Behind the Curtain: Why I Started Filming Surgery in 2014, and What It Did to the Consult

Black and white photograph of a phone mounted on a small tripod in the foreground of a dim corridor outside an operating room, its screen dark, double doors softly out of focus behind it, no people in frame. Illustrative image. Commentary by Frank Agullo, MD, FACS.

“For a long time everything was behind doors, and everybody questioned what really is going on there. I think that also made the whole subject of plastic surgery give people anxiety, because they didn’t know what to expect.”

Marc McKee asked me on This Is My Journey why a Mayo-trained surgeon would show people what happens in an operating room. That’s how I started.

2014

“Around 2014 a few surgeons started doing some social media. A lot of them were criticized. My wife was really behind me, telling me, hey, you should really put yourself out there and start sharing your results, I think people would really like it. I was apprehensive, because that’s the way you were trained, to keep it kind of behind the curtain.”

The criticism was real. So was my training. My wife was right anyway.

“But I went ahead and started showing the surgeries, the before and afters, what patients were saying, how they were recovering.”

It started on Snapchat as RealDrWorldWide. Haute Living wrote about it in a spotlight this month and put the following past 3.5 million. This post is about the consult, though.

What It Did to the Consult

“What it became is a way of educating patients even before they saw me. They got to know me, they got to see my results, they got to see how everything is very consistent, how we treat patients. I think it took the fear factor away.”

Before:

“Before, I would have a consultation with a patient in front of me and they were so anxious and worried, and I was giving them all this information, and I think it just went in one side and came out the other. At the end of the consultation they were more confused than before.”

After:

“Now they come in and they know what’s going on. They’re telling me what they want. I start explaining and they’re like, yeah, yeah, I know, I know. It’s a lot more comfortable, and I think they are better for it.”

The Other Thing It Fixed

“That’s the toughest part of my job, telling patients that’s not possible. Realistic expectations. We have to set that from the beginning, otherwise nobody’s going to be happy. I’m not going to be happy, the patient’s not going to be happy, it’s going to be a sad story. Thankfully, with social media and the way we’ve been educating patients, less behind the curtain, patients are having a lot more realistic expectations.”

“Some patients bring wish photos and you have to coach them. You have to tell them, this patient you’re showing me is 20 years old, you’re 40. Or this patient’s BMI is 20 and you’re still at 30. You look much better than you did before, but we can’t compare apples to oranges.”

I didn’t see that one coming.

The Part Nobody Warns You About

Show the work and you get judged on the work, in public, every day. Haute Living called that out. I think it’s the best quality control I have.

“I would stay away from anybody that has one or two or three amazing before and afters and that’s it. You want to see a surgeon that’s posting before and afters every day, and they’re all consistent, and they’re all getting good results. They’re not going to all be home runs, because it depends how the patient comes in.”

#StayBeautiful

Marc asked about the t-shirt.

“This is one of the slogans we came up with early on. Everybody’s beautiful when they come in. We’re helping you become the best version of yourself, and we’re working as a team to get there, but it doesn’t mean that if you don’t have plastic surgery you’re not beautiful. There are certain things that make each person beautiful, and it’s not always the physical. The other slogan we say a lot is happy is beautiful. If you’re happy, you’re beautiful.”

“The reason I started doing this social media was to educate patients. Education and knowledge is power, and it gives you more options as you go through life and this journey.”

The loose skin and GLP-1 part of the episode is in the earlier post. The camera’s been on since 2014.

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.