Most patients who book a liposuction consult at Southwest Plastic Surgery arrive already worried about the same thing: the lumpy, scooped, over-done result they have seen online. Dr. Frank Agullo tells them that fear is a healthy one, and that the answer to it is not luck. It is judgment about how much fat to leave, paired with an aftercare plan that starts the day after surgery.
This is how Dr. Agullo walks patients through liposuction 360 and fat transfer.
What a Lipo 360 Covers
Three-sixty means the contouring goes all the way around the trunk. Dr. Agullo treats the full abdomen including the waistline, a little blending into the mons, the lateral chest, the upper and lower back, and the flanks. For arms, the approach is essentially circumferential. The goal is a result that reads from every angle, which is why the practice focuses on full body contouring rather than a single panel.
Why He Leaves Healthy Fat Behind
The over-done look comes from one error: taking out too much. Dr. Agullo leaves enough healthy fat so the contour still looks natural. A bad lipo, he says, is one where you can tell at a glance that someone had liposuction, with an irregular contour and a belly button that looks off.
To smooth the surface over what remains, the practice uses J-Plasma skin tightening. How much the skin tightens depends on how each patient’s body responds, which is why Dr. Agullo is careful not to promise a fixed number.
Lipo or Tummy Tuck? The Honest Answer
| What You Notice | What Dr. Agullo Recommends |
|---|---|
| Fat you can pinch, skin that snaps back | Liposuction 360 |
| A bulge only when you relax your muscles | Tummy tuck to repair separated muscle |
| Loose skin after major weight loss | Tummy tuck or skin excision, not lipo alone |
| Flat tummy but lost curves | Lipo plus fat transfer to the hips |
Liposuction removes the fat that can be pinched. If a bulge appears when the muscles relax, that is usually muscle separation, and the only thing that repairs it is a tummy tuck, which flattens and tightens the abdomen like a built-in corset. Dr. Agullo lays out that trade-off, scar and all, before anyone decides.
Don’t Discard the Fat
Once fat is discarded, it cannot be recovered, and rebuilding volume later with a product like Sculptra gets expensive. Dr. Agullo encourages patients to consider keeping it.
It does not have to mean a dramatic Brazilian Butt Lift. Sometimes filling the hip dips is enough to carry a smooth line from waist to hip without much projection. He tailors the transfer from very subtle to dramatic, working from a photo of the shape the patient likes, and overfills slightly because about thirty percent reabsorbs. The result looks a little full at first, then settles. The same own-tissue approach guides fat injection elsewhere on the body.
Aftercare Is Half the Result
Smooth results are built after surgery as much as during it. Two things matter most at Southwest Plastic Surgery.
First, lymphatic massage. An in-house tech sees patients two or three times a week for about four weeks to break up fibrosis before it sets. Second, Dr. Agullo leaves a small abdominal drain so trapped fluid clears quickly during massage, because trapped fluid is what creates lumpiness.
Garments are provided: two Marena fajas with clips so the team can size patients down as swelling drops, worn four weeks, off twice a day to shower. Patients shower the next day, a nurse visits to help with that first shower, and most swelling clears by two weeks, with improvement continuing up to six months. The Med Spa supports recovery from there.
What Recovery Actually Feels Like
Patients are often surprised that liposuction recovery is gentler than the recovery videos suggest. Dr. Agullo, who has had liposuction himself, describes the soreness as similar to returning to the gym after a long layoff: uncomfortable with movement, but tolerable. For anyone who has had a C-section, this is the easier recovery.
A visible difference shows up almost immediately, though swelling masks the final result for a while. Most patients are back to normal activity in about a week and cleared for full exercise at four weeks, with the contour continuing to refine for up to six months as swelling fully resolves.
Pairing Fat Transfer With Skin Tightening
When the goal is a smoother, more balanced silhouette rather than dramatic projection, Dr. Agullo often pairs a modest fat transfer to the hips with J-Plasma skin tightening over the treated areas. The fat restores curve where weight loss or anatomy created hollows, while the skin tightening helps the surface lie smooth over the new contour.
How much the skin tightens depends on the individual, which is why the practice frames it as a meaningful boost rather than a guarantee. The combination is planned to the patient’s own goals, from very subtle to more pronounced, using a reference photo of the shape they want.
Am I a Candidate for Liposuction 360?
The best candidates have localized fat they can pinch, reasonably good skin tone that will retract over the new contour, and a stable weight. Dr. Agullo is clear that liposuction is a contouring procedure, not a weight-loss tool. Patients who are still actively losing weight are usually advised to settle it first for a better, longer-lasting result.
If the main concern is loose skin or separated abdominal muscle rather than pinchable fat, liposuction alone is the wrong tool, and the team will say so at the consultation. That is exactly the kind of distinction the practice sorts out before any plan is set, so patients invest in the procedure that actually matches their anatomy.
About Dr. Frank Agullo
Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and completed his plastic surgery fellowship at the Mayo Clinic. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and has been named a Castle Connolly Top Doctor for thirteen consecutive years.
Ready to Talk?
If you want contour without the over-done look, bring a photo of the shape you like to Southwest Plastic Surgery and let the team map it out. For the surgeon’s editorial take, see Dr. Agullo’s essay on drworldwide.com. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.
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