Dr. WorldWide | Frank Agullo, MD

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May is the month of Mother’s Day, hot weather creeping back, and somebody in the group chat asking, again, what I think she should get done before her sister’s wedding.

So this is my answer in writing. Three things on the May board at our Med Spa. Three I would actually book. Honest read on each.

If you have read me before, you know how I feel about wellness specials. Most of them are spa theater. Pretty room, candle, tiny outcome. The point of writing this post is the opposite. The three on this list move skin or move ink, and they move it in ways I can defend with a straight face the next morning when I scrub in.

Renew. Laser tattoo removal at 20 percent off per session.

Tattoo removal is the special on this list that earns its 20 percent discount the loudest, because tattoo removal is not one appointment. It is a course. Most patients need somewhere between six and ten sessions, spaced out about six weeks apart so the body has time to clear the broken pigment.

That spacing matters more than people realize. Stack the sessions too close and the skin punishes you. Space them right and the pigment lifts cleanly, with no scarring, on most colors and on most skin types.

Twenty percent off, applied across a full course, is real money. On a sleeve or a back piece it is the difference between thinking about it and doing it. May is also a strategically smart time to start. By the time the first holiday party season hits, a patient who started in May has three or four sessions in and is well past the point where the tattoo is the loudest thing on her arm.

What I want a tattoo removal patient to know going in.

We use medical-grade laser tattoo removal. The pigment, broken into smaller particles by the laser, is then cleared by your immune system, which is why the spacing between sessions exists. Color matters. Black is the most cooperative. Reds and warm yellows take more work. Cosmetic eyebrow tattoos and amateur work are usually the fastest cases. Old, deep, layered ink is the longest road. Whatever the case, sun avoidance between sessions is non-negotiable.

If you have been postponing it, this month is the time.

Restore. The Mother’s Day Radiance Facial, $125.

I am picky about facials. Most of them are smell-good and feel-good and do not actually change anything that I, as a surgeon, would be able to see two weeks later.

The Mother’s Day Radiance Facial my Med Spa team built for May is the exception. It is a real treatment facial, structured around exfoliation, deep cleansing, and active serums chosen by the aesthetician based on what your skin is actually doing that day. It is not a candle and a vibe. It is a $125 piece of skin care that earns its slot.

Who I would book this for.

A daughter buying for her mom. A mom buying for herself, which I am increasingly seeing and approving of, because a $125 facial bought without permission from anyone is a healthy line item in the budget.

The patient who has been working too hard, in too much sun, and whose skin looks duller than her actual age. This facial is a reset.

The pre-event patient. Wedding next month. Reunion. Big trip. A radiance facial twelve to fourteen days out is the right window. Long enough for any redness to settle, close enough that the glow is still on the skin when the photos happen.

What this facial is not. It is not a chemical peel. It is not a laser. It is not going to undo a decade of sun damage in one sitting. It is the maintenance layer of a real skin program. Used as such, it is excellent.

Revive. The Mother’s Day Refresh, $3,650. Nurses’ discretion.

This is the special I would have written off as marketing copy if I were not the one signing off on the protocol.

The Mother’s Day Refresh is a $3,650 facial balancing package. Dermal filler plus upper-face neuromodulator (the wrinkle-relaxer in the forehead, brows, and crow’s feet area), with the specific products and quantities chosen at the appointment by the injecting nurse based on the patient’s actual face, in the room, that day.

The phrase “nurses’ discretion” is the part I want to talk about, because that is what makes this package interesting.

Most filler-and-tox packages are sold by the syringe. One syringe of this, twenty units of that, on every face that walks through the door. That is convenient for billing. It is not great for outcomes. Faces are not standardized. A patient with a heavy lower lid and a flat midface needs a totally different distribution of filler than a patient with deep nasolabial folds and a strong cheekbone.

The Refresh package solves that by giving the nurse the budget to spend where the face actually needs it. If your forehead lines are loud, more goes there. If your cheekbones are flat, more filler in the malar area. If your upper lip is fine and your jaw is what is bothering you, the package goes where the work is.

This is how I want injectables done. By a nurse who has been trained to look at the whole face and to allocate product accordingly, not to count units off a price list.

Two real cautions.

One. This is a refresh, not a redesign. If your face has changed materially in the last decade, what you actually want is a surgical conversation with me, not a filler package. Filler is a tax. A facelift is an investment. I have written that line before and I will keep writing it, because it keeps being true.

Two. If you have never been injected before, the Refresh is a good first step but go in with realistic expectations. The result is a quieter, more rested version of you. Not a different face.

A clean comparison

Where to come, East or West

The Med Spa at Southwest Plastic Surgery runs out of two El Paso locations.

The Eastside office is at 1387 George Dieter Drive, Building C, El Paso, Texas 79936.

The Westside office is at 5925 Silver Springs Drive, Suite C, El Paso, Texas 79912.

You can book at either. The Med Spa team works across both sites and the protocols are the same. Pick the side of town that is easier for you that week.

