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Too Good to Be True: A Texas Surgeon on Mexico Prices, Canadian Patients and the Five-Minute License Check

Black and white photograph of a person seen from behind at a large airport window at dusk, a small carry-on bag at their side, the runway lights blurred beyond the glass. Illustrative image, not a patient. Commentary by Frank Agullo, MD, FACS.

My office is a few minutes from the Mexican border. You would think the question I get most is about surgery in Juarez. It is. But the answer I give surprises people, so let me start with the map.

“About 70 percent of our patients are from out of town. At least 40 to 50 percent of those come from within Texas and New Mexico. Although we get patients that come in from Mexico, it is surprising that we get a lot more patients from Canada. Other places where we have a large draw from are Seattle and the Washington area, California, Florida, and New York. We also get a fair number of patients from the Midwest. I am proud to say that we’ve had a patient from every single state in the United States, from all of North America, and as far as Japan and Dubai.”

More Canadians than Mexicans, in a city that shares a river with Mexico. People who fly the farthest tend to be the people who did the most homework.

Now the price question, because it is the real one.

“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.”

That is the part nobody quotes. The surgeon’s fee, at the top of the profession, is roughly the same on either side of the river. What moves is the anesthesia, the room, the supplies. Small moves.

“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.”

“Of course, lodging during your recovery may be less expensive in Mexico than in the United States.”

So the hotel is cheaper. Fine. The anesthesiologist should not be. I wrote the line-by-line version of what to ask before, and it applies in Texas as much as anywhere.

Which brings me to the website problem. Every practice site in Texas says board certified. Here is how you find out in five minutes whether it is true.

“Patients can look up a doctor’s Texas medical license on the Texas Medical Board website, and they can see if it’s in good standing and any history the doctor may have.”

“But I think it’s more important to make sure that your plastic surgeon is board certified. You can do this by going to the American Board of Plastic Surgery website and looking up your physician, and they will quickly confirm whether the physician is board certified in plastic surgery or not.”

“On top of that, board certified plastic surgeons can be vetted even further by checking if they are members in good standing of the American Society of Plastic Surgeons, The Aesthetic Society (formerly the American Society for Aesthetic Plastic Surgery, ASAPS), and even the International Society of Aesthetic Plastic Surgery.”

Texas Medical Board for the license. American Board of Plastic Surgery for the board. Then the three societies. A license proves the person is a doctor. The board proves what kind. If the second search comes back empty, you are done reading that website.

Run it on me, since I am the one telling you to.

“I am honored and proud to say that I am a licensed physician in Texas, New Mexico, Florida, California, Washington, Nevada, and Arizona. I am board certified by the American Board of Surgery and the American Board of Plastic Surgery, and I am a member of ASPS, ASAPS (The Aesthetic Society), and ISAPS.”

Then there is the part after surgery, which is where medical tourism usually falls apart. Someone flies home on day two and the first problem shows up on day four, a thousand miles from the surgeon.

“The instructions are the same as for patients coming in from other states in the United States or from Canada. Depending on the procedure, I will give the recommendation of what time to stay in El Paso. For large procedures, it’s usually a minimum of seven days. For smaller procedures, they can travel as soon as two to three days.”

“We have several hotels that we’ve partnered with for accommodations for our patients. And we also have the ability to have nurse visits, and even 24-hour care can be arranged. Some patients choose to stay in an Airbnb for comfort, or many patients may have family that they can stay with, and that makes it even easier.”

Seven days. Not a suggestion. I covered the rhinoplasty version of the trip here already, and the logic is the same for a tummy tuck or a facelift, only longer.

Why do they come? I asked myself the same thing and this is the honest answer.

“I think patients come here because they realize the quality of treatments and care we provide at Southwest Plastic Surgery. They see that I deliver consistent results with significant body and face transformations. They are also impressed by the high number of five-star reviews. And I think that they also hear it from friends and family, as word of mouth.”

“I think they also appreciate the fact that we’re used to taking care of patients from out of town. So we’ve streamlined the process and make it as easy and automatic as possible for the patient, through our patient coordinators.”

The full guide, with the checklist table, the five directory links, and what each procedure costs in El Paso as of this writing, is on agulloplasticsurgery.com. The fees page has the current numbers.

