Southwest Plastic Surgery

May is on the board at our Med Spa, and my team built three specials around the same idea. Renew. Restore. Revive. One per word. All three running at our Eastside office on George Dieter and our Westside office on Silver Springs, all month.

I want to spend a few minutes telling you who each one is for, because they are not interchangeable, and the most useful thing I can do for somebody scrolling our practice site this week is help her figure out which of the three is actually meant for her.

Renew. Laser tattoo removal at 20 percent off per session.

Of the three on the May board, this one is the longest commitment, and I want patients to hear that part of it before they hear the discount.

Tattoo removal is never one appointment. It is a course. Six to ten sessions on most tattoos, six to eight weeks between each one. Most patients hate hearing that, and I do not blame them. The reason for the spacing is not a sales tactic. It is the physiology. The laser fragments the ink. Your own immune system carries the broken pigment away. Stack the sessions too tight and the skin pays for it. Space them right and the tattoo lifts cleanly.

The 20 percent applies per session. So a patient who locks in the full course in May rides the discount for the whole run. On a sleeve that adds up to hundreds of dollars. On a back piece, more. If you have been postponing tattoo removal because of the price, this is the month.

A few honest notes on candidacy. Black ink and dark blue ink are easy. Reds and warm yellows take more sessions. Cosmetic eyebrow tattoos and amateur ink are usually quick. Old, multi-layered professional work is the long road. We will tell every patient at the consult what a realistic course looks like for the specific tattoo on the specific skin in front of us. If a clinic anywhere is promising you three-and-done on a real tattoo, walk out.

Two things I am rigid on. One. Sun avoidance between sessions. Sunscreen every day on the treated area for the entire course. The patient who hits the laser, then goes to the pool, then comes back six weeks later asking why her skin looks unhappy is a story I have watched more times than I want to admit. Two. Respect the spacing schedule. Compressing the timeline does not get the tattoo off faster. It gets the skin angry.

Restore. The Mother’s Day Radiance Facial, $125.

I am picky about facials. Most facials are not medical. They are pleasant. Skin looks slightly better for forty-eight hours and then nothing has actually changed.

The Mother’s Day Radiance Facial my team built for May is structured differently. It is medical-grade exfoliation, deep cleansing, and active serums chosen by our aesthetician based on what your skin is doing the day of the appointment. It is not a fixed protocol. It is a treatment facial that adjusts to the patient.

At $125, this is one of the easier yes’s I can give a patient.

I am seeing three different people book this one.

A daughter buying for her mom. The card prints cleanly. The mother walks out with skin care she would not have bought for herself. Best $125 you can put on a Mother’s Day card and we both know it.

A patient buying for herself, no apology, no permission. A forty-something or fifty-something woman who decides on a quiet Tuesday to drop $125 on her own face. I see this more every year and I approve of every one of those bookings.

A pre-event patient. Wedding next month. Reunion. A photographed thing on the calendar somewhere. The window is twelve to fourteen days before the event. Far enough that any treatment redness has settled. Close enough that the glow is still on the skin in the photographs. I am rigid about that timing.

What this facial is not. Not a chemical peel. Not a laser. It will not undo a decade of sun damage in a single afternoon, and any clinic that pretends otherwise is selling you a story. It is the maintenance layer of a real skin program. Used as such, it earns its $125.

Revive. The Mother’s Day Refresh, $3,650.

This is the special on the May board worth reading carefully, because the structure of the package is the part that makes it interesting.

A standard injectable package is sold by the syringe. One syringe of this. Twenty units of that. Same numbers on every face that walks in the door. Convenient for billing. Not great for outcomes. Faces are not standardized.

The Refresh is built the other way around.

The package combines dermal filler with an upper-face neuromodulator, the wrinkle relaxer used in the forehead, between the brows, and around the crow’s feet. The phrase the flyer uses is “nurses’ discretion.” That phrase is the whole point.

What it means is this. My injecting nurse has the budget, in the room, to spend product where the face actually needs it. If the upper face is dominant, the toxin moves there. If the cheekbones are flat, the filler concentrates in the malar area. If the lower face is intact and your real complaint is fine perioral lines, the package goes there. The nurse is looking at the whole face and allocating accordingly. Not counting units off a price list.