A note on who is doing the work

I want every patient who walks into my Med Spa to know who is supervising the room. I do. I am Frank Agullo, MD, FACS, double board-certified, Mayo Clinic plastic surgery fellowship alum, Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, Castle Connolly Top Doctor for thirteen consecutive years. The Med Spa is not a side hustle. It is the non-surgical arm of my surgical practice, and the protocols are written and overseen by me.

That is the only way I would put my name on a $125 facial or a $3,650 refresh package. The standard is the standard.

Ready to talk?

Call our Med Spa at (915) 590-7907 to book any of the May specials at the Eastside (1387 George Dieter Building C) or Westside (5925 Silver Springs Suite C) office. For surgical or combined consults, call my main office at (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. Follow me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful

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I recently did surgery on a woman three weeks ago. When she got seated in the examination room two weeks after surgery, looked in the mirror at her hands and asked the single question that I’ve been asked 100 times over by every patient in that room: “Why do I feel so good already? ” She was doing so with a deep plane facelift. The bruising she had anticipated just didn’t manifest, the post-op fatigue warning she had been issued only seemed to last maybe four days, and, oddly enough, she slept the entire first night of surgery-a feat she was sure she’d be incapable of.

In a lot of ways, I told her the truth: It’s a combination of the right technique (a true deep plane lift lifts ligaments and layers tissue, it’s not skin tightening, which will always cause more swelling and more bruising), good anesthesia and precise closure and a post-op peptide regimen I developed over the past few years, now an option for practically all my surgery patients.

This is the post on what those peptides are, why I use them, and what I think every patient considering plastic surgery should know about them. Not the version a wellness influencer would write. The version a double board-certified plastic surgeon writes.

What a peptide actually is

A peptide is a short chain of amino acids. Examples include insulin, growth hormone, and oxytocin. These signal molecules are synthesized by your body every day to enable communication between tissues. The peptides used for surgical recovery are bioidentical copies manufactured pharmaceutically, dosed precisely.

That’s the part that matters. Peptides aren’t herbal supplements. They aren’t hormones in the testosterone or estrogen sense either. They’re signaling molecules. Inject a small dose of BPC-157 subcutaneously (250 to 600 micrograms daily, in my protocols) and your body responds the way it already knows how. It heals a wound. It lays down new collagen. It recruits cells and growth factors to a sutured edge. It restores mitochondrial energy. The dose is the signal. Your own cells do the work.

Used well, they speed up what the body was going to do anyway. Used poorly, or by patients shopping on the gray market, they are a waste of money or a real safety problem. The version I prescribe comes from a US-manufactured, cGMP-certified pharmacy, with a certificate of analysis, on a dose I selected for the patient and the procedure.

GLOW for face, KLOW for body

I prescribe two related peptide blends, depending on the operation. GLOW is a three-peptide blend: GHK-Cu, BPC-157, and TB-500. KLOW is the same three peptides plus a fourth, KPV. The reason the menu has two versions is that face and body procedures call for different emphasis on the recovery side, and the right blend tracks the operation.

GHK-Cu (glycyl-L-histidyl-L-lysine copper) is a copper tripeptide that exists naturally in human blood. As a person ages, the level of GHK-Cu in the body naturally declines. The same active compound is in many topical copper peptide anti-aging products you’ll find at Sephora, but injected GHK-Cu skips the struggle of the stratum corneum and reaches the dermis directly. This copper peptide activates more than three hundred genes associated with tissue repair. It signals fibroblasts to lay down new collagen and elastin. It also supports basal stem cells in the skin. In plain terms, it’s the piece of the blend that helps a fresh facelift incision heal flat and undisturbed, and that improves the surrounding skin six months down the road.

BPC-157 stands for Body Protection Compound. It is a fifteen amino acid peptide derived from a protein in human gastric juice. The mechanism people care about for recovery is angiogenesis, which is the formation of new blood vessels at injury sites. Healing tissue needs new microvasculature, and the body builds it slowly without help. BPC-157 accelerates that process. It also dampens local inflammation and supports tendon, ligament, and muscle repair. For a body procedure, where I am separating tissue planes and closing layers, this is the workhorse of the blend.

TB-500 is a synthetic analog of Thymosin Beta 4. It regulates a cellular protein called actin, which is the rail system cells use to crawl across tissue. The simple way to put it is that BPC-157 builds the new blood vessels, and TB-500 mobilizes the repair cells to use them. The two are synergistic. The original published research on the pair came out of sports medicine, where elite athletes were using them to push back from soft tissue injuries faster. The same biology applies to a surgical site.

KPV is a tripeptide (lysine-proline-valine) derived from alpha-MSH. Its job is anti-inflammatory. KPV inhibits NF-kB, the master switch for inflammatory gene expression in the body. For a face procedure, where the inflammatory load is comparatively small and the priority is incision quality and skin remodeling, the GHK-Cu story does most of the work, so I run GLOW. For a body procedure, where the inflammatory field is large (BBL, gluteal fat grafting, tummy tuck, mommy makeover, breast surgery), I add KPV to the same three peptides. That is KLOW. Same once-daily injection, same compounding pharmacy, broader anti-inflammatory coverage where the surgical field calls for it.