Check the license. Check the board. Then ask what got cut.

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.

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If a BBL Price Seems Too Good to Be True

Black and white photograph of a woman seen from behind, standing at a tall window holding a folded fee sheet at her side, in hard directional light. Illustrative image, not a patient. Commentary by Frank Agullo, MD, FACS.

I put my prices on the internet. Most surgeons will not, and I understand why: a published number invites a comparison, and the comparison is usually with someone cheaper.

Here is the BBL line, as of this writing.

“As of this writing, the Brazilian Butt Lift starts at $11,500, with an additional $2,000 per extra liposuction site. A BBL with buttock implants starts at $14,500, and the Supercharged BBL starts at $20,500. Fees are kept current at agulloplasticsurgery.com/fees.”

Those are all-in numbers. The operating room, the anesthesia, the garments, the vitamins, the scar care. You pick up your own prescriptions and that is it.

They are also starting numbers, and this is where patients get confused. The fee includes one liposuction site. Almost nobody wants one. Every site after the first is $2,000, so three sites is $15,500 before I have done anything else.

Then the something else.

“A lot of times, we will combine liposuction with skin tightening using BodyTite and/or Renuvion J-Plasma. These are charged per site and can increase the overall cost of the procedure. Also, for lengthier procedures, depending on each person, or if they have had liposuction before, it may increase the operative time, which increases the cost of the OR and anesthesia. Sometimes we will use VASER liposuction to break up scar tissue at previous liposuction sites, and this can increase time spent in the OR.”

Sites. Skin. Time. Scar. That is the whole list of what moves a BBL quote, and none of it is a surprise if you ask at the consult.

Now the question I actually get asked, which is about the other quote. The one from across the border, or from a clinic two states over, at a fraction of my fee.

“In general, medicine is less expensive outside of the United States. The cost of the OR and anesthesia is lower, and salaries for staff and supplies are lower. But in my experience, the very good surgeons from abroad, and I know many of them, charge very close to top surgeons in the United States. So when you see a really low fee, it is probably a surgeon that is not as busy as they would like, and they have to lower prices to attract patients. They may be shortcutting some parts of the procedure. They may not be using the best equipment and the latest technologies, and they may not be using the best fat preservation techniques, soaps, and preparation. Some of these facilities may not be using ultrasound for increased safety.”

Read that last sentence twice. Ultrasound is the thing that made this operation safe. It is also a machine that costs money and a skill that takes time, which is exactly the kind of thing a discount removes first.

And the bargain is not always abroad.

“I would also add that sometimes these kinds of prices are actually offered right here in the United States, often in clinics that do very high volumes. These are very common in Florida, for example. A lot of times, we are not sure who is performing the procedure, whether it is a board-certified plastic surgeon or a physician from another specialty. And often the recovery and follow-up are cut down, as these surgeons only come in to perform the procedure, and then the clinic is the one that continues the follow-up.”

The surgeon comes in, operates, leaves. The clinic does the follow-up. You find out who your surgeon was after the fact, if at all.

“In short, if a price seems too good to be true, it usually is.”

The full breakdown, with the tables and what each line covers, is on my practice site: What a BBL Actually Costs in Texas. How much of the fat survives is its own post. And an exact quote can only be provided after a consultation.

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.

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The Tummy Tuck Quote That’s Half of Ours: What You’re Actually Paying For

Greyscale editorial photograph for a tummy tuck cost essay by Frank Agullo, MD, FACS.

I received a quote from a surgeon in Mexico less than half of ours from a patient this week. She was not haggling; she simply wanted to know where the difference lay. She was right to ask, however, and deserved a real answer, not a defensive one.

The Numbers and the Content

Our price for a tummy tuck begins at $16,000 and extends to $26,000, genuinely all-inclusive: surgeon’s fee, facility fee, anesthesia, garments, and the preoperative and postoperative package, SinEcch for bruising, Skinuva scar cream, a skin moisturizer, and Exparel for extended pain relief, among other items. In addition to every session of drainage therapy and postoperative examination, we include, if necessary, even a BBL cushion. The sole exception is that you must claim your prescriptions.

