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: September 23rd 2026
- Category: Commentary
A tattoo removal laser does not erase anything. It shatters the ink into fragments and hands the cleanup to your immune system, which is why you feel it the next day and why the scar you never noticed shows up at the end. A surgeon on what the machine does, why we start low, and why four to six sessions is the honest number.
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- Posted on: September 23rd 2026
- Category: Commentary
Most people walk in assuming a tattoo removal laser works like an eraser, and I understand why, because the word “removal” is right there in the name. It is closer to a hammer than an eraser. Nothing actually leaves your skin during the session itself; what the laser does is break the ink into pieces small enough for your own body to carry off, and then your body has to go and do that part on its own time, over weeks, with no help from us.
Once you have that one fact, most of what surprises patients about the process stops being surprising: why the whole thing takes months rather than an afternoon, why you can feel a little off the day after a session, why we keep telling you to drink water, and why a scar you never knew you had can appear at the very end rather than at the beginning.
The sessions in my practice are run by our esthetician and laser technician at Southwest Plastic Surgery, on a PicoSure by Cynosure, and rather than paraphrase her I asked her to explain it the way she does when a patient sits down for the consult.
“The laser goes through the skin to shatter and break apart the ink, and then the body absorbs it and it gets removed through the waste. That’s why it’s very important for the patient to stay hydrated before and after their session. That way, the ink gets flushed out through the body a little bit faster. Sometimes patients can feel flu-like symptoms after the treatment. That is also expected with laser tattoo removal, since your body is absorbing that ink. This happens more with larger tattoo pieces than smaller ones.”
Shatter, absorb, flush. That is the entire sequence, and the only part of it we control is the first word.
The flu-like feeling she mentions is your immune system working overtime on the fragments, and in my experience it is mild, it passes on its own, and it is more likely after a large piece than after a small one. What it is not is a fever. A true fever or chills after a session is a different animal altogether, and it means you call the clinic that day, because it can signal an infection or an immune reaction that is stronger than the one we planned for.
The Count
“On average, about four to six sessions are recommended. It does depend on the tattoo itself, how old it is, and what colors were used in the tattoo.”
Anyone who quotes you one session is selling something.
I space the sessions every four to six weeks, and the spacing bends to how the patient is healing, how big the tattoo is, and what their calendar allows. The floor of that window is not negotiable.
“Some blistering is expected after a laser tattoo removal session, so your skin does need to be completely healed before we go in for the next one.”
Colors push the count up.
“Usually sunset colors, red, orange, yellow, pink, or even green, can be more stubborn. More sessions might be needed if your tattoo contains these colors.”
The Sting
“Yes, tattoo removal can be a little bit spicy, a little bit uncomfortable, but we do help the patient become more comfortable during their session. We offer topical lidocaine, which is almost always used. We also offer injected lidocaine, which is a little bit better than the topical. Patients on average are more comfortable with the injection versus just topical.”
There is a third option at our main location, Pro-Nox, which is inhaled nitrous oxide. Her description is better than mine.
“Pro-Nox is a laughing gas that makes you a little bit ditzy and makes you have a little bit more fun during your session, so you don’t think it is as bad.”
The Scar You Never Noticed
This is the part I want people to hear from a surgeon.
“Sometimes scarring is present after the ink is removed.”
“It can leave behind scarring, but since you have the tattoo present, you don’t really notice the scarring until all the ink is removed.”
Read that again. The tattoo gun that went in too deep left texture in the dermis years ago. The ink camouflaged it. Take the ink away and the texture is still there, and the patient blames the laser for a scar the artist made.
That said, I will not tell you the laser never scars. Scarring and blistering are both possible after a session. The reason they stay uncommon in my practice is how the energy is set. We start most treatments at a lower energy level and ramp up as we see how the patient’s body and skin respond to the treatment. The cautious first session is the one that protects the skin for the next five.
The Money
Per treatment, by size, as of this writing: $150 extra small, $250 small, $350 medium, $450 and up for large. Multiply by the session count and you have the honest total. Packages can bring the per-session price down, and we run occasional promotions on packages. The fees page is where the current numbers live.
