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: July 19th 2026
- Category: Body Contouring, Commentary
A plastic surgeon on why loose skin will not bounce back after major weight loss, the circumferential body lift, and why he stages the more aggressive scars.
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- Posted on: July 19th 2026
- Category: Body Contouring, Commentary
Some of the most rewarding consultations I have are also, for the patient, some of the most maddening.
Sixty pounds gone. Eighty. A hundred. Bariatric surgery, a GLP-1, or sheer stubborn discipline, it does not matter which. They finished the part most people never do. And then they are sitting across from me genuinely upset, because the skin will not play along.
Here is the truth I hand them, pulled from real consultations and anonymized. The skin is not a willpower problem. It is a tissue problem. Willpower does not fix tissue.
Why the Skin Will Not Go Back
Stretch skin that far for that long and the elastic fibers give out. You can hit a beautiful weight, carve out a tiny waist, and still have skin hanging off the breasts, the belly, the inner thighs, the arms.
No squat program reverses that. The only thing that removes loose skin is surgery. I say it bluntly because I have watched too many people blame themselves for something that was never theirs to fix at the gym in the first place. That is precisely the work body contouring after major weight loss was built for.
What I Do for the Breasts
After massive weight loss the breast usually still has volume. It is just hanging very low. Most of the time a lift alone gives a beautiful result, no implant needed. I bring the nipple up, take out the excess skin, and because your skin has lost its elasticity, I lay a mesh on the inside so the result no longer leans on skin that cannot hold. Skip that mesh and everything drifts back down over the years.
When the breasts hang extremely low, I usually hold off on the implant during the lift. Moving the nipple a long distance up while adding an implant in the same sitting can choke the blood supply to that nipple, and that is not a gamble I take. The implant is an easy second step later. One breast almost always outsizes the other, so I trim the bigger side to match.
Standard Tummy Tuck or All the Way Around?
With a standard tummy tuck I make a low incision, pull out the excess skin, draw everything down tight, and repair the muscles up the middle and along the sides for that corset effect and a smaller waist. Liposuction goes with it.
After massive weight loss, though, the looseness rarely stays in front. It wraps around the sides and the back. So I often steer toward the circumferential procedure, also called a lower body lift. The incision carries all the way around, which lets me pull the skin down in front while lifting the outer thigh and the buttock in the same pass. When the laxity is not just frontal, this is the most complete option on the table.
| If your laxity is | I usually recommend |
|---|---|
| Mostly in the front | A tummy tuck with liposuction |
| Wrapping around the sides and back | A circumferential lower body lift |
| Hanging low at the breasts | A breast lift, often with internal mesh |
| Loose on the inner thighs | A thigh lift, staged thoughtfully |
The Honest Tradeoff on Stubborn Laxity
The circumferential lift pulls everything down and in. But carry a lot of side-to-side laxity and you may still have some looseness up top when it heals. Erasing that completely takes a vertical incision, one that gathers everything in like a corset.
Most people would rather not wear that scar, because it is harder to hide. So I almost always park it as an optional second stage, done later only if the looseness truly bothers you. I am not in the habit of talking patients into scars they do not need.
And the Inner Thighs
Real excess skin on the inner thighs? Liposuction alone will not touch it. I run an incision in the groin crease that continues just below the buttock and pull everything up. Want it tighter still? That means a vertical scar down the inner thigh, which I again hold in reserve.
Let me be upfront. The thigh lift is the hardest of these to recover from. Right where the tension pulls upward, the incision tends to open a little, almost every single time. The good news is we just keep it covered with gauze, it closes on its own in about two to three weeks, and more often than not we never even have to revise the scar.
Why I Stage It This Way
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Mayo Clinic plastic surgery fellowship alum, and a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. Body contouring after massive weight loss is never one operation that fits everyone. It is a plan. I would rather hand you a safe, powerful result today and keep the more aggressive scars in my back pocket than chase perfection in a single marathon surgery and gamble with your healing.
Ready to Talk?
If you have lost the weight and you are ready to deal with the skin, let us build a plan together.
For the patient-facing version, see the companion post on agulloplasticsurgery.com. For the El Paso treatment menu, see the version on swplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
- Posted on: July 18th 2026
- Category: Commentary, Skincare
A plastic surgeon ranks collagen powders, capsules, gummies, and serums by the evidence, and explains what actually protects the collagen you still have.
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- Posted on: July 18th 2026
- Category: Commentary, Skincare
Flow Space called this month to do a piece on collagen supplements. When we got on the phone, the interviewer finally asked the real question on everyone’s mind: powder, pill, gummy, or serum; what actually gets absorbed and works for you?
The explanation I gave her was shortened to fit the article. Here is the full one. The formats are not equal, and the gap between the worst and the best is larger than the price suggests.
Powder Wins, and It Is Not Close
There are no other formats in that aisle with enough human data behind them. Only powder. The researchers did not measure mouse models; they did not measure cells under a microscope. They measured human volunteers at the end of human trials.
They study dosages of anywhere from 2.5 to 10 grams of hydrolyzed collagen peptides a day, and those have resulted in measurable, though often subtle, improvement in skin hydration and elasticity over 8 to 12 weeks.
Read it twice. Modest. And 8 to 12 weeks.
Powder wins because the doses in those studies come out of the tub by the spoonful. You can take exactly what the studies used, which happens to be the hardest thing to manage among all the products in this category.