When you see a quote that is half of that price, something in that list is lacking. It is time to ask what is there. How do all these quotes vary so much?

Why the Number Isn’t the Same Everywhere

Location differs, and overhead in one city versus another. One factor is how much a surgeon is in demand and indeed how complicated the specific case is; this takes into account combinations and expected time. There is a wide difference.

The Type of Tuck Changes the Math

The calculation changes with the kind of tuck. Mini tummy tuck patients do not have as much loose skin. It is a quicker operation and involves a C-section or equivalent incision length being determined, while the excision of surplus tissue within a standard abdominoplasty requires more effort and skill. The incision of an extended tummy tuck extends as far as the hips where the abdominal fold begins to extend over the buttocks. The full circumferential procedure, however, for overall looseness with a sag, is the longest and most comprehensive of the four, adding an increasingly large charge depending on the duration.

Where the Real Savings Show Up

These actual savings can be gained during an abdominal tuck with liposuction combined with a mommy makeover. In this particular case, each operation is included under a single fee in one cost-effective payment; this also allows for just one dosage of anesthesia.

The tummy tuck alone dictates the time for recovery whether combined with other procedures or not. From the time of surgery to return to activity takes up to two weeks and up to six weeks before the patient, as shown above, resumes heavy exercise, even with an additional procedure combined.

How Patients Actually Pay for This

PatientFi, AlphaEon, Cherry, CareCredit, or financing directly through the practice, as well as the major credit cards, cash, or financing through an outside bank, are all accepted, so terms of payment for the surgery ahead can work around whatever schedule you need.

The Part I Actually Want to Warn You About

However, this one piece of warning will suffice to warn you of a risk. I perform abdominoplasty revisions on numerous patients every year, after operations previously completed elsewhere, at times across borders in countries such as Mexico which charge less than what it takes. The price of rectifying a botched abdominoplasty can go beyond anything the original surgery charged, while the outcome usually cannot surpass what could have been achieved if it were done correctly the first time.

Check what has been cut in a quote that seems too good to be true: the surgeon’s training, the facility’s certifications, or the anesthesia used. A deal that demands a revision later, on top of the financial and health cost of that revision, is not a bargain at all.

Why I Price It This Way

As a Mayo Clinic fellowship-trained, double board-certified plastic surgeon and a Castle Connolly Top Doctor for thirteen consecutive years, I would rather be transparent about what’s in the number than let a patient find out what’s missing after the fact. An exact quote can only be given after a consultation, but the starting range and what’s included in it are not a secret. For the complete breakdown, see the full guide on agulloplasticsurgery.com.

Ready to Talk?

Bring your quote. I’ll tell you exactly what’s different about ours.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful

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

  • Full guide on agulloplasticsurgery.com: “What a Tummy Tuck Actually Costs in El Paso (And What Moves the Number)” (canonical)
  • Med spa side on swplasticsurgery.com: “What a Tummy Tuck Costs at Southwest Plastic Surgery” (link once live)
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The Price Nobody Posts: What You Are Really Paying For in a Mommy Makeover

Frank Agullo, MD, FACS, in consultation with a patient about the cost of a mommy makeover in El Paso, Texas.

I put my fees on my website, where anyone can read them. Competitors included.

That decision gets questioned, and the questioning usually comes with a warning attached. So let me start with the thing I am supposedly not supposed to say out loud.

As of this writing, a mommy makeover, which includes a tummy tuck, liposuction, and a breast procedure, ranges from about twenty-five thousand five hundred to forty-five thousand dollars. If we add a BBL, that becomes an extreme mommy makeover, ranging from about thirty thousand to fifty-five thousand dollars. Prices are subject to change, and you can always find my updated fees at agulloplasticsurgery.com/fees.

That took one paragraph. In this field, that paragraph is unusual, and the reasons it is unusual are worth your attention.

Why the Range Is Wide, and Why That Is Honest

A twenty-thousand-dollar spread looks evasive until you understand what sits inside it. These are not tiers of the same operation. They are different operations.