This is how I want injectables done.

I should also make my standard speech about filler.

Filler is a tax. A facelift is an investment. I keep saying that line because it keeps being true. The patient who has been getting filler every six months for ten years is the patient who often cannot tell where her face ended and where the filler began. The Refresh, used correctly, is the right kind of filler appointment, balanced, not run on a quota. But it does not replace a face that has structurally changed. If your face has dropped, the conversation needs to be a surgical one with me, not another injectable package. My team will route you to that consult before they will sell you the Refresh under the wrong premise. That is not bad for business. That is how a real practice operates.

Two cautions I want every Refresh patient to walk in with.

A first-time injectable patient should know that the result is a quieter, more rested version of the same face. Not a different face. Patients who confuse those two outcomes are the patients who are unhappy at follow-up regardless of how technically clean the work was.

A patient with a face that has changed materially in the last decade should book a surgical consult with me before booking the Refresh. We can use the package after surgery, not in place of it.

A clean side-by-side

Special	What it is	Investment	Best for
Renew	Laser tattoo removal	20 percent off per session	Patients ready for a real course of removal, lock in the discount across the run
Restore	Mother’s Day Radiance Facial	$125	A meaningful gift for mom, or a maintenance reset for the patient herself
Revive	Mother’s Day Refresh	$3,650	Dermal filler plus upper-face wrinkle relaxer, balanced across the face by my injecting nurse

Where to come, East or West

The Med Spa at Southwest Plastic Surgery runs out of two El Paso locations and the May specials are valid at both.

The Eastside office is at 1387 George Dieter Drive, Building C, El Paso, Texas 79936.

The Westside office is at 5925 Silver Springs Drive, Suite C, El Paso, Texas 79912.

My Med Spa team works across both sites. Same protocols, same products, same supervising physician. Pick the side of town that fits your week and your commute.

Who is supervising the work

I am Frank Agullo, MD, FACS, 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 a Mayo Clinic plastic surgery fellowship alum. I serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center and Affiliate Professor at the University of Texas at El Paso. I have been named a Castle Connolly Top Doctor for thirteen consecutive years. The Med Spa runs under my license and on protocols I have written. That is the bar.

For two more reads on the same three specials.

The editorial take is on my personal blog, drworldwide.com: Renew, Restore, Revive: The May Med Spa Specials I’d Actually Book.

The longer clinical version is on my medical-grade blog, agulloplasticsurgery.com: Mother’s Day at the Med Spa: A Plastic Surgeon’s Read on Three May Specials Worth Booking.

Schedule a Med Spa appointment at Southwest Plastic Surgery

To book any of the May specials at our Eastside (1387 George Dieter Building C) or Westside (5925 Silver Springs Suite C) Med Spa, call (915) 590-7907. For surgical or combined consults with me, call my main practice line at (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. Follow me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful

This entry was posted on Monday, May 4th, 2026 at 4:22 pm and is filed under Med Spa, Tattoo Removal. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

Three weeks after surgery, a deep plane facelift patient sat down across from me at her two week visit. She lifted the hand mirror she had brought, looked at her own face, and asked the question I get more often than any other in that chair. “Why do I feel this good already?” The bruising she had braced for never really showed up. The fatigue lasted four days. She had slept the night of surgery and every night since.

I told her the truth. Part of it is the operation itself. A well-executed deep plane facelift releases the four retaining ligaments and repositions the soft tissue without tension, which means less swelling and less bruising than a traditional skin-tightening lift. Part of it is anesthesia and a meticulous closure. And part of it, increasingly, is what I add on the back end. A short, supervised peptide protocol that I have been refining for several years and that we now offer almost every surgical patient at Southwest Plastic Surgery.

More and often than not, when patients request I write peptide protocols, this is why. The recovery benefit is only one application for these molecules. Many patients use these molecules as part of an enhanced fitness and wellness program, for instance, they’ll use these peptides exclusively for support on their skin health, boost their immune and energy systems and ward off aging, which have nothing to do with post-surgery support. This specific article addresses only surgical recovery. If you wish to read my article concerning these peptides as a standalone benefit within a wellness program, please refer to the hyperlink found at the end of the document.

