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: August 9th 2026
- Category: Body, Editorial
BBL patients from a decade ago are coming back for reversals. A surgeon on why, what the surgery combines, and why the BBL era still is not over.
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- Posted on: August 9th 2026
- Category: Body, Editorial
A patient called me from the East Coast for a virtual consultation. Years ago I had done her BBL myself, a supercharged one, implants plus fat. Since then she had babies, started her family, and moved somewhere more conservative. She wanted her body back, or at least a quieter version of it. More discreet. More athletic.
She is not an outlier. She is a wave.
I wrote earlier this year about how beauty standards keep moving, and the buttock is where that pendulum is swinging hardest right now. So let me explain what a BBL reversal actually is, because it is more interesting, and more surgical, than the headlines suggest.
Why They Come Back
The most important reason is time. A BBL is a procedure where liposuction is done in the trunk, including the upper back, lower back, lateral chest, abdomen, and sometimes the thighs and arms, and that fat is transferred to the buttock. Once liposuction is done in those areas, they do not increase in volume as much when the patient gains weight. The buttock becomes the one area that increases the most.
So a patient gains weight years later, and the proportions run away from her. The buttock is no longer proportionate, or has developed cellulite or even droopiness. Some patients develop a double butt crease deformity, which patients themselves call elephant butt or frog butt. Their words, not mine, and they are not wrong about the shape.
Another portion of patients have not gained anything. They just want a more natural, less aggressive body contour. And a certain percentage were never happy in the first place: exaggerated hips, too much projection, a lower back scooped too aggressively, a buttock that doesn’t transition well into the thighs.
The Reversal Toolkit
Reversal surgery can involve a combination of a lot of procedures, and the plan is assembled per patient.
| Tool | What it does |
|---|---|
| Liposuction | Reduces buttock volume and recontours |
| Renuvion J-Plasma | Radiofrequency with helium plasma for skin contraction |
| Morpheus8, stacked on top | Microneedling with radiofrequency, more contraction |
| Buttock lift, lateral thigh lift | Removes loose skin and lifts when volume loss is significant |
| Miami thong lift | Corrects the double butt crease deformity |
| Implant removal | For the supercharged BBLs of the 2010s |
The honest caveat: when we perform liposuction, the skin often becomes looser, and the buttock can droop more. Renuvion and Morpheus8 help create skin contraction, but the amount of contraction is hard to predict, as each patient reacts differently to these technologies. If we’re removing a significant amount of fat, then oftentimes a buttock lift, and even a lateral thigh lift, is necessary. Skin quality work continues afterward with microneedling when needed.
I prefer to do the surgery all at once, which gives the best results. The exception is the patient trying to avoid scars, who declines the lifts in hopes that the energy devices create enough contracture. Those patients know that at three or six months, if they develop buttock ptosis or loose skin, the lift conversation returns.
Can You Get Your Old Body Back?
We can get patients to their pre-BBL body, although most patients don’t really want to go that far back. They’re looking for a result in between: tighter contours, tighter skin, sometimes a more athletic look. That target gets set at consultation, along with an honest answer about whether it is achievable given which procedures they are willing to undergo.
How the East Coast Case Went
Her plan: buttock implant removal, liposuction of the lateral thighs, saddlebags, and buttock, a buttock lift with a lateral thigh lift, and a Miami thong lift to correct the double crease and create a sweeping curve where the lower buttock meets the thigh.
Four and a half hours under general anesthesia. Hotel the same day. My nurse saw her the next morning with IV fluids, helped with her first shower, got her into her garments. Lymphatic massages every other day. Drains out on day seven, and she flew home. No complications, and at four months she is mostly healed and very pleased with the new contour. Most of my reversal patients fly in exactly like this; the majority had their original surgery out of town or in another country, usually more than five years ago. This kind of travel case is routine in my body contouring practice.
Recovery in general runs about a week to get back to normal activity and driving, and about four weeks to return to the gym, running, and jumping. The risks specific to reversal are asymmetries, development of cellulite, and buttock ptosis if a lift is not performed at the same time.
No, the BBL Era Is Not Over
The BBL era is far from over. Patients’ desires have shifted, but it really depends on their culture and each person’s definition of beauty. I still perform minimal BBLs, or skinny BBLs. I also still perform some exaggerated ones.
The tendency is toward a reduced size: maybe only the hip dips and a little projection, more of an upside-down heart shape than a shelf, some reduction in hip width. And still, plenty of patients want a very small waist with larger hips.
My tool for keeping everyone honest: photographs. The buttock is a hard anatomical place to describe with words, so I have patients bring pictures of what they want to the consultation, and again on the day of surgery, so that we’re both on the same page.
I served as founding vice president of the World Association of Gluteal Surgeons. I have watched this pendulum from the front row, in both directions. The surgeons who did the shelf era well are the ones patients now trust to quiet it down.
Ready to Talk?
If your BBL no longer fits your life, there is a surgical path back, and it can usually be planned from a virtual consultation. Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Companion reads: the clinical reversal guide on agulloplasticsurgery.com, and the destination-patient overview at swplasticsurgery.com.
