Dr. WorldWide | Frank Agullo, MD

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Here is something most surgeons do not put on a billboard. A good result is half operation and half aftercare.

I can do a beautiful surgery, and if the aftercare falls apart, the result drifts. The patients who do their massages, wear their garments, and call early when something feels off are the ones who heal beautifully. The ones who skip all three are the ones who write the bad reviews.

So the questions I get after surgery are remarkably consistent, and I want to answer the common ones the way I do in a follow-up visit. These are pulled from real follow-ups and consultations, anonymized.

“Is This Firmness Normal?”

Usually, yes. After surgery, firm or hard areas are fibrosis and edema, which is a normal part of healing. I have patients massage these areas a lot, and I tell them it keeps getting softer over about three months. It is a lot better at three months than at three weeks.

What is not routine is new, painful, red, or rapidly changing firmness. That is a reason to call, not to wait.

“A Stitch Is Poking Out, or My Incision Opened a Little”

That is usually a suture working its way to the surface, which is common and minor. If a small area opens where a suture extruded, we keep it covered, sometimes with a little silver dressing because it is antimicrobial, and it heals. It does not mean something went wrong. Rarely an incision needs a few extra sutures, maybe one patient in fifty.

“How Do the Massages Work?”

For body work, the lymphatic massages are not optional in my book. They are how we keep fibrosis from becoming a problem. We have an in-house tech, and I recommend two or three a week for about four weeks. In the abdomen I leave a small drain so that when you massage, any trapped fluid comes out fast, because trapped fluid is what creates lumpiness.

“Which Garment, and for How Long?”

We provide them, two Marena fajas with clips so we can size you down as the swelling drops. You wear them for four weeks, taking them off twice a day to shower and let your skin breathe. If a standard post-op bra is uncomfortable, a supportive alternative is often fine. Comfort that keeps you in compression beats a “correct” garment you refuse to wear.

“When Can I Shower?”

The next day. My nurse actually visits to help with your first shower, check that you are healing well, give IV fluids if you need them, and go over instructions and questions.

What’s Routine vs. What’s a Call

“What About Nausea and Pain?”

If you tend to get nauseous from anesthesia, there is a pill called Emend you take the night before that usually prevents it. Facial procedures barely hurt at all. Liposuction feels like going back to the gym after a long break, sore with movement but tolerable, and easier than a C-section.

“Who Is Actually Taking Care of Me?”

My anesthesia is run by CRNAs who are army and combat trained and have been with me over ten years. They have done anesthesia on me and my family. My surgical techs are certified first assist and have been with me since 2012. After surgery you get a wristband with a 24-hour line to my nurses or nurse practitioner.

“Anything That Speeds Healing?”

A few things I like. NAD infusions with glutathione before and after surgery help clear the anesthesia. Post-op peptides, GLOW for face work and GLOK for body, help with inflammation and tissue regeneration. Arnica and bromelain help with bruising. And for facial recovery, our ElixirMD LED therapy starting seven days out roughly doubles the speed of healing.

The Three Habits That Separate Good Recoveries

If I had to put it on a sticky note, it would be three things. Do your massages. Wear your garment. Call early.

The patients who do their lymphatic massages on schedule are the ones whose tissue stays soft and even. The ones who skip them are the ones I am breaking up fibrosis on months later. The garment is the same story. It is not a fashion accessory, it is the mold your new contour sets into, and the patient who refuses to wear it is fighting against the result we built together.

The third one is the quiet hero. Call early. Almost everything that worries a patient at three weeks is normal, and the few things that are not are easiest to fix when caught early. I would rather take a hundred calls about normal firmness than miss the one that mattered.

“When Can I Travel or Go Back to Work?”

That depends on the procedure and how you are actually healing, so it is a per-patient answer, not a number off a chart. I would rather clear you based on how you look in front of me than on a generic timeline.

If a trip is coming up, tell me early. We can often plan around it, including any precautions to take with you, like movement on long flights and what to watch for. The worst version of this is finding out about the trip after the surgery is booked, so bring it up at the consult.

The Credential Behind the Care

Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, Mayo Clinic plastic surgery fellowship, and Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. A good result is half operation and half aftercare, and I treat the second half with the same discipline as the first.

Ready to Talk?

Recovery questions deserve real answers from the surgeon, not the internet. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com. For the recovery 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.