What a peptide actually is

A peptide is a short string of amino acids. The body makes thousands of them every day to send signals between tissues. Insulin is a peptide. Oxytocin is a peptide. Growth hormone is a peptide. The peptides I prescribe for surgical recovery are synthetic versions of molecules the body already makes, manufactured under cGMP pharmaceutical conditions, dosed precisely.

That is the part that matters. These are not herbal supplements. They are not hormones in the testosterone or estrogen sense. They are signaling molecules. The dose tells the body to do something it already knows how to do, just faster and more completely. Lay down collagen. Recruit fibroblasts to a sutured edge. Build new microvasculature. Restore mitochondrial energy.

Used well, with a physician selecting the dose and the duration, peptides accelerate the work the body was going to do anyway. Used poorly, with patients shopping the gray market on Instagram, they are a waste of money or a real safety problem. The peptides we prescribe at Southwest Plastic Surgery come from a US-based, cGMP-certified pharmacy with a certificate of analysis on every batch.

GLOW for face, KLOW for body

I prescribe two related peptide blends, depending on the operation. GLOW is a three-peptide blend (GHK-Cu, BPC-157, TB-500). KLOW is the same three peptides plus a fourth, KPV. The reason the menu has two versions is that face and body procedures call for different emphasis on the recovery side, and the right blend tracks the operation. The pharmacy compounds the peptides together in one vial, which makes it a single daily injection rather than three or four.

GHK-Cu is a naturally occurring copper tripeptide found in human plasma. The concentration drops as we age. It’s the same active compound in the copper peptide cosmetics you see at Sephora, with one important difference: injected, the peptide reaches the dermis directly at a controlled dose, instead of having to fight through the stratum corneum. Mechanistically, GHK-Cu activates more than three hundred genes involved in tissue repair. It signals fibroblasts to lay down new collagen and elastin. For a facelift patient, it is the part of the blend that helps a fresh incision heal flat and helps the skin in the operated zone look better six months out. The blue color of the solution comes from the copper. It is normal.

BPC-157 stands for Body Protection Compound. It is a fifteen amino acid peptide derived from a protein in human gastric juice. The mechanism that matters most for recovery is angiogenesis, the formation of new blood vessels at injury sites. New tissue cannot survive without blood supply. The body builds that supply slowly. BPC-157 accelerates it. The peptide also dampens local inflammation and supports tendon, ligament, and muscle repair. For a body procedure, this is the workhorse of the blend.

TB-500 is a synthetic analog of Thymosin Beta 4. It regulates a cellular protein called actin, which is essentially the rail system cells use to crawl across tissue. The simple way to put it: BPC-157 builds the new blood vessels, and TB-500 mobilizes the repair cells to use them. The two are synergistic, and the original published research on the pair came out of sports medicine, where elite athletes used the combination to come back from soft tissue injuries faster.

KPV’s a tripeptide (lysine-proline-valine) derived from alpha-MSH, and the job it does is anti-inflammatory. It works by inhibiting NF-kB, which is the master switch in the body for inflammatory gene expression. BPC-157 and TB-500 already dampen inflammation as a side effect of their main jobs, but KPV is the dedicated anti-inflammatory anchor sitting on top of that. For face procedures, where the inflammatory load is small and the priority is incision quality and skin remodeling, GHK-Cu’s doing most of the heavy lifting and GLOW gets the job done. For body procedures (BBL, gluteal fat grafting, tummy tuck, mommy makeover, breast surgery), the inflammatory field is much bigger, so I add KPV. That’s KLOW. Same once-daily injection from the same compounding pharmacy. The surgical field just gets broader anti-inflammatory coverage where it needs it.

I dose both blends subcutaneously, abdomen or thigh, once daily for the first three to four weeks after surgery. Most patients self-inject at home with a 30 gauge insulin syringe. We adjust at each post-op visit.

NAD plus, the mitochondrial side

NAD+ is a different molecule for a different problem. Technically it is a coenzyme rather than a peptide, but it sits next to peptides on the same prescribing menu and pairs with them well. The “nicotin” in Nicotinamide Adenine Dinucleotide is from vitamin B3 etymology. It has nothing to do with cigarettes, a clarification I make at the start of every consultation.