Capsules Are Usually Underdosed
Capsules are not fraudulent. They are just small.
You would need a large number to get close to even the lower end of what is used in the studies. People pick up a two-cap bottle, think they are being proactive, but still end up with a small fraction of the dose used in the trials, with virtually none of the bottles labeled to warn them about that reality.
Just look at the label to know how much you actually have per serving. Go for the real dose and stick with it, rather than fine-tuning something you will abandon in a month anyway. It costs more per gram with less in the bottle.
Gummies Are the Weakest Option, and Sugar Is Why
Gummies push my buttons in two specific ways, and the two go together poorly.
First, you do not get a meaningful dose. How much collagen can you pack into a gummy and still make it taste good and look like a gummy.
Second, and this one is my main point as a surgeon: most gummies contain added sugar. Sugar in the blood drives glycation, which is essentially when excess sugar in your body binds to proteins and stiffens them. One of the body’s proteins, collagen, happens to be sensitive to this, which leads to stiffness and makes repair take longer. After glycation, collagen fibers become less stretchy, brittle, and break easily, losing the elasticity we all want to retain.
It essentially provides you with a collagen-infused product while including an ingredient that destroys the collagen your body possesses. Strange trade-off to make in the name of skin care, wouldn’t you agree?
| Format | Delivers the studied dose? | Evidence behind it | My read |
|---|---|---|---|
| Powder | Yes, easily | Best human data in the category | Where I would put the money |
| Capsule | Rarely, without high pill counts | Same peptides, wrong dose in practice | Acceptable if you take enough |
| Gummy | No | Low content plus added sugar | Weakest option in the aisle |
| Serum | Not applicable, does not absorb | Surface hydration only | A moisturizer, priced like medicine |
Serums Cannot Reach the Place That Matters
A collagen serum is a hydration product wearing a lab coat.
The collagen molecule is too large to cross the outer barrier and reach the dermis. Collagen synthesis happens inside the dermis, and for the collagen in a serum to get there, it has to travel all the way from outside the skin. However, if the barrier let large molecules like that pass, it would defeat its one job of providing protection to everything below it.
Collagen serum just makes skin appear moisturized because it is holding water in the outermost layer of the epidermis. Skin appears dewy because it is storing and keeping that moisture. For a short amount of time, collagen serum helps skin perform that duty better than it would on its own. When you stop, the effect fades right back out.
If you want to tell your skin to produce new collagen, buy retinoids, decent vitamin C, and peptides. Do not ever buy something just because “collagen” is slapped onto the packaging.
The Menopause Number Nobody Prepares You For
The statistic I gave Flow Space hit me right in the head, since it quantified something many of my patients go through but cannot explain.
The average postmenopausal woman loses anywhere from 25 to 30 percent of her skin’s collagen in as little as five years after menopause, not over a lifetime. Within five years.
Therein lies why women report feeling as if they hit a sudden wall with their skin. It changed rapidly, not gradually, and falling estrogen is a big part of why.
No, you are not adding powder and getting 25 percent of your dermal collagen back. That is the reality. Supplements can support the tissue you have left. They cannot rebuild the structure once it is gone.
The Thing That Beats Every Supplement in the Aisle
The cheapest way to protect the protein that keeps our skin tight and supple is not a pill or powder. It is sunscreen.
UV damage is the number one controllable reason collagen loss happens. It causes enzymes to destroy collagen in the skin and hinders new collagen development. One can eat heaps of collagen every day and undo the benefit simply by spending time outdoors in the sunlight later on.
You top it with your retinoid, vitamin C, a bit more protein so your body gets what it needs to make new collagen, real sleep, no tobacco, and less sugar, which relates to glycation all over again, except now you are eating it with dinner.
All free, all better than anything you can buy by the tub.
Where the Real Collagen Work Happens
When a patient wants a bigger push, we work our way through the epidermis and down into the dermis.
Sculptra, as an example, has been shown to produce genuine collagen over a span of months, not days. Radiofrequency microneedling, and microneedling generally, provides enough controlled injury to encourage remodeling. Resurfacing lasers work at the surface and just below it.
When it is descent and not quality, nothing ingestible touches it. Descent means the thing has moved downward and it has to move back up. That is precisely what a deep plane facelift accomplishes, and no amount of scooping replaces real repositioning.
Mayo Clinic trained, dual board certified, and a 13-time consecutive Castle Connolly Top Doctor, yet not one time in my entire career have I seen any of these supplements make any sort of difference to a person’s jawline. Believe me, I have looked.
So Should You Take It?
Sure, if your bank account and your timeline allow, and if you take it in a delivery system that actually works.
I told Flow Space that collagen is a nudge, not a lift. It is not a facelift in a scoop. But it is good for something, and when a category is choked with things that are good for nothing, that is a real step.
The powder is the one, definitely get some. Wear sunscreen always. And give it three months before you call it. #StayBeautiful.
The El Paso patient version can be found on agulloplasticsurgery.com. Our practice version, describing how we fold skin support into in-office treatment, can be found on swplasticsurgery.com.
My comments originally appeared in Flow Space, “Powders, Serums, Gummies. What’s the Best Way to Get Your Collagen?” by Maggie Ryan, July 16, 2026.
Ready to Talk?
Want an honest breakdown to find out if your skin needs a supplement, a treatment, or surgery? Then you may want to invest in seeing somebody, and not another dollar out for a tub.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
