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 12th 2026
- Category: Commentary, Skincare
WOWMD asked me to weigh in on hyaluronic acid serums alongside a colleague in Sydney. Here’s the actual mechanism, not the marketing version.
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- Posted on: August 12th 2026
- Category: Commentary, Skincare
WOWMD called last month asking me to weigh in on the best hyaluronic acid serums on the market, alongside a colleague in Sydney. It’s a good question, and most of the coverage out there skips the one detail that actually determines whether a serum does anything at all.
Here’s the honest version.
What Topical HA Actually Is
Hyaluronic acid is not exotic. A topical HA serum is, at its core, water and hyaluronic acid. The molecule pulls moisture to the top layer of skin and holds it there, which is why skin looks plumper and fine lines look softer within an hour of applying it.
That’s the whole mechanism. It’s a humectant, not a filler. It doesn’t rebuild collagen, it doesn’t penetrate the dermis, and it doesn’t do what an injectable HA filler does. Anyone marketing a topical serum as a filler alternative is overselling it.
The Detail Everyone Skips: Molecular Weight
Hyaluronic acid comes in different molecular weights, and the weight determines where it sits in the skin.
High molecular weight HA stays on the surface. It forms a film that holds moisture in and slows water evaporation through the day. Low molecular weight HA is a smaller molecule, so it penetrates further, into the epidermis, where it can do more for texture and fine lines.
A serum with only high molecular weight HA gives you surface hydration and not much else. A serum with only low molecular weight HA penetrates but doesn’t hold onto surface moisture well on its own. The serums that actually perform well blend both, so you get the surface film and the deeper hydration at the same time. If a label doesn’t tell you which type is in the bottle, that’s worth noticing.
What to Pair It With
HA serum works better with support. Niacinamide protects the skin barrier. Ceramides help repair it. Peptides stimulate collagen production over time, which topical HA alone does not do. Glycerin is another humectant that works alongside HA rather than competing with it.
A serum built around HA plus one or two of these supporting ingredients does more than HA on its own, in my experience watching what patients respond to.
Who Actually Benefits
Dehydrated skin is the clearest case. So is anyone recovering from a procedure or using a retinoid, since both can leave skin temporarily more prone to water loss and a good HA serum offsets that. People in arid climates lose more surface moisture day to day, so the film effect of high molecular weight HA does real work there. And perimenopausal and postmenopausal women dealing with estrogen-driven dryness are a group I see benefit consistently, since declining estrogen affects the skin’s own moisture retention independent of anything topical.
Who Should Be Careful
Sensitive or broken skin, an active rosacea flare, a known preservative sensitivity like methylparaben, or a recent aggressive peel or laser session are all reasons to hold off or check with whoever did the procedure first. HA itself is about as low-risk as skincare gets, but the rest of the formula around it isn’t always.
About Dr. Frank Agullo
Frank Agullo, MD, FACS, is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery and a Fellow of the American College of Surgeons. He completed his plastic surgery fellowship at Mayo Clinic and serves as a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. He has been named a Castle Connolly Top Doctor for thirteen consecutive years.
Ready to Talk?
A good skincare routine and a surgical consultation are different conversations, but they start the same way: an honest look at what your skin actually needs.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Cross-links
- Patient-facing version on agulloplasticsurgery.com: “Choosing a Hyaluronic Acid Serum: What Your Skin Actually Needs” (link once live)
- Practice version on swplasticsurgery.com: “Southwest Plastic Surgery’s Take on Hyaluronic Acid Serums” (link once live)
- Source: WOWMD, “9 Best Hyaluronic Acid Serums for Smooth, Hydrated Skin,” WOWMD Staff, July 23, 2026. https://www.wowmd.com/blogs/wellness/best-hyaluronic-acid-serums
- Posted on: August 11th 2026
- Category: Body, Editorial
RibX, Ribella, Invisarib, the Barbie waist: all one procedure. A surgeon explains scarless rib repositioning, the real numbers, and who should consider it.
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- Posted on: August 11th 2026
- Category: Body, Editorial
Scroll aesthetic TikTok for ten minutes and you will meet the same operation wearing six different outfits. RibX. RibXcar. Ribella. WASP. RIBOSS. H-Curve rib remodeling. The nicknames are even better: the Barbie waist, or Invisarib.
These are all the same procedure with different names, due to marketing or surgeon preference. We tend to call it rib repositioning. It can also be referred to as rib remodeling or minimally invasive rib contouring.
