an urgent care center four days later.
“You have an infection,” Berretti said the urgent care doctor told her. “I cannot treat you and I cannot help you. You need to run to the emergency room.”
That evening, Beretti underwent emergency surgery at Mount Sinai Medical Center in Miami Beach to treat a serious streptococcus infection, according to her complaint.
Had she not had the surgery, Beretti was later informed, she could have died from sepsis, the body’s extreme response to an infection that can quickly become fatal, according to the Centers for Disease Control and Prevention.
She was hospitalized for five days and treated with “IV antibiotics” after the surgery, according to her complaint, and remained bedridden for most of August.
Berretti estimated she has paid around $14,000 in medical bills following the procedure, and has gone through extensive physical therapy. Once an avid Pilates goer, Beretti struggles to go up the stairs and can no longer run or jump.
“I’m grateful that I’m here, that I’m still alive,” Beretti said. “I’m grateful that I can walk, that I can drive, I can do my basic activities, of course, but I want to go back to my normal life.”
Beretti hasn’t spoken to Guarino since August. She said she has had fights with friends who still “adore him.”
‘I have been in a dark, dark place’
Cantone, a painter and artist, said she and Guarino had been friends for around two years before she visited him for a plasma facial treatment to offset aging.
Like Beretti, Cantone found Guarino to be charismatic, describing him as a “professional,” even fatherly. She had already gotten one plasma treatment with Guarino, but didn’t like the results. So she visited Guarino again on Dec. 16, 2025. This time, she said, he suggested the Endo One laser.
After being administered anesthesia, Cantone said she woke up two hours later and felt like her face had “exploded.”
She experienced “significant atypical swelling of the face and neck,” and “marked loss of movement on the left side of [her] face,” her health department complaint alleges.
She said Guarino informed her the symptoms were “expected,” and “part of the healing process.” At Guarino Academy, she was later administered a cortisone injection, despite having glaucoma, according to her complaint. For individuals with glaucoma, a steroid injection can damage their eyes, according to the American Academy of Ophthalmology.
Cantone said in an interview with the Herald that Guarino gave her an electro-stimulation device to use on the left side of her face in the days following the initial procedure. The treatment subsequently worsened her ability to close her left eye, her complaint said.
“The right was closed, and the left was open, or the left was open, the right was closed. It was a nightmare,” Cantone said. “The nose, the left side, all my face was completely down. Like an old, old lady.”
Cantone said Guarino stopped communicating with her and the “persistent symptoms” led her to see a neurologist, according to her complaint. She then had rounds of doctor appointments, MRIs, blood tests and double vision that prevented her from working for months — ‘another nightmare,’ she said.
Eventually, she had to have the left side of her face surgically rebuilt, which she estimated cost around $4,000 to $5,000. She still has challenges moving the left side of her face, but her nose and eyes have improved.
“I have been in a dark, dark place because of that man for months and months and months,” Cantone said.
‘I just want to start feeling better’
Although Beretti received confirmation Jan. 14, 2026 — nearly a year after she submitted her complaint — that the Investigative Services Unit of the Florida Department of Health was investigating Guarino, she said their communications with her have been “vague.”
Cantone has not received explicit confirmation of whether the department is investigating her complaint, filed in January 2026, although the state agency asked her and Berretti for medical records from Guarino. Both said they haven’t been able to obtain any records from Guarino, even after Beretti issued an official request through Appleton & Appleton LLC, a Connecticut-based law firm.
Beretti and Cantone want their stories — the stories of two women seeking a safe, “easy,” way to fix what they didn’t like about themselves that turned into life-altering damages — to be a lesson for others. They have both made progress since their procedures, but are not yet back to their full selves.
“I just want to start feeling better,” Beretti said.