The final cost really depends on the exact combination of procedures, the number of liposuction sites, and whether we are using Renuvion J-Plasma, BodyTite, or FaceTite anywhere on the body. It also depends on the type of breast surgery, whether it is an augmentation, a breast lift, a breast lift with augmentation, or a breast reduction, and whether or not we are using mesh support with GalaFLEX or DuraSorb.

The surgery also depends on each patient’s physique, which may make the procedure longer or shorter, and that can increase or decrease the anesthesia and operating room time.

On the tummy tuck side, it depends on the type of abdominoplasty, whether it is a mini tummy tuck, a standard abdominoplasty, an extended tummy tuck, or a circumferential tummy tuck. It is important to note that I perform the triple plication internal corset on all the different types of abdominoplasty, so this benefit does not go away.

The Arithmetic of Combining

Patients often ask whether they should split the procedures up and pay over time. It sounds prudent. It costs more.

When you combine your procedures into one surgery, you share one anesthesia, one operating room, and one recovery, and I can perform it all safely in a single setting. The main savings comes from the time in the OR and anesthesia. The first hour of anesthesia in the operating room is the most expensive, because it includes all the equipment necessary and all the setup for a routine surgery.

Therefore, when you do everything in one surgery, you only have that one first hour. Whereas if you break it up into two or three surgeries, you have the cost of that first hour two or three times. On top of that, you also do not have to spend on medications two or three times, or the body moisturizer, scar creams, and lymphatic massages.

Staging is sometimes the right medical decision. It is almost never the cheaper one, and I would rather patients choose it for the actual reason instead of a financial one that does not hold up.

What Is In the Fee

The quoted number covers the surgeon’s fee, the operating room, anesthesia, garments, the preoperative and postoperative vitamins and supplements, SinEcch and Bromelain for bruising and swelling, Skinuva scar cream, Elastin moisturizer, Exparel for long-acting pain control, a BBL pillow if the case needs one, every lymphatic drainage massage, and every postoperative visit.

Really, the only thing you are responsible for is picking up your prescription medications at the pharmacy.

I list all of that because unbundling is where the number gets played with. A practice can advertise thousands below mine and take it all back in anesthesia, facility, garments, and massage, billed as they arrive. By the time the patient adds it up, she has already scheduled.

The Cheap Quote Is the Expensive One

I always feel like when things are too good to be true, they usually are.

If a price seems far below what everyone else is charging, you have to ask what is being cut, whether it is the surgeon’s experience, the accreditation of the facility, the type of anesthesia, or the follow-up care. With a mommy makeover, you are not just paying for the operation, you are paying for safety.

Unfortunately, I perform a lot of revision surgeries for procedures done by other surgeons from around the United States and Mexico. I can tell you that the cost of revising a surgery here is far greater than the fees for the initial procedure. And the final results are usually compromised, so the patient will not obtain their best possible result, the result they would have had if it were done correctly the first time.

Read that last part again, because it is the whole argument. Not that she pays twice. That the ceiling comes down permanently, and no price comparison she ran will ever show it.

What I Do About Affordability Instead

The alternative to a cheap operation is not an unaffordable one. It is a payment structure.

Making a mommy makeover affordable is something we take seriously, so we offer several financing options, including PatientFi, AlphaEon, Cherry, and CareCredit. Beyond those, we also offer direct financing through the practice itself, where a patient can make payments toward their surgery ahead of time. This lets them schedule their procedure around a timeline that works for them, paying gradually and at their own convenience. And of course, patients are always welcome to use a credit card, pay in cash, or finance through their own bank or another institution.

Insurance covers none of it, because it is cosmetic. I would rather a patient take eighteen months to pay for the right operation than six weeks to pay for the wrong one.

Back to Why I Publish

The warning is always the same: post your prices and you become the cheapest-wins option. I think it does the opposite.

Patients shop on price because nobody will give them one. Hide the number and price becomes the only thing she can actually compare, so it becomes the only thing she uses. Post it and the conversation can move to what is included, who is operating, in what facility, and what month three looks like.

Roughly sixty percent of my patients fly in. Canada, Seattle, California, New York, Florida, plus the drive markets across Texas. A woman flying home to Seattle on day five cannot absorb a surprise invoice, and she certainly cannot absorb a facility that turned out not to be set up for her case. For that practice, transparency is not generosity. It is the only version that works.

