Pierre Christian Lawlor (33), of Belarmine Place, Stepaside, Dublin, went under the knife because he was convinced he was "fat and ugly and had big ears".

He feared his young wife, Andrea Galeano, who was 23 when he died, would "go off with one of his friends" because "that had happened his parents".

The inquest also heard that Mr Lawlor's sister Claudine did not believe her brother died as she had been told by a "trusted" psychic that he had in fact been murdered in Columbia.

Ms Galeano told an inquest into her husband's death that she pleaded with him not to go ahead with the drastic operation but he refused to listen.

He paid €3,500 to have liposuction and numerous nips and tucks to his face and neck during a trip to Bogota.

His wife, who met Pierre over the internet, believes he took cocaine and drank at an Irish bar the day before he died.

She was at his side when he died on September 3 last year after a heart attack.

He had travelled to the Colombian capital with his wife and baby Zachary for surgery at the Centro Columblade Cirujin Plastica.

State Pathologist Professor Marie Cassidy, who carried out an autopsy, said drugs may have contributed to his death but he may have suffered strain from lengthy surgery.

Dublin County Coroner Kieran Geraghty said the tiler had died from cardiac arrest due to prolonged surgical procedure.

He warned people should "avoid unnecessary surgery" but returned an open verdict as no clinical notes were available.

During the heated inquest into Mr Lawlor's death, the coroner frequently clashed with a solicitor for the family, Michael Walsh.

He accused Mr Walsh of "trying to suggest" that Ms Galeano was lying. The coroner ordered him to stop when he queried her about the circumstances in the theatre when her husband died and whether she advised him against taking drugs.

"I'm the coroner and as far as I'm concerned these are not proper questions," he said.

Ms Galeano said she met Mr Lawlor in 2006 after meeting on the internet and moved to Ireland where they were married. She said he was a good husband but "had some difficulties". "He used to say he was fat and ugly and had big ears," she said. He had botox. He also took penicillin for skin problems, but threatened to kill himself if the condition spread to his face.

"He was afraid I would go off with one of his friends as that had happened with his parents," she said.

He trawled the internet for cheap clinics for surgery before travelling to Colombia when she made appointments.

When he got there, he asked for work on his eyes, cheekbones, nose, neck and liposuction.

She told him he was "foolish" to get the surgery.

"I didn't think he needed it," she said. "He was paranoid all the time about his looks and getting old and what people would think when they see us together."

She thought he was happy on the morning before surgery and they hugged before she left.

A doctor called her between 5.30pm and 6pm and said there was a "big problem" with her husband's heart.

She begged him not to let him die without her seeing him but his hand was "cold and purple" when she went in.

She told him he was the "most beautiful thing" in her life and she would look after their baby and be strong.

Mr Lawlor's mother, Margaret, said her son told her he was having surgery to "ease" an area behind his ear where a tumour was removed.

He was also getting fat removed, she said.

She knew his doctor advised against it but said he was in "perfect health" when she dropped him to the airport.

The only illness he ever suffered from was asthma, but was not so bad he needed an inhaler.

Margaret Lawlor believe the couple also wanted to show their son Zachary to Andrea's family, who lived in Colombia.

She said she was not surprised if he "dabbled" with cocaine, "knowing the people he hung around with".

Her daughter Claudine said she did not believe her brother died "as she was told" and trusted a psychic who said he was murdered. She later saw a photo of her brother's remains but did not believe they belonged to Pierre.

"I believe he was murdered in Colombia," she said in a statement, as she sat in the witness box at the inquest.

Speaking after the verdict, the Lawlors said they were disappointed and would seek to have it quashed in the High Court

"There is a lot more to it than this," said Tom Lawlor.