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: November 14th 2026
- Category: Celebrity, Commentary, Injectables
Carmella got a lip flip before her 39th birthday, got “a little more than they normally do,” and now cannot put her upper lip down. She told her podcast audience not to get one. I inject lips every week. Here is what her episode is actually about.
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- Posted on: November 14th 2026
- Category: Celebrity, Commentary, Injectables
Carmella opened a recent episode of her podcast with a warning about the way she talks. “I got Botox in my lip,” she says. “Why the hell did I do that?” She was a few weeks from 39, had not touched her lips in years beyond an occasional filler touch-up, and decided on a lip flip. She believes she got “a little more than they normally do.” Now she cannot put her upper lip down, she is pressing her lips together all day hoping to wear it out, and she expects four months. Her verdict: “Don’t get a lip flip, guys. Don’t do it.” Ringside News transcribed the episode on November 1.
I like her for saying it out loud. Most people who get a bad toxin result just disappear for four months. But her advice is aimed at the wrong target, and I say that as someone who gets toxin in his own face every three to four months.
Where Toxin Goes Wrong
A lip flip is a few units placed along the top edge of the ring muscle around the mouth, so the upper lip rolls out and shows more pink. That muscle moves every time you speak, sip or smile. It is one of the easiest places on the face to overshoot, and I told a reporter as much this summer.
“I see this often, and the good news is that it is temporary, but will last for 3-4 months. It most commonly happens with Masseter injections that drift or are not placed correctly, crow’s feet injections that are too low, lip flips, perioral treatments, gummy smile treatments, and DAO injections that miss. Dysport gets mentioned a little more because it has a tendency to spread a little more. The real risk factor is not the product, it’s the injector.”
“The key is the border of the lip itself. This is an area that can easily go wrong, and more often than not, less is better and you really need precision. Over-relaxing the muscle or putting too much filler into the lines can age someone more than the lines themselves.”
“We see a good number of patients where the botulinum toxin is incorrectly applied resulting in eyelid droopiness, brow droopiness, and uneven smiles.”
A lip that cannot close is the mouth’s version of a drooped brow. The product did what toxin does. It did too much of it, in a spot where a unit or two is the difference between a flip and a freeze.
Why There Is No Undo
She is right about this part, and it is the part patients forget. Filler has an eraser; hyaluronidase dissolves hyaluronic acid in an afternoon. Toxin has none. The muscle comes back on its own clock, and pressing your lips together does not move the clock.
“If you stop getting Botox, your facial muscles should regain their full strength in a few months.”
“Most people who stay away from toxin are not afraid of the needle. They are afraid of looking frozen or wrong for four months. A product that wears off in a few weeks takes that fear off the table, so it works as a trial run.”
That is exactly why a first lip flip should be underdosed on purpose, with a two-week check and a top-up if the patient wants more. You can always add. You cannot subtract.
The Dose That Lets a Face Move
People read a story like Carmella’s and conclude that toxin freezes faces. It does not. Dose does.
“I myself get botulinum toxin in the forehead, crow’s feet, and glabella lines every three to four months, just to maintain the wrinkle free appearance with a dose that still lets me express my face without looking abnormal.”
“If the lines are primarily from muscle activity, tiny doses of Botox can relax the pursing action without restricting your lip movement, though it is easy to overdo in such a sensitive area.”
“Use low doses and find an injector that will examine your face and discuss your individual anatomy and goals before recommending treatment. I would encourage avoiding Botox specials/deals offered without medical supervision.”
| Lip flip | Lip filler | Lip lift | |
|---|---|---|---|
| Changes | Muscle | Volume | Length of the upper lip |
| Lasts | Six to eight weeks | Six to twelve months | Permanent |
| Undo | None, wait it out | Hyaluronidase | None |
| Carmella’s complaint fits | Overdosed flip | No | No |
What I Would Tell Her
Wait it out; it is already fading. Next time, if there is a next time, ask for half, come back in two weeks, and decide then. And if what you actually want is a fuller upper lip at 39, the flip was never the right tool. That is a volume question, and the answer is a small amount of filler or your own fat, which I lay out on my surgical site. How my MedSpa doses a first lip flip, and what the first two weeks should look like, is on Southwest Plastic Surgery. I made the same point about dose on BOTOX Cosmetic Day, and about filler and the camera in the Megan Fox read.