NAD+ powers the mitochondria, the cellular machinery that makes energy. It also fuels sirtuins, a family of enzymes involved in DNA repair. Levels drop with age, with stress, and with illness. Surgery is a stress. Recovery is a period of accelerated cellular work. Adequate NAD+ is the cofactor that work needs.

We primarily use at-home self-injections. Patients can go home with one month total supply. You’re supposed to split the doses evenly between morning and night in two separate injections a week apart. I usually inject patients two times per week for a total of eight doses. A total of 62.5 mg each time to recover nicely over the four weeks post surgery. Patients typically have minimal discomfort and it’s convenient for at-home self use. The constant infusion will ensure constant mitochondrial support throughout this crucial period in your healing.

If you do decide that you want to add an IV option in addition to the self injections, Southwest Plastic Surgery does offer a NAD+ and Glutathione drip. One IV infusion a few days before surgery and another one about a week after the surgery. One before surgery primes the body’s mitochondria so that we can have as much support as possible for the body going through stress from the surgical trauma. One after surgery helps the body as we head into the critical phase in the healing and repairing processes of the body’s cells. Glutathione is added slowly over time as the IV infusion slows. Glutathione is an antioxidant peptide which is useful in liver Phase 2 cleansing and it also helps clear leftover anesthesia and metabolites that come from the surgery.

One IV complication to note: Run the NAD+ infusions too quickly, the NAD+ will cause chest tightening, nausea, flush and a hot burning sensation. The reaction to IV NAD+ is dose and speed related. Run the NAD+ drip at the recommended rate, the NAD+ (500 mg) will usually be administered at over two to three hours followed by 1000-1500 mg of Glutathione at a push rate of five to 15 min, the entire time the infusion is happening is comfortable for the patient. Our medspa nurses are excellent in titrating rate to patient comfort. Asthma patients should be watched carefully during the glutathione push as we’ve had a patient or two experience bronchospasm.

How the protocol matches the procedure

The recovery protocol is not a single template. It shifts with the operation.

Procedure	Blend	Cycle	NAD plus
Facelift, neck lift, blepharoplasty	GLOW	3 to 4 weeks daily	250-500 mg SQ/IM monthly, divided 2x/week. Optional IV pre-op + post-op.
BBL, gluteal fat grafting, body contouring, tummy tuck, mommy makeover	KLOW	4 to 6 weeks daily	Same SQ/IM schedule, sometimes extended through month two. Optional IV pre-op + post-op.
Breast surgery, including Motiva Preserve augmentation	KLOW	3 to 4 weeks daily	250-500 mg SQ/IM monthly, divided 2x/week. Optional IV pre-op + post-op.
Combination procedures (face plus body, multi-site)	KLOW	Longer cycle, individualized	Standard SQ/IM schedule, IV often included.
Isolated minor procedures (lip lift alone, blepharoplasty alone)	Often none	Patient-specific	Patient-specific

Where the MedSpa fits, and where it does not

The Southwest Plastic Surgery MedSpa runs the IV NAD+ plus glutathione infusions, the subcutaneous NAD+ refills, and the peptide pickup and education for patients on a GLOW or KLOW protocol. The MedSpa nurses also handle the technique training for self-injection at the post-op visit, including site rotation and disposal.

Two things the MedSpa does not do, and that I want to be plain about. The MedSpa does not adjust the prescribed dose without me. The MedSpa does not add additional peptides on top of GLOW or KLOW based on something a patient read online. Both of those decisions live with me as the prescribing physician. That is not a service limitation. That is a safety floor.

We integrate the peptide protocol with the rest of what the MedSpa offers in the same recovery window. Lymphatic massage, ElixirMD post-op recovery, scar protocols. The peptide piece is not a replacement for any of those. It is an addition.

Who is a candidate, and who is not

The starting question is whether the patient wants the smoothest possible recovery, will tolerate four to six weeks of daily self-injection, and has a medical history that supports the protocol. Most do.