I dose both blends subcutaneously, in the abdomen or thigh, once daily for the first three to four weeks after surgery. Most patients self-administer at home. Adjustments happen at the post-op visits. The blue tint of the solution is the copper in GHK-Cu. It is normal and not a sign of contamination.

NAD+, the mitochondrial side of recovery

NAD+ is a different molecule for a different problem. It stands for Nicotinamide Adenine Dinucleotide. It is technically not a peptide, but it sits next to peptides on the same prescribing menu, and it pairs well with surgical recovery. The “nicotin” in the name is from vitamin B3 etymology. It has nothing to do with cigarettes.

NAD+ drives our power generators: the mitochondria. And it powers sirtuins, proteins that repair DNA and generally keep the cell tidy. NAD+ levels decrease with age, stress, and illness. Surgery is a stress. The body has to work hard to heal and recover. Adequate NAD+ is the cofactor that work needs.

The default protocol I prescribe is at-home, subcutaneous or intramuscular. Patients go home with a one-month supply, 500 mg total, divided into two doses per week for four weeks. Eight injections, sixty-something milligrams each, spaced through the recovery window. It is well tolerated, easy for patients to self-administer, and it keeps mitochondrial support steady through the period when the body is doing the most cellular work.

For patients who want the IV layer on top, we offer a NAD+ plus glutathione infusion. One before surgery, one after. The pre-op infusion primes mitochondrial reserves before the stress of the operation. The post-op infusion replenishes during the highest-demand recovery week. Glutathione is added as an IV push at the end of the NAD+ drip; it is an antioxidant tripeptide that supports phase 2 liver clearance and helps clear the residual metabolites of anesthesia.

A note on the IV experience. Run too fast, NAD+ causes chest tightness, nausea, and a hot burning sensation. That is rate-dependent and expected. Run slowly, over two to three hours, the patient is comfortable for the entire session. We always run it slowly. The glutathione push that follows takes another five to fifteen minutes.

Who is a candidate

Almost every elective plastic surgery patient is a candidate, with a small number of caveats. Active cancer is a contraindication for most growth-factor-adjacent peptides because we do not want to fertilize a tumor we do not know about. Active infection is a temporary contraindication. Pregnancy and breastfeeding are off the protocol. Patients on therapeutic anticoagulation get adjusted dosing.

Beyond that, the question I ask is whether the patient wants the smoothest possible recovery and is willing to do daily self-injections for a few weeks. If yes, we talk about which blend fits which procedure. A facelift patient gets the skin and incision benefit of GHK-Cu more than anything else, so I prescribe GLOW. A BBL or tummy tuck patient gets more out of the angiogenesis, cell migration, and especially the anti-inflammatory benefit of KPV across a large surgical field, so I prescribe KLOW. Breast surgery and combination cases default to KLOW because the inflammatory load is meaningful. Isolated minor procedures (lip lift, blepharoplasty alone) sometimes do not need a peptide cycle at all, and I will tell a patient that.

The cautious side

Peptides are not on FDA approval pathways the way a new pharmaceutical is. They are compounded by US 503A pharmacies under physician prescription. That is legal. That is also why they are easy to find on the gray market in versions of unknown identity, unknown dose, and unknown sterility.

Two rules I tell every patient. First, do not buy peptides off Instagram, Telegram, or any vendor that ships in unmarked vials. The pharmacy I use issues a certificate of analysis with every batch. The price is higher. The peace of mind is the entire point. Second, do not stack peptides without a physician. The blends are calibrated. Adding random fourth and fifth peptides on top of GLOW because someone on a podcast said to is how you give yourself a problem.

I love fillers for the right patient. I use them every day. But fillers are a tax. Peptides are different. They support the work the body is already doing, and when you stop, the body simply continues at its own pace. There is no rebound. There is no dependency. Used during a defined recovery window, they are a high-leverage tool. Used as forever therapy, they are something else, and we will get into that on a separate post.

Why choose Dr. Agullo for a peptide-supported recovery in El Paso?

Double board-certified, American Board of Plastic Surgery and American Board of Surgery. Fellow of the American College of Surgeons. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, where I teach the same techniques I use every day. Affiliate Professor at UTEP. Castle Connolly Top Doctor for thirteen consecutive years. The peptide protocols I prescribe are dosed by me, sourced through a US cGMP-certified compounding pharmacy, and integrated into the same surgical recovery plan I have built operating on out of town and international patients for the last fifteen years.

Ready to talk?

The right time to start the recovery conversation is during the initial consultation, not the day before surgery. We will look at your anatomy, the operation you are considering, your overall health, and we will decide together whether peptides belong in your protocol. If they do not fit, I will tell you. If they do, you will leave the consultation with a clear plan, a price, and a timeline.

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.