October 20, 2026 | Body Contouring, Liposuction, Plastic Surgery Consultation
If you live in Texas, you have seen the ads. Sono Bello has offices in Austin, Dallas, Houston, San Antonio, Lubbock, McAllen and Del Rio, and one across the line in Albuquerque. None in El Paso.
So the quotes come to me. A patient sits down, unfolds a printout, and asks the same thing almost word for word: how does Sono Bello work, and how is that different from what you do?
Fair question. I will answer it twice. First from their own website, then from my operating room.
How Sono Bello Works, In Its Own Words
Everything in this section comes from Sono Bello’s public website, read on September 26, 2026. I am not adding to it.
Their procedure is called TriSculpt, described as micro-laser liposuction. It is performed “100% awake” under a local anesthetic. They say it removes “50-70% of fat from your stomach in just one session.” Patients “return home the same day” and “return to daily activities within days.” They describe “150+ expert surgeons.” Pricing, per the page, depends on your BMI, how many areas you treat, and seasonal promotions.
That is the model. One visit, awake, local anesthesia, home the same day.
What I Tell Patients
These are my answers, in my words, to the four questions I hear most. Where I talk about Sono Bello, I am describing their model as they and independent reporting describe it. The rest is how I practice.
What is different about how you do liposuction compared with a high-volume lipo chain like Sono Bello: who operates, what anesthesia, how much comes out in one session?
Dr. Agullo: “You have to understand that I’m a board-certified plastic surgeon, and I do all different kinds of liposuction in multiple body areas. That can be done at one time, or all at the same time. This is really body contouring, and it’s the way that I can shape bodies into what the patient is looking for.
“To understand Sono Bello, you need to understand that it is a network. The company has a network of physicians who are not necessarily board-certified plastic surgeons. They could be board-certified in OB-GYN, general surgery, emergency medicine, family medicine, and other specialties. Another thing to understand is that through Sono Bello, your first point of contact and consultation may be with a layperson, or at least a non-physician, who really is trying to sell the procedure, and then channels you to a provider. At my practice, you consult directly with me, the surgeon who will perform your procedure.
“Sono Bello physicians will perform the liposuction only under local anesthesia, and they’re usually limited to one or maybe two areas of liposuction per procedure. During these surgeries, the patient is awake and may experience discomfort.
“I myself offer liposuction under local anesthesia, but I often discourage it because of the discomfort level for the patient as well as the discomfort level for the surgeon, which can compromise the final results. I perform most of my liposuction procedures under general anesthesia or IV sedation. I find that when the patient is comfortable during a liposuction procedure, I can be more aggressive in the areas that need it and remove as much fat as I need to, without any struggles for myself or the patient. I can also combine these procedures with skin tightening, such as Renuvion J-Plasma, BodyTite, or Quantum RF. Since I perform my procedures in a certified surgery center, certified by QuadA, I can safely remove up to five liters in one session.”
That last number matters. Up to five liters is a general-anesthesia volume. It belongs in an accredited facility, which is where I do it.
Who is a good candidate for awake, local-anesthesia liposuction, and who is not?
Dr. Agullo: “I really shy away from local-anesthesia-only liposuction. I find that even though the pain can be moderated with the local anesthesia, the patient is more stressed and anxious during the procedure, and continues to feel movement, and pulling and tugging. Nevertheless, in small areas like the neck, arms, and flanks, liposuction can be performed with local anesthesia. I usually recommend my patients undergo IV sedation in these cases, so that they’re more relaxed and comfortable during the procedure. If we really want to tackle multiple body parts and really contour the body, then general anesthesia is a must, and it should be done in an accredited surgery center, like the one at Southwest Plastic Surgery.”
Small area, local is possible. Full contouring, you sleep.
Do you see patients after a chain procedure? What do you usually find, and what can and cannot be fixed?
Dr. Agullo: “I do see patients after they’ve had liposuction elsewhere, either through chains or other physicians. A lot of times the results are just fine and appropriate. Unfortunately, most of the patients that come to me are seeking revision work. This is often due to excessive liposuction in certain areas, like in the abdomen, which results in fibrosis and skin and fat irregularities. I see some patients with excessive liposuction with skin discoloration. And a lot of times I see that patients experience complications and contour irregularities because they are not offered the post-operative treatment, which includes compression garments and lymphatic massages to work out the fibrosis and the excess fluid. I also incorporate moisturizers and scar creams into my post-operative regimen to achieve the best results, as well as inserting garments and post-liposuction foam pads.