Active malignancy is a contraindication for growth-factor-adjacent peptides because we do not want to support an undiagnosed tumor. Pregnancy and breastfeeding are off the protocol. Active infection is a temporary contraindication and we delay until cleared. Patients on therapeutic anticoagulation receive adjusted dosing in coordination with their cardiologist. Patients with a personal cancer history, even if treated and clear, get a longer conversation and often an oncology clearance before we proceed.

The cautious side

Peptides aren’t actually FDA-approved new drugs, as most physicians use compounded peptides from US 503A pharmacies. This practice is legal and valid, however, it also contributes to a black market rife with peptides of unspecified origin, unverified dosage and questionable sterility. As a peptide is an injectable sterile medication, purchasing it from a source on Telegram represents a risky decision about one’s well-being and is a lawsuit waiting to happen. I personally use a U. S. -based, cGMP-certified pharmacy, which provides a certificate of analysis with each prescription. The price is higher than that of the black market. You’re paying for the quality differential that this represents.

The second rule, and the one patients sometimes struggle with: a compounded peptide blend is calibrated. Adding random fourth and fifth peptides on top of GLOW or KLOW because of a podcast is not optimization. It is a way to give yourself an unintended hormonal or hematologic problem. If a patient wants to expand the protocol, that conversation happens in my office, with new prescriptions written for the new molecules.

Two more reads

For the editorial, shorter version of this post, with the Vogue-side voice rather than the practice-side voice, see After the Operating Room: The Peptide Stack My Patients Recover On on drworldwide.com.

For the longer, more clinical version, with deeper mechanism, dosing, and contraindications, see Peptides for Plastic Surgery Recovery: A Clinical Guide to GLOW and NAD Plus on agulloplasticsurgery.com.

Why choose Dr. Agullo for a peptide-supported recovery?

Double board-certified, American Board of Plastic Surgery and American Board of Surgery. Fellow of the American College of Surgeons. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, teaching the same techniques I use every week. Affiliate Professor at UTEP. Castle Connolly Top Doctor for thirteen consecutive years. The peptide protocol is prescribed by me, sourced through a US cGMP-certified compounding pharmacy, and integrated into a recovery plan refined operating on local, national, and international patients for the last fifteen years.

Ready to talk?

The right time to start the recovery conversation is during the surgical consultation, not the day before surgery. Schedule a consultation at Southwest Plastic Surgery and we will review your anatomy, the operation you are considering, your medical history, and we will decide together whether peptides belong in your plan. If they do not fit, I will say so. If they do, you will leave the consultation with a written protocol, a price, and a timeline. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. Follow along on social at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful.

This entry was posted on Friday, May 1st, 2026 at 12:39 pm and is filed under Recovery. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

For about five years, every Morpheus8 appointment at our El Paso MedSpa started the same way. Patient checks in. Vitals. A small tube of blood drawn from the inside of the elbow. The tube goes into a centrifuge. Twelve minutes later, our team paints platelet-rich plasma onto freshly microneedled skin. Patient leaves with a small bandage on the inner arm and (usually) a glow.

Then, sometime around the start of the year, the routine changed. The blood draw disappeared. The bandage on the arm disappeared. Patients started asking the obvious question. What happened to the PRP.

We took the question to Dr. Frank Agullo, the medical director of Southwest Plastic Surgery. He has been running this MedSpa long enough to remember when PRP was the new exciting thing nobody had heard of. He gave us the long answer.

The shorthand version

“PRP works,” Dr. Agullo told us. “It still works. We did not stop because PRP failed. We stopped because something cleaner showed up. Recombinant pure PDGF, in a controlled dose, with no blood draw. The brand we use is Ariessence pure PDGF+.”

The longer version of that explanation is worth a few minutes. The MedSpa team has been getting a version of this question every week since the change, and the answer is genuinely interesting once a patient takes the time to hear it.

What is PDGF, in plain English

The body has a small set of proteins it relies on to handle injury. When tissue gets cut, scraped, microneedled, lasered, or otherwise irritated, platelets release a cocktail of proteins called growth factors. PDGF is one of the leaders of that cocktail. It calls in the cells that lay down new collagen. It helps the body build the new blood vessels healing tissue needs. It is, in a real sense, the molecule the dermis is asking for at the exact moment it just got injured.

