FRAMINGHAM, Mass. – A Brazilian doctor and his wife accused of performing illegal liposuction surgery on a woman who died because of the procedure were charged with manslaughter Friday.

Luiz Carlos Ribeiro and his wife, Ana Maria Miranda Ribeiro, already have pleaded not guilty to unauthorized practice of medicine and drug charges in the July 30 death of Fabiola DePaula.

The manslaughter charges were announced as Middlesex District Attorney Martha Coakley disclosed autopsy findings indicating the 24-year-old victim died as a result of the fat-removal surgery, which police said was performed on a massage table.

DePaula, a native of Brazil, died soon after being brought unconscious to a Framingham hospital, authorities said.

The autopsy listed the cause of death as “intraoperative complications,” including pulmonary fat emboli – fat clots in the lungs.

Luiz Ribeiro performed liposuction on DePaula in the basement of a condominium, investigators said. He is not licensed to practice medicine in Massachusetts, but had a medical license in Brazil, they said.

Investigators believe Ana Maria Miranda Ribeiro assisted in the surgery, Coakley said.

The condominium’s owner, Ana Celia Pena Sielemenn, 40, of Framingham, was charged with distributing illegal narcotics to people undergoing plastic surgery. She pleaded not guilty on Aug. 1.

Authorities say DePaula underwent plastic surgery to her nose by Ribeiro earlier in the week before the liposuction. They believe she paid a total of $3,300 for the two procedures – much less than the typical cost of those surgeries.

Two other women have come forward saying they also had surgery by Ribeiro. Coakley said there are many more.

“He was well-known in the community,” she said.

Prosecutors said the couple, originally from Belo Horizonte, Brazil, had 30-day work visas for the sole purpose of performing plastic surgery in the basement of Sielemenn’s condominium.

At their arraignment on the initial charges, Luiz Ribeiro was ordered held on $250,000 cash bail while his wife’s bail was set at $50,000. They also were ordered to surrender their passports. Both remain in custody and face arraignment on the new charges Aug. 25.

A phone message seeking comment from the Luiz Carlos Ribeiro’s attorney was not returned Friday.

Framingham, a town of about 67,000 about 20 miles west of Boston, is home to an estimated 14,000 Brazilian immigrants.