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: October 24th 2026
- Category: Commentary, Patient Safety, Weight Loss
The headline says GLP-1 patients do better after surgery. Two million records, 11 percent lower odds of a heart complication, 8 percent lower odds of an infection. I believe the numbers. I also read the fine print: one point zero percent against one point one, no record of when the last dose was taken, nothing on aspiration. Safer is a word for a headline. Ready is a word for a consult. A surgeon on the difference.
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- Posted on: October 24th 2026
- Category: Commentary, Patient Safety, Weight Loss
See? Safer.
The note that comes with the Newsweek headline of October 18. Good study. Nothing changes.
The Numbers, Without the Headline
UTHealth Houston. 2,028,601 elective inpatient operations, Epic Cosmos, 2016 to 2024, American Society of Anesthesiologists meeting this month. The 145,610 on a GLP-1: 11 percent lower odds of a major cardiac event (1.0 percent against 1.1), 8 percent lower odds of infection (4.9 against 5.3). Observational. No last-dose date. Nothing on aspiration.
My read: the weight came off first, and the gut still works.
“We also see that GLP-1 patients are healthier than bariatric patients, because bariatric patients also have the nutritional deficit; we’re taking out intestinal parts that absorb nutrients. So the complications are lower and the healing is better.”
“There are unique risks in this population, and the post-bariatric patients are still at higher risk for wound complications than the GLP-1 patients. This has been seen in recent studies, and it’s not surprising, because the bariatric patients do have more nutritional deficiencies, and they often have a much higher percentage of body weight loss.”
Healthier than 60 pounds ago. Safer. Not the same as ready.
The Two Weeks
“Our practice really hasn’t changed because of the increase in GLP-1 weight loss patients. We still do our complete workup and consultation prior to surgery. The financing is done in the same terms. I think the most important thing with GLP-1 patients is to stop the GLP-1 medication two weeks prior to surgery. Otherwise, it’s like any other patient, with the same high-grade attention to detail.”
A GLP-1 slows the stomach. That is the mechanism, not a side effect. A full stomach under anesthesia is how people aspirate; the anesthesia societies said a one-week hold in 2023, case by case in 2024. I hold two weeks. My nurse gives the second reason better than I do:
“I’m gonna need for you to stop taking it 2 weeks before the surgery and 2 weeks after. The reason why, they slow down your intestinal motility, as well as the surgery, and we do need for you to have bowel movements right after surgery.”
Nobody writes a headline about the first bowel movement after a tummy tuck. Everybody who has had one remembers it.
“Everybody’s expecting the midsection to get smaller and to have some skin laxity there. We know a lot about it, because pregnancy is the number one reason we do tummy tucks, and weight loss has been a big reason as well, both bariatric and GLP-1 and even diet and exercise. The skin envelope has been stretched out. It’s lost those connections with elastin, and you can’t make any new elastin. Once you deflate, just like a balloon, the outside wrinkles. We’re going to get some contracture, it’s just not as much as we would want.”
Three Months at the Same Weight
“With GLP-1s, it’s a little bit less clear, because the weight loss usually happens in a period between three to nine months, sometimes a year. But the patients seem to plateau a little bit quicker, and they seem to be ready a little bit faster after they plateau, usually about three months.”
“The most important thing is for the patient to be stable at their weight. If they continue to lose, or go up and down, they may need more procedures in the future.”
Not safety. Geometry. I remove the skin that exists on the day of surgery; thirty pounds later there is new skin and I did not get a vote. More: body contouring after GLP-1 weight loss, the BMI read.
The operation itself is different too:
“For a massive weight loss patient, the traditional tummy tuck or breast lift or buttock lift may take a little bit longer, maybe an hour, because there is a lot more skin and tissue to be removed versus a patient that has not lost weight. Of course, more time in the OR and anesthesia can increase the overall cost of the surgery. The difference is usually going to be in the two to three thousand dollar range.”
“So we have to look at the protein levels and protein intake before the surgery. And another thing we like to look at is the hemoglobin levels, to make sure the patient’s not anemic.”
The Bounce Back
“The timing is shorter now with the GLP-1s, but it’s still cooking. We don’t know exactly how it’s going to work. And the main thing is not to bounce back. When you stop taking it, if we have a bounce back, that can pretty much destroy everything we did, and the fat is not going to come back in the right places necessarily.”
“I don’t think there’s a huge health hazard or urgency. With the weight loss you got healthier. If you gain it back, some of your other problems might come back, like blood pressure or glucose intolerance. But the skin will keep stretching.”
Four weeks off is not a bounce back. Quitting with no plan is. The study measured weeks. I am measuring the next thirty years.
The consult version is on agulloplasticsurgery.com, the face while the scale moves is on the Southwest Plastic Surgery post, and one in three is how these consults took over my week.
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026.
Ready to Talk?
Safer is a word for a headline. Ready is a word for a consult. Bring the drug, the dose and the date, and we will figure out which one you are.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
- Posted on: October 24th 2026
- Category: Breast Augmentation, Commentary
Byrdie published a first-person review of a “ballerina boob job,” written by a patient who learned in her first consultation that she had tuberous breasts. I read it as a surgeon who does this operation every week. Here is what it gets right, and the one thing a review can never tell you.