“Unfortunately, some of these complications or contour irregularities can never be completely fixed. We can perform many procedures to make them better, but seldom can we obtain the result that could have been obtained if done correctly the first time. That is why I recommend that whether you go to a chain, a multiple-practice environment, or a single-practice environment, you seek a board-certified plastic surgeon with experience. The reason I say this is because a board-certified plastic surgeon can perform the liposuction effectively, knowing the risks and limitations, and can offer appropriate post-operative treatment regimens. Most importantly, if things don’t go well, a board-certified plastic surgeon can offer other procedures that may be a better fit, and that can help reconstruct or repair any complications that you may have.”
Notice what I did not say. I did not say chains get bad results. Plenty of the work I see from other places is fine. The patients who end up in my chair are the ones it did not go well for, and the fix is always harder than doing it right once.
What should anyone ask before booking liposuction, wherever they book it?
Dr. Agullo: “There are several questions a person must ask before booking a liposuction procedure. The first is whether the physician is a board-certified plastic surgeon. Second, that the procedure is going to be performed at a certified facility. Third, the patient should ask to see multiple before-and-afters, if they’re not already published on the website or social media. Patients should also look at Google reviews and RealSelf reviews. An added credential that can help patients select specialists in aesthetic surgery is searching to see if the board-certified plastic surgeon is a member of the Aesthetic Society. With those questions in line, a patient should always be comfortable with the physician after a consultation, and build good rapport, knowing that this relationship will be long-lasting.”
Side by Side
| Sono Bello (per their site, and the model as Dr. Agullo describes it) | My practice | |
|---|---|---|
| First consult | May be with a non-physician, then channeled to a provider | With me, the surgeon who operates |
| Who operates | A network of physicians (“150+ expert surgeons”), not necessarily board-certified plastic surgeons | Dr. Agullo, board-certified plastic surgeon |
| Anesthesia | Local, “100% awake” | General anesthesia or IV sedation for most cases; local offered but often discouraged |
| Areas per session | Usually one or two | Multiple areas, one session, when the plan calls for it |
| Volume | “50-70%” of the stomach fat, per their page | Up to five liters in one session, QuadA-certified surgery center |
| Skin tightening | Mentioned on their page as an added cost | Can be combined: Renuvion J-Plasma, BodyTite or Quantum RF |
| Pricing basis | BMI, number of areas, seasonal promotions | Starting prices on the fees page; exact quote after consultation |
| Nearest office to El Paso | Lubbock, Del Rio, McAllen or Albuquerque | El Paso |
The Skin Is the Part Nobody Advertises
Liposuction removes fat. It does not tighten skin. Take the fat out from under loose skin and the skin has to go somewhere.
That is why I combine so many of my cases with Renuvion J-Plasma, a helium plasma and radiofrequency device applied under the skin through the same small openings. I started using it in 2019:
“I saw a missing need after liposuction, which was skin tightening. We were able to perform liposuction effectively, but after deflating the subcutaneous tissue layer, many patients were left with loose skin, which required surgical excision. When we began using Renuvion, we noticed that the tissues would contract, and oftentimes the surgical excision of excess skin was not necessary anymore.”
Apyx Medical, the manufacturer, counts my practice among the ten highest-volume Renuvion J-Plasma users in the world. And it does not slow anyone down: “The recovery itself and the protocol are the same with or without Renuvion J-Plasma when you have liposuction. We still use the garments, and we still use lymphatic massages.”
Why Choose Dr. Agullo
Double board-certified, by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Member of the Aesthetic Society. Castle Connolly Top Doctor for 13 consecutive years. Liposuction, body contouring and Renuvion J-Plasma almost every day since 2019, in an accredited surgery center.
Ready to Talk?
If you have a Sono Bello quote in your hand and want a second opinion, bring it. I will tell you honestly whether local, sedation or general anesthesia fits your plan, and what I would take out.
Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
