October 23, 2026 | Patient Safety, Plastic Surgery Consultation, Plastic Surgery News
“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?'”
Those are my words from Texas Today’s cover story this week on what patients should consider when choosing a plastic surgeon in Texas. While it’s flattering to me to be the featured plastic surgeon in this important story, my favorite part of this story is the helpful advice it gives to patients on how to check credentials before undergoing a cosmetic procedure with a doctor they don’t know.
The Title Is Not the Training
Last month I sat down across from a patient who showed me a printout from a clinic in another city. At the top, in large letters was a doctor’s name, and right below it the title, “cosmetic surgeon.” My patient wanted to know if this doctor was like me. While I can’t speak for this doctor, I can assure you that plastic surgery and cosmetic surgery are two very different animals.
Plastic surgeons, like myself, have undergone an accredited plastic surgery residency or fellowship and passed grueling written and oral exams administered by the American Board of Plastic Surgery in order to obtain board certification. Cosmetic surgeons, on the other hand, can include any doctor (and, in Texas, can legally include any holder of a medical license) who performs any number of procedures on a patient’s appearance.
How to Check in Five Minutes
If you’re looking for a cosmetic or plastic surgeon in Texas, I suggest you perform these quick credential checks, which I dictated for my coordinators back in September:
- Check the doctor’s medical license on the Texas Medical Board website to make sure it’s in good standing and look for any history you may want to be aware of.
- Check to see if the doctor is board certified in plastic surgery on the American Board of Plastic Surgery website.
- Go the extra mile and see if the doctor is a member in good standing with 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.
The Four Questions
Before you commit to any plastic or cosmetic surgeon, make sure you ask these important questions:
- Are you board certified by the American Board of Plastic Surgery?
- Is the facility where you perform your surgeries accredited?
- How many of these procedures do you perform in a typical year?
- What conditions would make a person NOT a good candidate for this procedure?
In my Texas Today interview I urged, “If the answer to that last one is ‘nothing,’ you are talking to a salesperson.” A good plastic surgeon will discuss with you in detail why you may or may not be a good candidate for a certain procedure based on your anatomy, other medical conditions, expectations, smoking status, etc.
My Credentials at a Glance
For those who would like to know a little more about my background and credentials, I am certified by both the American Board of Plastic Surgery and the American Board of Surgery. After medical school, I completed a general surgery residency at Texas Tech University Health Sciences Center and a plastic surgery fellowship at the Mayo Clinic. Since 2011, I’ve also served as Clinical Associate Professor of Plastic Surgery at the Paul L. Foster School of Medicine, where I mentor and help educate Texas’ next generation of plastic surgeons.
I’m honored to have been named a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026, and am privileged to count myself as a licensed physician in Texas, New Mexico, Florida, California, Washington, Nevada, and Arizona, which allows me to perform consultations and follow up on my out-of-state patients. Additionally, I serve on the editorial board of the peer-reviewed scientific journal Aesthetic Plastic Surgery, published by the International Society of Aesthetic Plastic Surgery, and have authored more than 40 peer-reviewed publications and textbook chapters on topics pertaining to plastic surgery.
Why Patients Fly In to See Me
Around 70 percent of my plastic surgery patients are from out of town. When asked in our Texas Today chat to explain why, I said, “People find us because of a specific procedure or a specific technique, then they do their homework and realize the trip is worth it.”
Here are a couple examples:
Preservé breast augmentation with Motiva implants. I was one of the first roughly 30 plastic surgeons in the US to be trained on this technique. “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 (buttock augmentation with fat transfer, the BBL). There have been fatalities associated with this procedure around the country (more on that below), and I’ve published peer-reviewed research on the technique.
Fat Grafting Safety
In plastic and cosmetic surgery, as in all fields of medicine, techniques and best practices evolve with time. Take fat grafting for buttock enhancement (“BBLs,” for example). There have been reported fatalities associated with BBLs, many of which have involved direct fat injection into muscle. We changed our technique years ago.
I explain it in my post on ultrasound-guided BBL safety. As I told Texas Today, “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.”
Turning Patients Away
I want you to know that I turn patients away regularly: those whose expectations don’t align with what their anatomy can realistically achieve, those whose medical conditions aren’t sufficiently well-controlled, those whose desired end results seem heavily influenced by social media and filtered images, active smokers (in some cases), etc. In our conversation, I emphasized, “A good consultation is a candidacy assessment, not a sales pitch. If a surgeon has never told you no, be careful.”
Plastic Surgery in Texas
Curious to learn more about flying in to have plastic surgery in Texas? Check out my plastic surgery in Texas article for tips about airfare, accommodations, how long to plan to stay, etc. The surgeon-to-surgeon version of this piece is on drworldwide.com, and the practice version is on the Southwest Plastic Surgery post.
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026, and was inducted into the Texas Super Doctors Hall of Fame in 2025. Fees are published at agulloplasticsurgery.com/fees.
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To keep up with me and see more educational plastic surgery content, find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
