DR. WORLDWIDE GETS SOCIAL
DR. WORLDWIDE GET TO KNOW HIM
Frank Agullo, MD, FACS — known globally as Dr. WorldWide — is a double board-certified plastic surgeon in El Paso, Texas. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center and Affiliate Professor at the University of Texas at El Paso. Specializing in preservation-based aesthetic surgery and the Deep Plane Facelift, he has been named a Castle Connolly Top Doctor for thirteen consecutive years and has a global social following of over 3.5 million across Instagram, TikTok, and Snapchat. He is the founder of Southwest Plastic Surgery and Plastic Surgery Studios.
Meet Dr.WWDR. WORLDWIDE GET TO KNOW HIM
Frank Agullo, MD, FACS is the plastic surgeon the world watches. Known globally as Dr. WorldWide, he has built one of the largest followings of any surgeon on the planet (over 3.5 million on Instagram @RealDrWorldWide) by pulling back the curtain on plastic surgery and showing what extraordinary results actually look like. Celebrities, influencers, and patients from across the United States and around the world make the trip to El Paso, Texas, because when you have seen the work up close, there is nowhere else to go. More than 80% of his patients travel from outside El Paso. The practice handles every detail of their journey.
Dr. Agullo is double board-certified, Mayo Clinic fellowship-trained, and a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. But credentials only tell part of the story. What sets him apart is a philosophy built on preservation: enhancing, restoring, and elevating what is already there rather than changing who you are. Not cookie cutter. Every plan is molded around the individual patient's desires, their anatomy, their life.
That philosophy drives every decision in the operating room. His Motiva Preserve breast augmentations deliver results that feel as natural as they look. His deep plane and endoscopic deep plane facelifts turn back time without announcing themselves. His Supercharged BBL has been refined, published, and presented on international stages. And his ability to combine face and body procedures in a single operative session is a capability few surgeons in the world can offer safely at his level.
The same philosophy applies outside the OR. Forget synthetic fillers. Dr. Agullo restores volume with regenerative grafts including Alloclae, Lipoderma, exosomes, and platelet-derived growth factors. Recovery is treated as part of the result: lymphatic massages, scar management, and Elixir MD LED light therapy ensure that what happens after surgery is as intentional as what happens during it.
Castle Connolly Top Doctor for eleven consecutive years. Texas Super Doctors Hall of Fame. Best Plastic Surgeon in El Paso for thirteen consecutive years. Aesthetic Everything Top Plastic Surgeon 2026. Founding Vice President and President of the World Association of Gluteal Surgeons, where he helped write the global safety standards for gluteal surgery.
The results are daily. The standard is uncompromising. The philosophy is simple: #MakeItHappen. #HappyIsBeautiful. #StayBeautiful.
#PlasticSurgeryIsMyPassion
GLAMOUR SHOTS
Plastic Surgery is a very personal choice and a unique experience for every individual who chooses to undergo a change, be it a discreet or major surgery. The one thing in common for my patients though is that they experience an inner transformation which ultimately shines through as confidence in themselves. Confident is Beautiful!
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- Posted on: August 10th 2026
- Category: Injectables, Surgeon Take
I have injected Kybella, operated on hundreds of necks, and taken the needle in my own chin. From all three chairs, here is what the fat-dissolving shot really buys you.
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- Posted on: August 10th 2026
- Category: Injectables, Surgeon Take
It surprises people every time: the plastic surgeon telling you to think twice about Kybella has had Kybella under his own chin.
I remember the first time turkey neck started creeping into the mirror, a few years back. So I took my own advice: one session, my own central pocket, my own experiment. This means I am not reviewing a brochure. I have been the injector, the surgeon who performs the more definitive operation, and the guy sitting in the chair.
The Three-Chair Review
It looks elegant. Your body already produces a form of deoxycholic acid. It is how your gut processes fat in your food. If you make a more concentrated version, inject it into the submental fat pad, and it kills the cells. The cells will burst and then be cleared out. Fat-cell-killing fact. Destruction is permanent, those cells do not come back.
Lying back, less glamorous. You get a bunch of injections that really burn. That is where the “unseen part” of this whole trend begins. You get swollen up to where you have a more janky turkey neck than the one you paid to fix up and it will be a while before the effect starts showing. Two to four weeks is how long you can expect, or even longer. Now remember, that was after just one treatment and people generally get three sessions.