The Credentials Behind the Opinion

Double board-certified. Plastic surgery fellowship at the Mayo Clinic. Clinical Associate Professor of Plastic Surgery at the Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, where I teach the residents. Castle Connolly Top Doctor thirteen years running.

None of that makes my price the right price for every patient. It does mean that when I tell you where the corners get cut, I am not speculating. I am describing operations I have been asked to go back and fix.

#StayBeautiful

Ready to Talk?

If you want a number for your case rather than a range for everyone’s, that is what a consultation produces.

Call (915) 590-7900, text 1-866-814-0038, or book online. Current pricing lives at agulloplasticsurgery.com/fees.

Follow along: @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

Related reading: The patient-facing line-by-line breakdown is at What a Mommy Makeover Really Costs on agulloplasticsurgery.com. Procedure details are on the Agullo Plastic Surgery mommy makeover page and the Southwest Plastic Surgery mommy makeover page.

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Before You Book Surgery Abroad, Ask These Five Questions

Black and white editorial image of a passport and boarding pass beside a stethoscope, illustrating medical tourism safety commentary by Frank Agullo, MD, FACS.

Yahoo Finance called about a piece on Americans flying to South Korea for $312 health screenings that would cost four times as much at home. It was mostly about general checkups, not surgery, but my practice sits forty minutes from Ciudad Juarez, and I see the surgical version of this question constantly. Here’s the fuller answer.

The Price Comparison Is Usually Apples to Oranges

An overseas quote and a domestic quote are rarely measuring the same thing. A US quote tends to fold in the surgical facility, anesthesia, and a defined postoperative period, all bundled into one number. An overseas quote often covers just the operation itself, with everything else priced separately or not mentioned at all. Before you compare two numbers, make sure you know what’s actually inside each one.

The Real Draw Isn’t the Discount

For most patients I talk to, the deciding factor isn’t the price gap. It’s access and speed, being offered an appointment in two weeks instead of five months. That’s a legitimate reason to travel. I’d just rather patients travel with eyes open about what they’re trading for that speed.

The Risk Sits in Aftercare, Not the Operating Table

This is the part that rarely makes it into the pitch. Complications after surgery often surface after you’re already home, and at that point the surgeon who operated is on the other side of a border. The physician picking up your case locally has no operative report, doesn’t know what was actually done inside, and is starting from zero on a case that isn’t routine anymore.

That gap, between when a complication shows up and who’s actually available to manage it, is the real risk in medical tourism. It has nothing to do with the surgeon’s skill and everything to do with distance and timing.

Five Questions Before You Book

Verify the operating surgeon’s individual credentials, not just the clinic’s marketing. Get an itemized quote in writing, so you know what the price actually includes. Confirm in writing who pays if there’s a complication, and what the revision policy is. Line up a physician at home before you travel, so you’re not searching for one mid-crisis. And build in more recovery time before flying home than the clinic recommends, since travel stress on a body still healing is its own risk factor.

None of that is meant to talk anyone out of traveling for care. It’s meant to make sure the trip doesn’t trade a five-month wait for a much worse problem six weeks later.

About Dr. Frank Agullo

Frank Agullo, MD, FACS, is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery and a Fellow of the American College of Surgeons. He completed his plastic surgery fellowship at Mayo Clinic and serves as a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. He has been named a Castle Connolly Top Doctor for thirteen consecutive years, and his El Paso practice regularly treats patients navigating exactly this decision given its proximity to Mexico.

Ready to Talk?

Whether you’re considering surgery here or weighing options abroad, I’ll give you the same honest questions to ask either way.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful.

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

  • Patient-facing version on agulloplasticsurgery.com: “Considering Surgery Abroad? Read This First” (link once live)
  • Practice version on swplasticsurgery.com: “Southwest Plastic Surgery on Medical Tourism” (link once live)
  • Source: Yahoo Finance (syndicated from Moneywise.com), “‘Still worth it’: Why Americans fly to South Korea for $312 healthcare that can cost up to four times more at home,” Victoria Vesovski, August 1, 2026. https://finance.yahoo.com/healthcare/articles/still-worth-why-americans-fly-120000175.html