Charlotte, N.C. Sally Jordan Hill let a grudge get the best of her and now could face life in prison.
Authorities believe Hill, a nurse anesthetist, poisoned a cosmetic surgery patient five years ago because of a high school rift in the early 1970s.
Sandra Baker Joyner died in 2001 after complications following a face-lift, fat grafts to her lips, and laser therapy on her eyelids and facial scars.
Hill went to Olympic High School in Charlotte with Joyner and believed the patient stole her boyfriend.
Hill, 50, is jailed without bail on first-degree murder charges.
For five years, Joyner was thought to have died from a medical error. An autopsy blamed her death on a lack of oxygen to the brain caused by respiratory arrest.
At a court hearing last month, Chuck Henson, a Charlotte-Mecklenburg detective, said he believes Hill poisoned the patient by injecting her with fentanyl, a powerful painkiller.