Looking at it from the doctor’s standpoint, it is a basic sum: Twenty percent of the central fat compartment is eliminated with Kybella. CoolSculpting likewise eliminates about twenty percent, except it freezes the fat instead of dissolving it, and I like it even less. In terms of effectiveness, even on a strong candidate, twenty percent of the single center compartment reads as a subtle change at best. On the wrong candidate, it reads as nothing.
Who the Shot Actually Fits
My peers and I may squabble a lot on many of the above issues, but Kybella candidature has little debate among people performing these procedures daily.
You want superficial subcutaneous fat, directly underneath the skin, not below the platysma muscle. The needle is too short to reach that far and the ads do not mention it, which is one of the reasons why it makes some people look worse. It needs to be mostly in the mid neck region. Lateral neck fat and jowls are off the map. The skin quality must be of good elasticity to take the deflation of fat within; if you just remove the fat below loose skin, you will have a worse neck.
A younger individual with elastic skin has one specific, isolated fat pocket right in the middle. That patient does exist, and for that person the Kybella program at our med spa is a legitimate option.
What I Do for Every Other Neck
In most necks walking into the office, the fat has migrated beyond being a simple neck issue and has already wrapped around the jawline, spilled onto the sides, or the skin has been relaxed for a long time. So for that patient, for many years, my solution has been neck liposuction combined with FaceTite.
It is not even close. Liposuction takes out up to 80% of the excess fat and treats the entire aesthetic unit (lower face, jawline, center neck, sides of neck). FaceTite runs RF underneath the skin through the same 3 little entries, one behind each ear and one below the chin, and tightens the envelope up as the volume drops. A real neck lift is the choice when the problem is larger than a single energy device will help, point-blank!
Plus, it all costs about as much as three sessions of Kybella. It is not like people were choosing cheap versus expensive. They are deciding between 20% off of one pocket versus 80% of the entire neck for the same price.
The Part I Trained For
The Mayo Clinic taught us that the diagnosis IS the surgery. The neck is our classic teachable moment. Is the fullness fat or gland? Is it above the platysma muscle or below? Is the neck fullness a narrow strip down the front or has it completely encircled it? Is the overlying skin a bystander or the focus of pathology?
They all swap out the correct tool, not that these questions could possibly be found on a spa menu, nor that 90 seconds’ worth of exam would not find the best tool. Ninety seconds is the most important part of every consultation on necks, even mine. This is precisely the reason I keep both the needle and cannula within arm’s reach of the procedure, rather than deeming one “king”.
My Bottom Line
Kybella is real. The science is sound, the fat it kills stays dead, and my own neck carries the proof years later.
However, in a one-pocket room, the shot has a ceiling of 20 percent, and most necks need more than that. When someone only talks about a particular needle treatment that is the only thing a clinic is willing to offer, they are not telling you what a treatment is supposed to be; they are telling you about an ingredient they offer.
Ready to Talk?
Bring me your neck and ninety seconds. I will tell you which chair you actually belong in.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Cross-links
- Med spa version on swplasticsurgery.com: “Kybella in El Paso: What the Fat-Dissolving Shot Can and Cannot Do” (link once live)
- Surgical version on agulloplasticsurgery.com: “Why I Still Reach for Liposuction and FaceTite Over Kybella” (link once live)
- Posted on: August 9th 2026
- Category: Body, Editorial
BBL patients from a decade ago are coming back for reversals. A surgeon on why, what the surgery combines, and why the BBL era still is not over.
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- Posted on: August 9th 2026
- Category: Body, Editorial
A patient called me from the East Coast for a virtual consultation. Years ago I had done her BBL myself, a supercharged one, implants plus fat. Since then she had babies, started her family, and moved somewhere more conservative. She wanted her body back, or at least a quieter version of it. More discreet. More athletic.
She is not an outlier. She is a wave.
I wrote earlier this year about how beauty standards keep moving, and the buttock is where that pendulum is swinging hardest right now. So let me explain what a BBL reversal actually is, because it is more interesting, and more surgical, than the headlines suggest.
