Category: Industry

My face is on this week’s cover of Texas Today. The headline: what to look for in a plastic surgeon in Texas. The second headline: my credentials.

I’ll pass on the credentials, because they’re also the easiest part of the article to verify, and the least interesting. Five minutes and two websites later, you’ll know:

• Whether your doctor is board certified in plastic surgery: the American Board of Plastic Surgery.
• Whether he or she is licensed to practice medicine: the Texas Medical Board.
• Any society memberships he or she claims: check with each organization.

I went over the full verification path in plastic surgery in Texas.

The Word That Means Nothing

The more interesting part of the Texas Today story is this quote:

“Anyone with a medical license can legally call themselves a cosmetic surgeon in Texas. Patients assume the title means training. It doesn’t. The question to ask is not ‘Are you a surgeon?’ It’s ‘Which board certified you, and in what?'”

All of my plastic surgeon colleagues know that, of course. But I’m willing to bet most of my patients didn’t.

A doctor can only refer to him or herself as board certified if he or she has successfully completed the relevant accredited fellowship or residency and passed the written and oral exams administered by the certifying board. For board certification in plastic surgery, that means the American Board of Plastic Surgery.

It’s a distinction with a difference, but a doctor can still legally hang the words “cosmetic surgeon” on his door. Sometimes they’re the same doctor. But you won’t know it from the sign.

Texas Today’s Four Questions

Texas Today recommends four questions to ask when you’re interviewing plastic surgeons. Three of the questions are about your surgeon, his board, his facility, his surgical volume.

The fourth is about you:

What would make me NOT a good candidate?

And this quote, right underneath:

“If the answer to that last one is ‘nothing,’ you are talking to a salesperson.”

I decline to operate on patients every week. Anatomy that won’t allow me to achieve what she’s envisioning. An uncontrolled medical condition. Unrealistic expectations informed by Instagram filters. For certain procedures, smokers who refuse to quit smoking.

“A good consultation is a candidacy assessment, not a sales pitch. If a surgeon has never told you no, be careful.”

It’s a good billboard, because there’s a corollary statement to make: If a plastic surgeon has never had an inappropriate candidate walk into his practice, one of two things is true: either he has never had an inappropriate candidate walk into his practice, or he’s operated on every inappropriate candidate that walked into his practice.

The Line I Would Put on a Billboard

That last quote from Texas Today? That’s the quote I’ll remember from this article. Not “featured on the cover of Texas Today.” Not “thirteen consecutive years on the Castle Connolly list.” Not “editorial board member.” Those are easy to check. The line about saying no is the one that tells you whether a surgeon will tell you the truth.

Most of My Patients Fly In, and Here Is Why

Speaking of quotes I appreciate from Texas Today, did you know most of my surgical patients fly in to see me?

“People find us because of a specific procedure or a specific technique, then they do their homework and realize the trip is worth it.”

By my estimate, 70 percent of my surgical patients live outside El Paso. Here are two of my procedures they make the trip for:

Preservé, nothing cut. I was one of the first roughly 30 plastic surgeons in the country trained in this prepectoral breast augmentation technique, which never cuts or releases the muscle: “I have patients who came to El Paso specifically because they researched Preservé and found out I was the only one offering it in the region. I had never seen that happen with any implant company before.”

Gluteal fat grafting, where every BBL fat embolism had one thing in common. “The technique that kills people is injecting fat into the muscle. We changed where and how we place it years ago, and we teach that. Fast and cheap is not a plan.”

Prices in El Paso (and in Mexico, Too)

It’s true that my prices are lower in El Paso than plastic surgeon prices on the coasts. Lower rent and wages have nothing to do with what happens in the operating room, but they do factor into overhead.

But the more common comparison I hear these days isn’t “Mexico versus the US.” It’s “Mexico versus El Paso.” Last month I dictated a quick response:

“I know many excellent surgeons in Mexico. And I can tell you that for most surgeries, top level surgeons in Mexico charge pretty similar to top US surgeons. The difference lies in that oftentimes anesthesia and operating room costs can be lower, as well as the cost of medications and supplies. So there may be a lower cost in Mexico, but not a very significant difference.”

“When you see very significant differences, where the cost is almost too good to be true, it is because there is a reason to it, and somehow the costs are getting cut in places that may be essential to your care.”

Your surgeon should be able to give you an answer as to why his prices are low. If you can’t get an answer, run.

What the Cover Is For

I wasn’t trying to get on the cover of a magazine when I agreed to do this Texas Today piece. I did it for a patient who sat across from me last month holding a printout from a clinic in another city, asking whether “cosmetic surgeon” meant the same thing as what I do. The patient-facing version, with the four questions laid out, is on agulloplasticsurgery.com. The practice version, with the travel logistics for fly-in patients, is on the Southwest Plastic Surgery post.

Ready to Talk?

Ask me the fourth question. I have an answer.

Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful

Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.