By Adriana Sinclair
The traditional facelift came with a catch for many years. Patients wanted to look younger, and in return they got a scar around the ear and a long recovery. Until recently, board-certified plastic surgeons in places like El Paso adhered to that contract. But times are changing, and so is the agreement being established between surgeons and their female patients throughout Texas.
Dr. Frank Agullo, a double-board-certified surgeon known online as Dr. WorldWide to millions of followers across Instagram, TikTok, and Snapchat, built his reputation on facial work oriented toward a natural, rested aesthetic rather than obvious surgical marks. Now he offers a technique designed to keep the incisions concealed entirely within the hairline. For the growing number of women who want to feel confident without anyone knowing why, this changes the conversation.
A Lift With Hidden Incisions
It is the endoscopic cousin of the deep-plane facelift. The technique earned its name, the ponytail lift, because the openings sit so far back that a patient can pull her hair into a high bun. The incisions are placed within the hairline, where they are kept out of view.
Instead of lifting skin to restore youth, Dr. Agullo threads a tiny camera, an endoscope, beneath the skin. Working underneath, he lifts the deeper layers of the face, including the brow, the midface, and the jawline, rather than pulling on the surface.
Surgeons who favor the deep-plane method keep the explanation simple. Dr. Agullo believes that tightening skin and adding tension is what creates the pulled, wind-blown look most of his patients hope to avoid. He chooses instead to reposition the structures beneath the skin, an approach central to his preservation-first philosophy. That philosophy runs through his entire practice, with an emphasis on doing less damage to tissue, protecting long-term health, and working toward a natural appearance rather than a surgical one.
Because the incisions sit within the hairline rather than in front of the ear, the technique is designed to avoid the visible scar or the stretched, tugged earlobe that signaled facelifts for years. Those were among the telltale signs older approaches often left behind.
Training With The Expert
Last spring, Dr. Agullo trained under Dr. Chia Chi Kao, the surgeon who created the ponytail lift. The Pittsburgh session he attended was the intermediate course. He then applied to the advanced Ponytail Academy, an invitation-only program held in Santa Monica at Dr. Kao’s own office, and was accepted.
These are not days of seminars and talking. The surgeons study the midface in the cadaver lab, watch live demonstrations of endoscopic tissue elevation, and weigh the pros and cons of who is a candidate to avoid mistakes in the operating room.
Upon returning, he brought all of it to Southwest Plastic Surgery, his AAAASF-accredited practice in El Paso, where he performs his version of the procedure. It is a total endoscopic deep plane facelift, performed by a surgeon whose training at the Mayo Clinic in Rochester, Minnesota, laid the foundation for a career built on precision and continuous advancement.
Suitable Individuals
The surgery is not indicated for everybody. For a patient with significant loose skin and jowling, a traditional deep-plane lift may be the stronger option. Dr. Agullo offers both approaches, which lets him guide each patient toward the choice that fits their anatomy and goals.
For patients who want to lift the midface and shape the eyebrows discreetly, the endoscopic deep plane facelift is a strong option. Recovery is similar to the open approach. Because both deep-plane techniques work by repositioning deeper tissue rather than relying on surface tension, they are designed to hold their shape over time.
The Bigger Picture
This is all part of the preservation-first approach Dr. Agullo favors, one that aims to do less damage to tissue and protect long-term health. The technique is built to be discreet, without the telltale markers people often associate with surgery. He takes pride in his work. Named the Best Plastic Surgeon in El Paso for thirteen consecutive years, recognized as a Castle Connolly Top Doctor for over a decade, inducted into the Texas Super Doctors Hall of Fame, and Mayo Clinic-trained, Dr. Agullo now offers one of the more discreet lifts available.
Beyond the accolades, his credentials speak to a career of sustained work in the field. As a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center and an Affiliate Professor at the University of Texas at El Paso, Dr. Agullo also trains the next generation of surgeons. He speaks both English and Spanish fluently, serving the bilingual community of the Southwest with cultural sensitivity and clear communication when patients make deeply personal decisions about their bodies.
El Paso is leaving behind the days when women traveled elsewhere for this kind of work, and Dr. Agullo is a prime example of that shift. The trend has now reversed. More than eighty percent of his patients travel to El Paso from across the country for procedures at Southwest Plastic Surgery. For many women, that reach matters, offering a discreet approach with a surgeon who now draws patients from across the country.
Contact Information
Dr. Frank Agullo, MD, FACS. Double Board-Certified Plastic Surgeon. Southwest Plastic Surgery · El Paso, Texas. Phone: (915) 590-7900 · Text: 1-866-814-0038 Web: Southwest Plastic Surgery in El Paso Instagram: Dr. WorldWide on Instagram
Disclaimer: This article is for general informational purposes only and does not constitute medical advice. Cosmetic surgery involves risks, and candidacy, recovery, scarring, and results vary by individual. Readers should consult a qualified, board-certified plastic surgeon for a personalized evaluation and discuss the potential risks, benefits, and alternatives before undergoing any procedure.
