November 04, 2026 | Patient Resources, Patient Safety, Plastic Surgery News
| Our certificate | |
|---|---|
| Issuer | QUAD A (accrediting outpatient surgery centers since 1980; formerly AAAASF) |
| Level | Class C ambulatory surgery facility: in the certificate’s words, one “in which major surgical procedures are performed under intravenous Propofol or general anesthesia with external support of vital organs” |
| Facility | Southwest Plastic Surgery, PA, El Paso, Texas (facility ID 8303) |
| Accredited since | October 10, 2022 |
| Annual expiration | October 27, 2027 |
| Standard | 100 percent compliance with every standard; QUAD A grants no partial accreditation |
| Verification | Public credential, blockchain-secured; signed by the QUAD A president and chief executive |
I bring this up in almost every consult, and almost nobody asks about it first. Here is why I do.
What QUAD A is
| What the certificate covers | |
|---|---|
| Emergency preparedness, with routine drills | Anesthesia monitoring |
| Sterile instrument processing | Equipment testing and maintenance |
| Infection control and hand hygiene | Specialty-specific training for every staff member |
| Patient selection and assessment | Every practitioner checked against their own board’s requirements |
| Quality improvement, continual self-assessment | A comprehensive discharge plan |
Why it decides how much I can do in one operation
“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.”
“All types of anesthesia are safe,” I tell the patients who want local only. Where it is given is the part that varies, and it varies a lot.
What it is doing in your fee
“The fee covers the surgeon’s fee, the anesthesia, the accredited surgical facility, your medical tests, your garments, and your recovery products. Prescription medications from the pharmacy are the one thing you pay separately.”
“I allow sufficient operating room time to work in a paced fashion, for safety. Low-cost surgeries get compressed to cut anesthesia and operating room fees.”
“Our patients get direct nurse access 24 hours a day, and all surgeries are done in an accredited surgical center.”
| Accredited Class C surgery center | Unaccredited office procedure room | |
|---|---|---|
| General anesthesia | Yes, with monitoring standards | Usually local only |
| Who checks the staff | QUAD A, 100 percent of standards, every cycle | Nobody outside the practice |
| Emergency drills | Required, routine | Optional |
| Large-volume liposuction | Up to five liters in one session | One or two areas, awake |
| Overnight observation | Available for large procedures | No |
The too-good-to-be-true test
What I tell the El Paso patient pricing the same surgery in Juarez:
“They should make certain that they are having their procedure in a certified surgery center or hospital. They should also understand that they will have to be crossing the border for continued care and possible complications. There are plenty of great doctors and plastic surgeons in Mexico. Most of the well-experienced and highly regarded plastic surgeons will probably have similar surgeon’s fees. Where the patient will save is in the facility and anesthesia fees, the aftercare supplies, and nursing care. I always say that if the deal seems too good to be true, it probably is. I also remind them that revision work is far more expensive than having the surgery done correctly the first time.”
Where the saving is, is where the certificate is. Ask for it.
After the operation
“For large procedures, we offer an overnight stay in our surgical center, and my nurse does a post-operative in-person visit at the hotel or at their home 24 hours later.”
More: how to choose a Texas plastic surgeon, aftercare when your surgery was somewhere else. The patient-side version is on swplasticsurgery.com; my read on why accreditation is the question nobody asks is on drworldwide.com.
Why Choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and teach as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor for thirteen consecutive years, 2014 through 2026. Every operation I do is in our QUAD A Class C accredited surgery center.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