Why They Come Back
The most important reason is time. A BBL is a procedure where liposuction is done in the trunk, including the upper back, lower back, lateral chest, abdomen, and sometimes the thighs and arms, and that fat is transferred to the buttock. Once liposuction is done in those areas, they do not increase in volume as much when the patient gains weight. The buttock becomes the one area that increases the most.
So a patient gains weight years later, and the proportions run away from her. The buttock is no longer proportionate, or has developed cellulite or even droopiness. Some patients develop a double butt crease deformity, which patients themselves call elephant butt or frog butt. Their words, not mine, and they are not wrong about the shape.
Another portion of patients have not gained anything. They just want a more natural, less aggressive body contour. And a certain percentage were never happy in the first place: exaggerated hips, too much projection, a lower back scooped too aggressively, a buttock that doesn’t transition well into the thighs.
The Reversal Toolkit
Reversal surgery can involve a combination of a lot of procedures, and the plan is assembled per patient.
| Tool | What it does |
|---|---|
| Liposuction | Reduces buttock volume and recontours |
| Renuvion J-Plasma | Radiofrequency with helium plasma for skin contraction |
| Morpheus8, stacked on top | Microneedling with radiofrequency, more contraction |
| Buttock lift, lateral thigh lift | Removes loose skin and lifts when volume loss is significant |
| Miami thong lift | Corrects the double butt crease deformity |
| Implant removal | For the supercharged BBLs of the 2010s |
The honest caveat: when we perform liposuction, the skin often becomes looser, and the buttock can droop more. Renuvion and Morpheus8 help create skin contraction, but the amount of contraction is hard to predict, as each patient reacts differently to these technologies. If we’re removing a significant amount of fat, then oftentimes a buttock lift, and even a lateral thigh lift, is necessary. Skin quality work continues afterward with microneedling when needed.
I prefer to do the surgery all at once, which gives the best results. The exception is the patient trying to avoid scars, who declines the lifts in hopes that the energy devices create enough contracture. Those patients know that at three or six months, if they develop buttock ptosis or loose skin, the lift conversation returns.
Can You Get Your Old Body Back?
We can get patients to their pre-BBL body, although most patients don’t really want to go that far back. They’re looking for a result in between: tighter contours, tighter skin, sometimes a more athletic look. That target gets set at consultation, along with an honest answer about whether it is achievable given which procedures they are willing to undergo.
How the East Coast Case Went
Her plan: buttock implant removal, liposuction of the lateral thighs, saddlebags, and buttock, a buttock lift with a lateral thigh lift, and a Miami thong lift to correct the double crease and create a sweeping curve where the lower buttock meets the thigh.
Four and a half hours under general anesthesia. Hotel the same day. My nurse saw her the next morning with IV fluids, helped with her first shower, got her into her garments. Lymphatic massages every other day. Drains out on day seven, and she flew home. No complications, and at four months she is mostly healed and very pleased with the new contour. Most of my reversal patients fly in exactly like this; the majority had their original surgery out of town or in another country, usually more than five years ago. This kind of travel case is routine in my body contouring practice.
Recovery in general runs about a week to get back to normal activity and driving, and about four weeks to return to the gym, running, and jumping. The risks specific to reversal are asymmetries, development of cellulite, and buttock ptosis if a lift is not performed at the same time.
No, the BBL Era Is Not Over
The BBL era is far from over. Patients’ desires have shifted, but it really depends on their culture and each person’s definition of beauty. I still perform minimal BBLs, or skinny BBLs. I also still perform some exaggerated ones.
The tendency is toward a reduced size: maybe only the hip dips and a little projection, more of an upside-down heart shape than a shelf, some reduction in hip width. And still, plenty of patients want a very small waist with larger hips.
My tool for keeping everyone honest: photographs. The buttock is a hard anatomical place to describe with words, so I have patients bring pictures of what they want to the consultation, and again on the day of surgery, so that we’re both on the same page.
I served as founding vice president of the World Association of Gluteal Surgeons. I have watched this pendulum from the front row, in both directions. The surgeons who did the shelf era well are the ones patients now trust to quiet it down.
Ready to Talk?
If your BBL no longer fits your life, there is a surgical path back, and it can usually be planned from a virtual consultation. Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Companion reads: the clinical reversal guide on agulloplasticsurgery.com, and the destination-patient overview at swplasticsurgery.com.
