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 21st 2026
- Category: Aesthetic Analysis, Commentary, Face
Salma Hayek told Allure she has had no plastic surgery and no filler, and pulled her hair back to show the skin by her ear. This week a doctor on social media put her before and after side by side and pointed to what he called surgical scars. I am not going to referee that from a photo, and neither can he. But I can show you where my facelift scars go, why the good ones are nearly invisible, and why a shadow by the ear proves nothing either way.
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- Posted on: October 21st 2026
- Category: Aesthetic Analysis, Commentary, Face
Allure, last year. Salma Hayek: no plastic surgery, no filler. Hair pulled back, ear out, see for yourself.
This week, a reel. A doctor, her photos side by side, a finger on “surgical scars.” Millions of views.
I have not examined her. Neither has he. What I can show you is my own incision map.
Where the Scar Goes
“In your case, you do have a lot of loose skin. So we would put a scar here. It would go here behind the tragus. And then it would continue behind the ear. Really, once the scar is healed, you really can’t see it.”
“The scar’s gonna be here, so they’re gonna be behind the hair, so you’re not gonna see those. But you are gonna have one scar here, and then it’s gonna go behind the ear, and hug in the hairline. So everything hides really, really well. I can’t do it without any scars in front of the ear. I’m afraid, because we do have to lift significantly, you’re gonna have these wrinkles here if I don’t take out your skin.”
Behind the tragus. Around the lobe. Into the hairline. That is the map.
“Those hide really well, and they’re very hard to see afterwards.”
The Facelift With No Scar in Front of the Ear
“So the ponytail, I make the incision here and here. And I’m still able to pull here, and I’m able to pull here, but without putting a scar in front of the ear. So that’s really nice.”
“So we do the ponytail endoscopic. There’s no scar in front of the ear. And you get the same result, but no scar.”
“The differentiator is how much excess skin there is. If there’s substantial excess skin, then we do a deep plane open facelift with an incision in front of the ear. If there’s not a lot of excess skin, we can get away with doing everything through the incisions behind the hairline. Nevertheless, a full facelift is always going to have the endoscopic portion of the forehead and brows.”
No scar in front of the ear proves nothing. The facelift you cannot see explains.
| By the ear in a photo | What it can be |
|---|---|
| A fine line in front of the ear | A well-placed facelift scar, a skin crease, the tragus shadow, or compression from a camera angle |
| Nothing in front of the ear | No surgery, a ponytail lift through the hairline, or a scar tucked behind the tragus |
| A notch or pulled earlobe | A lift closed under tension, usually an older technique |
| Hair over the ear | A hairstyle |
How I Actually Read a Face
“A facelift will change the position of the tissues, and what we’re seeing on her is a change in the volume or amount of tissue.”
Position, volume, skin. Not shadows by an ear. Same method as Kristen Wiig yesterday and Kris Jenner before that.
Why ‘No Surgery’ Can Be True
“I don’t think this is surgical. It is quite clear that she’s had surgery in the past, but not in this recent transition.”
Different actress, same lesson. A denial is not proof. A reel is not an exam.
The incision map, drawn out, is on agulloplasticsurgery.com. The no-incision version is on the Southwest Plastic Surgery post.
Why Choose Dr. Agullo
Double board-certified, by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor for 13 consecutive years. Ponytail Academy courses in Pittsburgh and Santa Monica.
Ready to Talk?
Pull your hair back. I will show you where the scar would go, and where it would not. (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
- Posted on: October 21st 2026
- Category: Body Contouring, Commentary, Patient Safety
Everybody arrives with a number. I give them mine: under 35, ideally under 30. But the number is a proxy. What limits a tummy tuck is visceral fat pressing on the diaphragm, and what decides the exception is a patient who has done everything and plateaued. A surgeon on the BMI question, with the published complication rates and the honest conversation.