For most of the past decade, the way clinicians delivered PDGF to skin in an aesthetic context was indirect. They drew a tube of patient blood, spun it down in a centrifuge, and applied platelet-rich plasma on freshly microneedled or lasered skin. PDGF rode along, mixed with several dozen other proteins, in concentrations that varied with the patient and the technician.

Recombinant pure PDGF is what you get when a lab makes only the PDGF molecule itself. The protein is produced in cultured cells from a human gene, then purified to a single active species. The dose is the same in every patient. There are no human-derived components in the formulation. The Ariessence product pairs the recombinant PDGF with a hyaluronic acid serum and is mixed in the treatment room in under a minute.

“Same idea as PRP,” Dr. Agullo said. “Just a cleaner version of the same idea. The thing the body was asking for, in a controlled amount, every time.”

Why right after a microneedling session, and not as a take-home serum

Patients ask if Ariessence is something they can buy and apply at home. The answer is no, and the reason is mechanical.

PDGF on intact skin sits on top of the stratum corneum. The stratum corneum is the skin’s outer barrier. It is highly effective at keeping large molecules out. A growth factor in a jar at home is mostly a moisturizer with an interesting label.

The post-procedure window changes that. After Morpheus8, RF microneedling, fractional laser, or a medium-depth peel, the skin has thousands of microchannels open into the dermis for a finite period. The treatment area is briefly ready to receive what gets applied to it.

“That window closes inside a couple of hours,” Dr. Agullo said. “Whatever I put on the skin in the first ten minutes is the second half of the procedure. We do not waste it on water.”

The study patients keep asking about

In September 2025, Michael Gold and colleagues published a randomized controlled trial in the Journal of Cosmetic Dermatology. Healthy adults between thirty and sixty got a single Morpheus8 RF microneedling session. They were randomized to receive either bland Aquaphor or topical recombinant pure PDGF-BB immediately after. A blinded evaluator graded them at seven and thirty days using a global aesthetic score, the Canfield Visia imaging system, and patient experience surveys.

The PDGF group did better on the global aesthetic score at thirty days. The result was statistically significant. The PDGF group came out ahead on six of the seven Visia metrics. Patient experience favored the PDGF group across the experience measures. No serious adverse events were reported.

We asked Dr. Agullo for his read.

“Two reads at the same time,” he said. “Patients deserve both.”

He started with the honest read. Topical recombinant pure PDGF after RF microneedling beat a bland emollient on the measures that matter for skin rejuvenation. The margin was not subtle.

Then the careful read. The manufacturer puts a disclaimer in writing. The exact formulation tested in the trial is not identical to the marketed Ariessence bottle.

“So I do not tell my patients the trial proves the bottle,” he said. “I tell them the science of the category is real, the trial supports the approach, and the bottle on our shelf is the closest commercial expression of that science right now. Both things are true. Better they hear it from me than from a Reddit thread at 2 in the morning.”

Where Ariessence sits next to PRP, PRF, and exosomes

The MedSpa team is asked about all of these in roughly the same week. Here is the comparison Dr. Agullo had us put together.

Modality	Source	Blood draw	Dose predictability	2026 role at our MedSpa
Aquaphor	Petroleum jelly	No	Total, but no biological signal	Default barrier, used after most procedures
PRP	Patient blood, single-spin	Yes	Variable patient to patient	Available on request, not the default
PRF	Patient blood, slower spin	Yes	Slightly more consistent than PRP	Not currently in rotation
Exosomes	Stem cell conditioned media (donor)	No	Manufacturer-dependent, regulatory uncertainty	Not in rotation
Ariessence pure PDGF+	Recombinant rhPDGF-BB in HA serum	No	Identical dose every kit	Default after Morpheus8, RF microneedling, fractional laser, or medium-depth peel

“That table changed in our practice this year,” Dr. Agullo told us. “It will change again. The right answer to a patient’s question is whatever the most current science supports. I am not married to a tray.”

Where MedSpa fits, and where it does not

A version of one question shows up in our consultations every week, particularly with patients in their forties and fifties. How far can MedSpa take me, the question goes, before I really do need to think about surgery.

Dr. Agullo’s answer has been more or less the same for years.