Why Choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor every year from 2014 through 2026. I inject toxin myself, every injector at my MedSpa works under my direction, and the vial comes straight from the manufacturer.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book at swplasticsurgery.com/med-spa. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
- Posted on: November 14th 2026
- Category: Commentary, Weight Loss
Eleven percent of American adults are on a GLP-1, Newsweek noted in August, and the flat look people call Ozempic butt is mostly not muscle. I sent the reporter my answer. Here is the part a surgeon adds: what is fat, what is skin, and which one I can fix.
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- Posted on: November 14th 2026
- Category: Commentary, Weight Loss
Newsweek ran it on August 9 under the headline “‘Ozempic Butt’ Isn’t Always Muscle Loss.” The setup was a Gallup survey: 11 percent of American adults are on a GLP-1 for weight loss, nearly four times the 2024 share. The point, from the two clinicians quoted, was that the deflated look everyone is posting about is mostly fat and volume leaving, not muscle, and that protein and lifting protect the muscle that is at risk.
I was one of the sources the reporter asked. I sent my answer the same week. It did not run, which is fine; they had two good voices and a word count. But I am the one who sees the buttock on the exam table after the drug has done its work, so here is what I told her, in the words I sent.
The first thing is that I do not read this the way a prescriber does.
“After people lose 20 to 60 pounds on these drugs, I examine what is left: how much fat was lost, how much muscle is left and how the skin is behaving. I do not look at this story as the endocrinologist and nutritionist do.”
The muscle number is real. It is also smaller than the headline.
“The DEXA substudies from the semaglutide and tirzepatide trials suggest the amount of weight lost that is lean mass could be 25-40%. Therefore, if one lost 50 pounds, then up to 20 pounds may be lean mass. However, lean mass is not the same thing as functional muscle. But that figure includes water, glycogen, and the organ weight, so the true skeletal muscle loss is smaller than the headline number.”
Then the question in the headline, answered the way I answered it.
“Not really. I am a plastic surgeon and most of what they call “Ozempic butt” or “Ozempic face” in my clinic is due to rapid fat loss. They are losing their fat and the skin envelope has not shrunk enough yet to fit. The buttock falls flat because there is not enough fat left to fill the skin that stays in place. There is some real muscle loss underneath, but the look that alarms people is mostly fat and skin.”
“Most of what people call Ozempic butt is deflation, not muscle wasting. The fat is gone and the skin envelope stays behind. Protein and lifting will protect the muscle, but they will not shrink loose skin.”
That last sentence is the whole reason a plastic surgeon belongs in this story. The article’s advice, protein and resistance training, is right, and I give it to every GLP-1 patient I see.
“Protein and weight resistance are really the two drivers that work. For my GLP-1 patients, I suggest 1.2-1.6 g of protein per kg of body mass daily plus lifting weights two to three times a week. Since the drug is so good at appetite reduction, my patients accidentally do not eat enough protein, so it must be intentional.”
But it fixes one of three problems. It does nothing for the other two.
“Most people do not realize that the scale measures mass (or weight), not the specific types of mass that a person loses. Two patients can each lose 40 pounds, but look differently based on whether their weight loss was composed of fat or muscle.”
So here is the sort I do in the room. A flat buttock with donor fat still on the flanks is a fat transfer, placed under ultrasound in the fat layer only, never the muscle. A flat buttock with a fold you can lift with your hand is a buttock lift, and no amount of grafting will fix a hanging envelope. A weak, soft buttock with the skin still tight is muscle, and that one belongs to the gym, not to me. Which is which, with the table, is in the full post on Agullo Plastic Surgery.
And whichever one you are, the weight has to stop moving before I plan anything. That rule, and who is actually a candidate for body contouring after a GLP-1, is the same one I gave Newsweek for its August body contouring story. Why I keep a probe on the skin for every fat injection is here, what the weight you keep means for the fat that survives is here, and the med spa half, what the devices can and cannot do for the skin, is on Southwest Plastic Surgery.
Ready to Talk?
I am Frank Agullo, MD, FACS, double board-certified, Mayo Clinic fellowship trained, Clinical Associate Professor of Plastic Surgery at Texas Tech, Castle Connolly Top Doctor 2014 through 2026. Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