Whatever you call it, the interesting part is not the branding. It is the anatomy, because the anatomy explains why some waists will not shrink no matter how disciplined the diet is.
Your Waist Has a Floor, and It Is Made of Bone
The waist is defined, or restricted, by the distance between the superior crest of the pelvis and the last rib. In some patients, this last rib almost touches the pelvis, which means that there really can be no further reduction in the waistline. You can lose fat. You can build obliques. The bones do not care.
To create a smaller waist, what we do is cut the outer portion of the last two floating ribs so that we can reposition them in a narrower configuration. That’s the way we create a smaller waistline. We move the floor.
What Changed: From Rib Removal to a Needle
This used to be done by removing the ribs in their entirety, which required a large incision, had an increased risk of injury to the lung or nerves, and sometimes led to chronic pain. That version earned its bad reputation.
The way this procedure is done now is through a small needle incision, using a device called a Piezotome, which is an ultrasonic needle device that helps us cut the outer portion of the rib with ultrasound guidance, and then the ribs are fractured into their new position. Today it is a scarless procedure with substantially fewer risks and complications.
I think this was a controversial procedure when we were removing entire ribs and accepting large scars and increased risks. With this new scarless technique, the risks are minimal. There is no scar. And if we only treat the two floating ribs, it’s an easy recovery. It’s not controversial at all.
The Real Numbers
| Two floating ribs | Adding the two false ribs | |
|---|---|---|
| Waist reduction | About 3 to 4 inches | 6 to 7 inches |
| Complication rate | Under 1 percent | Around 1 to 2 percent |
| Extra requirement | None | CT scan before surgery |
| How it works | Outer portion cut, ribs repositioned | Ribs cut at the cartilage in front and in back, converted into floating ribs, then repositioned |
Not every patient is a good candidate for the false rib extension, which is why it starts with imaging rather than a wish list.
Who Actually Books This
The ideal candidate is somebody who wants to reduce their waistline and get a more feminine figure. This is very common in women who have an athletic body build and do not have much waist. It is also very common in male-to-female transgender patients. And it’s very common in women who are already curvy but want to reduce their waist further.
Other times, I see patients who have already had liposuction and tummy tucks and just want even more waist definition, and this would be the last option for them to achieve it.
The Ultimate Waist, Assembled
Rib repositioning rarely works alone in my practice. Liposuction is a very strong tool for the waist contour, and I often combine the two: if you’re able to pinch excess fat in the waistline area, liposuction there buys more definition.
The way I perform a tummy tuck also gives a lot of waist definition, because I plicate the rectus muscles and the oblique muscles. It’s like an internal corset, a triple plication, which brings in the waistline further. (That triple plication deserves its own article, and it will get one.)
And corset training is not a gimmick here, it is the recovery. We actually use the waist trainer for three months to help heal the ribs in their new position. Many patients notice their waist trainer can be placed tighter and tighter as they heal, and they often have to downsize to a smaller waist trainer toward the end of the three months. Watching your own recovery require smaller equipment is a satisfying way to convalesce.
So the ultimate waist definition procedure would be a combination of liposuction, rib repositioning, a triple plication internal corset through a standard or mini tummy tuck, and then the waist trainer for recovery. For some patients this folds into a larger body contouring or mommy makeover plan.
Pain, Risk, and the Three-Month Rule
The risk of injury to the lung, if we’re only targeting the floating ribs, is minimal, probably less than one percent. I inject Exparel in the area prior to the procedure, a local anesthetic that lasts for three days and numbs the area for a much smoother recovery. Most patients describe the pain as mild to moderate, and they feel the waist trainer helps them through it.
The non-negotiable: abstain from strenuous exercise and activity for three months while the ribs heal in their new position.
Why Me, for This
This technology did not come into development until about two or three years ago, so be careful who you let near your ribs. I am a board-certified general surgeon and plastic surgeon, and I have experience with rib fractures and rib removal procedures from both careers. I use the ultrasound to identify the ribs and visualize while I’m cutting the outer table before repositioning, and this decreases the risk of injury to other structures. The Mayo Clinic fellowship taught me many things, and one of them was respect for what sits behind a rib.
Ready to Talk?
If your waist has stopped responding to everything you throw at it, the limiting factor may be bone, and that is now a solvable problem. 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 candidate guide on agulloplasticsurgery.com, and the practice overview at swplasticsurgery.com.