“Our MedSpa has real tools, not props,” he said. “Botox, hyaluronic acid fillers, BBL Forever Young, laser resurfacing, Morpheus8 RF microneedling, chemical peels, and now Ariessence on top of all of those for cleaner recovery. Every one of them earns its keep. On a forty-year-old face the whole toolbox can buy years before surgery is the right move. The catch is that none of those tools repositions deep tissue. They treat surface, volume, and tone. Try to use them as a permanent stand-in for a facelift on a face that has actually descended, and what you get is not a younger face. You get a fuller one. Puffy cheeks, no jawline, an upper lip nobody asked for. We call that the filler tax.”

He spends almost as much time on sequencing.

“In your forties and early fifties, lean into MedSpa. Be sparing and precise with injectables. The day structure actually starts to slip is the day to be sitting at a surgery consultation. Earlier than later. After the facelift heals, MedSpa picks back up. Skin care, energy-based treatments, growth factors after each procedure for faster recovery, and small injectables on a careful cadence. Not a wall of syringes.”

That arc is something the surgical team and the MedSpa team plan together for facelift patients. It is one of the reasons our practice draws patients from out of state for the long view, not just one operation.

What patients should ask about Ariessence specifically

We asked Dr. Agullo what questions he wishes patients would put to any provider who is offering Ariessence, or for that matter any other growth-factor adjunct.

He came back with four.

First, what procedure are they pairing it with? The right answers are Morpheus8, RF microneedling, fractional laser, or a medium-depth peel. If the provider tells you “oh, you can just take it home and apply it daily,” he says, walk out.

Second, how fast is it going on after the procedure ends, and how is the kit being mixed in front of you? Within roughly ten minutes is what you want. Hours later is past the point where it does much.

Third, what is the dose, and where does the protein come from? Recombinant pure PDGF-BB, controlled concentration, no human-derived material, is the standard he wants you to ask the provider to confirm. Vague answers there are a red flag.

Fourth, is the product being marketed and used as a topical cosmetic, or is somebody quietly offering to inject it? Topical cosmetic is the entire regulatory category for this product. A provider offering to inject it has decided to operate outside that category, and that is not a position you want a stranger making on your face.

What it is not, said cleanly

Ariessence pure PDGF+ is sold as a topical cosmetic. It is not an FDA-approved drug. It is not approved to diagnose, treat, cure, or prevent any disease or condition. It is not for injection. The four FDA-approved drug products that contain PDGF (GEM 21S, Augment, Augment Injectable, Regranex) are unrelated formulations approved for non-cosmetic medical indications. Their long safety record informs the molecule’s general safety profile, but does not transfer regulatory approval to the cosmetic.

The MedSpa is clear about this with every patient. So is Dr. Agullo. So is the manufacturer.

About Dr. Frank Agullo, MD, FACS

Dr. Frank Agullo is the medical director of Southwest Plastic Surgery in El Paso. 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 a Mayo Clinic plastic surgery fellowship alum. He serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center and Affiliate Professor at the University of Texas at El Paso. He has been named a Castle Connolly Top Doctor for thirteen consecutive years, was inducted into the Texas Super Doctors Hall of Fame in 2025, and was named Aesthetic Everything Top Plastic Surgeon for 2026. Roughly sixty percent of his patients fly into El Paso from out of town.

For two more reads on the topic above, both written or co-developed with Dr. Agullo himself:

The editorial take is on his personal blog, drworldwide.com: After the Needles: The Growth Factor That Earned Its Spot Next to My Morpheus8.

The deeper clinical version is on his medical-grade blog, agulloplasticsurgery.com: Pure PDGF After Microneedling: A Clinical Read on Ariessence and the Gold Trial.

Schedule a Morpheus8 consultation at Southwest Plastic Surgery

Southwest Plastic Surgery is the El Paso practice of Frank Agullo, MD, FACS. To book a Morpheus8 session, an RF microneedling course, a chemical peel, or to talk to our MedSpa team about the right post-procedure protocol for your skin, call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. Follow Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook. #StayBeautiful

This entry was posted on Tuesday, April 28th, 2026 at 4:43 pm and is filed under Noninvasive Skin Treatments. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.