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- Posted on: October 21st 2026
- Category: Body Contouring, Commentary, Patient Safety
Everybody arrives with a number. Mine is under 35, ideally under 30. The number is a proxy. Here is what it stands for.
The Line
“The plastic surgery literature has shown that complications go up the higher the BMI. The most likely complications in higher BMIs are seromas, infection, blood clots, and longer surgical times.”
“BMI above 35 is regarded as class II obesity, and at this point we see risks significantly increase.”
The studies back it. Gupta and colleagues (Aesthetic Surgery Journal, 2016), 127,961 patients: major complications 1.6 percent at normal weight, 4.2 percent at BMI 40 and above, worst in abdominoplasty and lower body lift. Brito and colleagues (Aesthetic Plastic Surgery, 2020): 74.1 percent complications in obese tummy tuck patients, mostly seroma. Their data, not mine.
Mine, to a patient in 2018:
“Your current BMI is at 37, which in my experience puts you at high risk for complications. Ideally your BMI should be under 30, which means you should weigh 190 pounds or less. I am willing to work with patients with a BMI under 35, which means you should weigh 220 pounds or less. I have not seen increased complications with BMIs under 35.”
What the Number Stands For
“For example, in higher BMIs, the abdominal plication cannot be performed as tight, because with higher BMI there is more visceral fat, and when we tighten the abdominal muscles, the visceral fat presses up against the diaphragm and the lungs. Therefore, if we plicate too tight in the presence of visceral fat, it can compromise breathing after surgery.”
That is the whole thing. The internal corset has to leave room to breathe.
“Also, the five liter limit on liposuction for safety applies to all BMIs, so in higher BMIs that five liter reduction is proportionally much less than in a normal weight patient.”
“Remember that the amount of liposuction is limited to about 5 L which translates to just under 5 pounds. The size reduction is often larger than the weight reduction.”
The Exception
“These decisions occur on a case-by-case basis, and there are exceptions. During consultation, if the patient mostly has external subcutaneous fat and excess skin, then these areas can be targeted. The exception is when most of the fat is visceral and lives inside the abdominal cavity. This fat cannot be targeted with plastic surgery and increases risks.”
“But the fact of the matter is that some patients have just plateaued and are no longer able to lose more weight. They continue to diet and exercise and use GLP-1s, or they may have already had a bariatric procedure. But the fact that they are not moving the scale is frustrating and sometimes causes psychological distress, resulting in bounce backs and weight gain, almost a vicious cycle of a yo-yo effect.”
“At this point, if the patient agrees that the benefits will outweigh the risks, and it gets them motivated to a healthier weight and lifestyle, I agree to proceed.”
One in three of my consults now arrives after a GLP-1; I wrote that up here, and the body contouring side here.
Staging
“At high BMIs, we also consider staging. The ideal is to keep a surgery under six hours, and at higher BMIs each procedure can take longer than usual. Many times we will opt to perform liposuction first and the excisional surgeries later. Sometimes we elect to remove the tissues, like in a panniculectomy, to improve quality of life, hygiene, and mobility, without emphasizing the cosmetic result.”
And at the far end of the scale, honesty:
“I recommend a BMI less than 35, although some exceptions can be made. To get to this BMI, your weight should be 190 or less. At your current weight you are at very high risk for complications. Your current BMI is 50, which makes you a candidate for a bariatric weight loss procedure.”
| What the patient asks | What I am actually deciding |
|---|---|
| Is my BMI too high? | How much visceral fat is in the way |
| Can I have it all at once? | Whether it fits under six hours |
| Should I lose more first? | Whether the scale is still moving |
| Will it be flat? | Whether the fat is under the skin or under the muscle |
The surgical read, with the full table and the literature, is on agulloplasticsurgery.com. The plateau conversation is on the Southwest Plastic Surgery post. Tomorrow: the panniculectomy.
Why Choose Dr. Agullo
Double board-certified, by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor for 13 consecutive years.
Ready to Talk?
Bring the number. I will tell you what it is standing in for. (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