Why It Is Done in My Practice
“The laser technicians are fully trained here at Southwest Plastic Surgery. Not only are we fully trained, but we also have one of the best machines on the market, the PicoSure by Cynosure. The Pico gives faster results than other machines on the market.”
I would add one thing. I am certified by the American Board of Plastic Surgery and the American Board of Surgery, I did my plastic surgery fellowship at the Mayo Clinic, I teach as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, and I have been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. The start-low, ramp-up rule is how we run that laser, and it is a surgeon’s rule. When it is your skin, that should matter.
The full patient guide, with the FAQ, the pricing table and the rest of the laser treatments, is on the practice site: laser tattoo removal at Southwest Plastic Surgery.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
- Posted on: September 22nd 2026
- Category: Commentary
The visible result of under-eye filler lasts about a year. The gel stays, spreads, and sits in the lymphatics. I have dissolved a lot of it. Here is what I put there instead.
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- Posted on: September 22nd 2026
- Category: Commentary
Ask an injector how long under-eye filler lasts and you will hear “about a year.” That is true of the result. It is not true of the product.
“Fillers over time have started to come out of favor, as we are now noticing that the filler really never dissolves. The results can last about a year, but the filler does not dissolve, it just disperses.”
It disperses into the one place on the face that cannot afford it.
“I have seen cases where it blocks the lymphatic drainage, and patients start having bags under the eyes, which are worse in the mornings, or they have discoloration or lumpiness. Sometimes they can also get inflamed. So I have dissolved a lot of under-eye fillers in order to improve all these complications, and that is why I am more inclined to use fat rather than hyaluronic acid fillers.”
Worse in the mornings. If that sentence describes you and you had filler under the eyes a few years ago, that is the first thing I will look for.
So what do I put there?
“The tear trough is a very common area that we inject. My preference is the patient’s own fat, as it gives us a lasting result. It is done in the operating room, and I use cannulas to inject right above the inferior orbital rim. It softens the tear trough and gives us long-lasting results.”
Fat is what was there before it left. I wrote about how grafting works and how much of it stays in Fat Transfer 101. For a patient who wants the exam room and not the operating room, there is a donor fat graft.
“We can also use Lipoderma, which is a donor fat graft. This comes already prepared in a vial, so it can be injected in the office in one of the exam rooms, and it gives a lot of the same benefits as using your own graft. These benefits are that the results are soft, very long-lasting, and very natural.”
Either way, no needle.
“I prefer to use a cannula in this area, as it decreases the chance of bruising from piercing a vessel, or even intravascular injection.”
Same argument I made about hands. Thin skin, vessels near the surface, a blunt tip that slides past them. And if you want to know what a sharp tip in the wrong place looks like, the 60-minute window covers it.
Now the part nobody selling filler says out loud. Some under-eyes should not be injected with anything.
“Patients with festoons, thin skin, and true fat herniation are not the greatest candidates for fillers under the eyes. Fat is one of the procedures we perform when treating the periorbital area, and just adding volume to the tear trough can hide the under-eye bags for a while. But as they keep progressing, it comes to a point where adding volume is not going to help, and we actually need to remove those herniated fat pads.”
A real bag is fat pushing forward. You can hide it next to more volume for a while. Then it wins, and the answer is a lower lid operation, not a fourth syringe.
Festoons are their own problem.
“Festoons are frustrating because they are very difficult to remove completely. They are a combination of edema or swelling in the area, skin retraction from the facial ligaments, and loose skin. We can usually improve them, and in some cases remove them, using Morpheus8 microneedling with radiofrequency, and it often takes more than one treatment to repair this area. Sometimes it just has to be done surgically with a midface lift.”
Put filler in a festoon and you have made a heavier festoon.
So the order is: diagnose, dissolve what should not be there, and then, if the problem really is a hollow, fat. The full write-up with the three options side by side is on the Southwest Plastic Surgery blog.
It does not dissolve. It disperses. Plan accordingly.
Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