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Let me say the quiet part first. “Mommy makeover” is a marketing name, not a single operation. It is a label that bundles several procedures under one friendly phrase, and the phrase sells better than the parts.

That is fine, as long as we are honest about what is happening underneath it. When someone books that consult with me, my first job is not to schedule the longest list. It is to figure out which procedures actually serve their goals and which ones they can skip.

Sometimes the most useful thing I do all day is talk someone out of part of it.

What “Mommy Makeover” Actually Bundles

It is a menu we combine, not a fixed package. It can include a breast augmentation or whatever your breasts need, the liposuction 360, the BBL (fat injections to the buttocks), and the tummy tuck. We pick from that list based on you. You do not have to do all of it, and most patients should not.

Being Scared of Part of It Is Normal

Almost everyone walks in certain about one thing and nervous about another. Sure about the tummy tuck, anxious about implants. Or the exact reverse. That is not a reason to rush, and it is not a reason to skip.

It is a reason to slow down and go through each piece on its own. We talk through the parts you are unsure about, one at a time, and you are completely allowed to leave my office undecided. The decision keeps until you are ready.

Implant, Lift, or Both?

This depends entirely on what dropped. If you mostly lost volume, an implant can be enough. If the nipple and tissue have descended, an implant alone can actually make it look worse, and a lift enters the conversation.

Often the answer sits in between. A donut lift, a small circle of skin removed around the areola, raises the nipple about an inch and re-centers it, and I can place a modest implant through that same incision to restore the upper fullness. You get a perkier, natural result without the longer scars of a full lift, and the scar hides at the edge of the areola.

Liposuction or Tummy Tuck? The Key Conversation

This is the one I never let a patient gloss over. Liposuction removes the fat we can pinch. But if your abdominal muscles separated during pregnancy, you will still see a bulge when you relax, and the only thing that fixes that is a tummy tuck.

A tummy tuck makes everything flat and tight and repairs the muscle, like a built-in corset. It is significantly more improvement than lipo alone, but it comes with a scar. I would rather you choose with that clearly in front of you than feel cheated later.

Should You Lose Weight First?

Stable matters more than low. If your weight is still swinging a lot, settling it first usually gives a better, longer-lasting contour.

But a tummy tuck removes loose skin and repairs separated muscle, and no amount of dieting fixes either of those. So the answer depends on what is actually bothering you, and we sort that out at the exam, not by a rule.

What Belongs on Your List vs. What Doesn’t

Can It All Be Done at Once?

Often yes, and it is usually the smarter choice. One anesthesia, one recovery, one block of time off work. When I plan combined surgery I am weighing your overall health and the total operative time, not just stacking a wish list. Adding something small, like the breast portion, frequently does not add much to your recovery.

There is a ceiling, though, and I respect it. Operative time has a relationship to safety, and at some point a longer list stops being convenient and starts being a risk I am not willing to take. When a wish list runs past that line, I stage it. Two calmer surgeries beat one marathon, every time, and I will tell you honestly when that is the smarter plan for your body.

The Recovery You Are Actually Signing Up For

People focus on the surgery and underestimate the recovery, so let me set expectations. The tummy tuck is the dominant part of the recovery in most mommy makeovers. It is the one that asks the most of you, with a real adjustment for the first week or two as the repaired muscle settles.

The breast portion and the liposuction ride alongside it without adding much. Lymphatic massage, the compression garment, and patience carry you the rest of the way. Most patients are back to normal daily life faster than they feared, with full exercise coming later. The point of planning it together is that you do this recovery once, not three separate times.

When Is the Right Time to Do This?

There is no universal answer, but there are good signals. You are finished having children, or confident that you are. Your weight has settled. You have help lined up at home for the first week, because you will genuinely need it. And the reasons are yours, not a date someone else circled on a calendar.

I will not rush a patient into a permanent decision to make an event. If the timing is wrong, I will say so, and we will plan for when it is right. The body you are restoring took years to change, and getting the timing right is worth more than getting it fast.

The Credential Behind the Plan

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 Paul L. Foster School of Medicine, and Castle Connolly Top Doctor for thirteen consecutive years. The best mommy makeover is not the longest list. It is the right list for your body and your goals, planned safely.

Ready to Talk?

Let us build the plan that fits you, not a template. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com. For the practice’s mommy makeover overview, 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.