- Posted on: August 9th 2026
- Category: Breast Surgery, Commentary
Yes, your own fat can augment your breast. It works, it looks natural, and it has a ceiling. Here is where that ceiling sits.
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- Posted on: August 9th 2026
- Category: Breast Surgery, Commentary
A lot of women who come to see me about their breasts open with the same disclaimer: no implants.
They do not want the look. They are worried about sensation because a friend told them a story. And so they ask the obvious question, the one the internet has primed them to ask: can we just use my own fat?
Yes. We can. It works, it looks natural, and you get a little liposuction out of the deal. But it has a ceiling, and I would rather tell you exactly where that ceiling sits now than have you discover it at six months.
The Honest Number Is One Cup Size
With fat, we usually cannot get more than a cup size. Anybody promising you two is either overfilling dangerously or overselling.
What you get along with that cup is shape. Most women asking about fat are empty in the upper pole, and filling that hollow changes the breast in a way an implant finds hard to fake: a taper instead of a dip, natural fullness with a little more projection. It is a natural look, not an implant look. For the right woman, that is precisely the point.
You Will Lose Some Fat, by Design
Not all transferred fat survives, and that is not a complication. That is the procedure. Most of my patients keep at least fifty percent, with retention running fifty to seventy.
I plan for it two ways. I overfill, placing roughly two cup sizes knowing about one will stay. And I process and wash the fat before injecting it, so I am not putting in fluid and debris that were never going to survive. That processing step measurably improves retention.
The Two-for-One
The fat comes from wherever you have extra, most commonly the abdomen and lower back together, sometimes the sides, upper back, or inner thighs. On the abdomen I use Renuvion J-Plasma during the liposuction to tighten the skin so it does not sag after the volume leaves.
That is the trade patients love about this operation: volume taken from where you do not want it, placed where you do, and a slimmer, tighter torso as the receipt.
The Mammogram Question, Answered Straight
No. Mammograms and screening stay the same after fat transfer. This is the question I am asked most, and it deserves a flat answer.
The nuance: some absorbed fat can form a small nodule or an oil cyst. Both are very easy for a radiologist to identify, neither mimics anything worrisome, and the chance of forming them at all is under five percent.
On sensation, the fear that drives many women toward fat in the first place: loss is possible but not what I see. Most patients are actually hypersensitive for a while from the inflammation, and that fades.
Small Incisions, Strict Rules
The liposuction enters through small stab incisions at the waistline and along the same line on the back. The breast gets two incisions in the fold underneath, small enough that you should not feel them at all. No long scar anywhere.
The operation runs about two and a half hours under general anesthesia, outpatient. The soreness is gym-after-a-layoff, not real pain, and most people are back to light activity and driving in five to seven days.
Then the rules that protect your result. No exercise for four weeks, because transferred fat needs stress-free time to re-establish blood supply. A special bra for four weeks, no underwire, no push-up. The principle underneath: squeeze the fat and you lose the fat.
And because it is live fat, it behaves like fat forever. Gain weight and the breast grows. Lose weight and it shrinks. Maintain, and you keep your result.
Where I Get Less Romantic About Fat
Asymmetry is where fat stops being my first recommendation. Fat is wonderful, but it is a little unpredictable: I never know precisely how much will stay, which is why I overfill, and a touch-up is sometimes needed.
Implants are predictable. They do not change size, and for a true asymmetry I can measure the difference in cc’s on 3D imaging and place a different size on each side, correcting it exactly.
| Fat Transfer | Implant (Preserve technique) | |
|---|---|---|
| Size gain | About one cup | Chosen precisely |
| Predictability | Fifty to seventy percent retention | Exact |
| Asymmetry correction | Approximate | Measured in cc’s per side |
| Bonus | Liposuction of the torso | Thirty-minute operation, next-day return to work |
| Feel and look | Completely natural | Natural with the nano-surface Ergonomix |
For the woman who wants small and natural but rules out implants on instinct, the Preserve technique deserves a hearing before the decision. Nothing is cut: a balloon creates the pocket above the muscle and behind the gland, your own ligaments hold the implant, and a smaller implant reads larger with a little lift. Three-centimeter incision, thirty minutes, IV sedation, back at work the next day. And screening survives implants too: when a mammogram cannot see an area, ultrasound answers, and MRI sees everything. The implants I use have a rupture rate under half a percent, and we replace them only if imaging shows a reason.
Why I Offer Both and Push Neither
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and a Mayo Clinic plastic surgery fellowship alum. My whole approach is preservation-based: add what is missing and damage as little as possible getting there.
Fat transfer and Preserve are two routes to that same destination. Fat is your own tissue and slims your torso. An implant is predictable and corrects asymmetry exactly. Which trade-off you can live with is a conversation, not a sales pitch, and I will not have it any other way.
For the patient-facing version, see the companion post on agulloplasticsurgery.com. The practice team covers it at swplasticsurgery.com.
Ready to Talk?
If you want more fullness but the word implant makes you flinch, fat transfer may be exactly right for you, and it may not be. Come in, let me examine you, and I will tell you what your own fat can realistically deliver. 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.