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- Posted on: October 24th 2026
- Category: Breast Augmentation, Commentary
Byrdie ran a first-person review of a “ballerina boob job” in September. The writer, Charlotte Bickley Meller, learned at her first consultation that she had tuberous breasts. She had the operation in New York and wrote down the wait, the tightness, the slow settling, and a change that was mostly mental.
Good review. I read it with a tape measure in my head, because half my patients now ask for this look (I wrote about why a year ago). Here it is, annotated.
What Is She Asking For?
“The patient that comes in looking for the ballerina look is usually asking for a subtle augmentation with an upper pole slope, without too much upper pole fullness, and an overall natural, not done look. This is usually a look that is achievable with a patient that is not very large breasted to start with.”
Upper pole: the top half of the breast. Slope: the line from collarbone to nipple, kept soft.
How I Get There: Fat, Implants, or Both
Byrdie’s writer needed her tuberous tissue reshaped plus a small implant. Without that shape problem, the menu is wider.
“If the patient is already happy with their breast shape and they just want a little bit more fullness, then this can be achieved with fat transfer alone. It usually gives you at least a cup size, preserves the current breast shape, and just augments the volume by 100 to 200 cc.”
“It can also be achieved with implants for a more predictable result. To achieve the ballerina look, we often use the Motiva Preserve technique, which preserves the arteries, the nerves, and the ligaments of the breast without performing any cutting, and the implant is placed just under the gland, above the muscle. It can also be done with a traditional breast augmentation.”
On the implant itself: “The implant of choice here would be a lower profile implant, like a Demi or a Mini, and the Motiva Ergonomix implant, which flows with the breast and lends itself to more movement. Because of this, the upper part of the implant becomes tapered when the patient stands and takes on a teardrop shape, which is the more natural ballerina look.”
A lower profile implant sits flatter against the chest for the same width. And sometimes it takes both: “At times, if the patient has a small amount of subcutaneous fat and breast tissue, then the implants can be complemented with fat as well, to even and smooth the edges and create that natural contour.”
When a Lift Is Not Optional
The review does not involve a lift, and the writer did not need one. Many women who want this look do, and this is where a first-person account cannot help you.
“The level of droopiness determines whether the patient will require a lift or not. If the nipple areola complex is below the inframammary fold, then a full lift, anchor type incision, will be necessary. If the nipple areola complex is at or slightly above the inframammary fold, I will often recommend a circumareolar lift or donut lift.”
Translation: the nipple areola complex is the nipple and the colored skin around it. The inframammary fold is the crease under the breast. An anchor lift uses an incision around the areola, down, and along the fold; a donut lift is a circle around the areola only.
The deciding number: “The ideal sternal notch to nipple areola distance is anywhere from 19 to 22 centimeters.” That is the distance from the notch at the top of the breastbone to the nipple. Any patient measuring more than that should consider some type of lift.
What happens if you skip it: “If the lift is not performed during the augmentation and there is considerable sagging, then the implants will appear to be higher up, even though they are in the right place, and the nipple areola and breast tissue will hang over it.”
On the lift most people have heard of, the vertical or lollipop lift: in my experience it has a high rate of bottoming out, where the breast tissue settles below the implant over time. “Nevertheless, it is a good procedure on very select patients.”
And the honest line I give every patient who hoped for no scars: “Although most of the patients seeking a ballerina breast want to avoid scars, a lift is necessary for optimal results when it is indicated. A lot of the patients seeking the ballerina look are already happy with their breast shape, therefore a simple augmentation is possible.”
Who Should Not Chase This Look
“The ballerina look is very appropriate for patients that already have a ballerina type structure. These are patients that are usually thin and athletic, so a ballerina breast is very proportionate in these cases. The ballerina breast can look disproportionate in heavier set patients, or those with wider bony structures. But in all reality, it really just depends on what the patient wants and what they will be happy with.”
That is where the simulation comes in. “One of the advantages in my practice is that we can simulate the results using the Vectra 3D system and the Crisalix system to visualize the results even before the surgery. This really helps the patient decide on the look, the size, the profile, and whether or not a lift will make the final results look better. So this takes away a lot of apprehension or anxiety.”
What a Review Leaves Out
She told you her diagnosis. Most reviews do not.
“What a first-person review usually leaves out is that the writer’s result started with the writer’s anatomy. A thin, athletic patient with good nipple position and a little breast tissue will get the ballerina look with a small implant or fat transfer alone. A patient with more sagging, a wider chest, or a longer sternal notch to nipple distance will need a lift or a different implant to get anywhere close, and the review will not tell you that. The other thing missing is the measurements. A consultation with 3D imaging and actual numbers tells you what is achievable on your body, which no review can.”
Her result started with tuberous breasts and a surgeon who reshaped them. Yours starts with yours.
Why Choose Dr. Agullo
Double board-certified. Mayo Clinic fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor for 13 consecutive years. Fat transfer, Motiva Preserve, traditional augmentation, and every kind of lift, under one roof, with 3D imaging in the consult room.
Ready to Talk?
Read the review. Then bring your own anatomy in and let us measure it.
Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. Pricing starts on the fees page. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
