Paul G. Ruff IV, M.D., F.A.C.S

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Double Board Certified Plastic Surgeon

Dr. Ruff is the founder of West End Plastic Surgery. He is highly regarded as one of the most experienced and skilled specialists in plastic surgery. His reputation for excellent surgical outcomes and compassionate patient care attracts numerous patients from not only all over the DMV area but nationally and internationally as well. Detailed in his approach, Dr. Ruff has an excellent artistic eye combined with over 25+ years of surgical experience and over 18,000 procedures performed.

Dr. Ruff has consecutively been voted Top Doctor in the Washingtonian Magazine since 2005 and voted nationally as a Top Doctor by Castle-Connolly for the last ten years. This recognition puts him among only 7% of all board-certified doctors in the US! The qualifications include board certification, experience, reputation, and peer recommendations.

Dr. Ruff is considered a world leader in the Renuvion skin tightening technology. He is a medical advisory board member, consultant, and clinical research investigator for Apyx Medical (Renuvion). He trains and lectures both nationally and internationally to surgeons on Renuvion and its incredible advancements in skin tightening. Dr. Ruff was the Principal Investigator for the Renuvion FDA study and his contributions were vital for the FDA clearance. His research was published in the Aesthetic Surgery Journal which is a prestigious acknowledgment of his work. The FDA cleared Renuvion for use in improving the appearance of lax skin in the neck and submental region. Dr. Ruff's work has been published in numerous books and medical journals.

Dr. Ruff was first exposed to patient care during his studies at Georgetown University. Deciding to become a surgeon, he went on to receive his MD at Eastern Virginia Medical School and performed his general surgery residency and surgical critical care residency at Washington Hospital Center and his plastic surgery residency at the University of California, San Diego Medical Center. Since then, Dr. Ruff returned to the area where he grew up and opened West End Plastic Surgery, establishing his reputation as one of the top plastic surgeons in Washington, D.C., and the surrounding areas.

Request a consultation online or contact us at or call us at 202-785-4187.

Results by Dr. Ruff:

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topless male patient before and after renuvion body sculpting, stomach flatter after procedure
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As his father was a Navy man stationed in Virginia, Paul grew up in and around the Washington, D.C. area. Paul attended Gonzaga College High School, graduating with honors. Gonzaga’s motto is to “create a well-rounded student, a young man who is intellectually competent, open to growth, religious, loving and committed to doing justice in generous service to the people of God. Simply put, we educate our students to be ‘Men for Others.'” This educational environment, coupled with being a competitive pianist and tennis player, helped shape Paul’s future as one who would serve others in the medical field.

Paul continued his Jesuit education in college at Georgetown University. These were transformative years. It was at GU, volunteering with the Georgetown Emergency Response Medical Service (GERMS), that Paul was first exposed to patient care. “The initial experiences I had while volunteering for GERMS cemented my resolve that medicine was what I truly wanted to do. I was helping people in need. This brought me both joy and compassion for people.”

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As a child, Paul adored his grandfather, who was a highly respected Obstetrician-Gynecologist. Paul didn’t know exactly what that meant, but he knew that his grandfather helped people. His grandfather’s joy and enthusiasm for his work showed. That passion sparked Paul’s own dream. After graduating from GU, Paul chose to enter one of the most challenging medical programs in the nation at Eastern Virginia Medical School (EVMS) in Norfolk, Virginia. “I chose to go there because it was one of the best programs for OB-GYNs. At that time my goal was still to be an OB-GYN like my grandfather,” Paul commented. EVMS also had a top plastic surgery program at the time.

Plastic surgery wasn’t even on my mind at that time. But when I was on rotation, I discovered that I really enjoyed surgery. I was continually complimented on my skills and surgical techniques. I believe that my years as a pianist and tennis player were key components in developing talent for surgery,” Paul recalled.

As Paul became more exposed to the field of plastic surgery, he became more interested in this medical specialty. “In the plastic surgery field, you are operating from head to toe. It provided me with limitless opportunities for what I could accomplish as a surgeon. In this specialty, thorough knowledge of anatomy and physiology are critical to providing optimal care and results for a patient. This key component, coupled with my skills, appealed to me, and I decided to pursue plastic surgery instead of becoming an OB-GYN.”

In 1993, Paul G. Ruff IV earned his new title as Paul G. Ruff IV, M.D. Following his graduation from EVMS, Dr. Ruff performed his general surgery residency and surgical critical care residency and was the chief administrative resident at Washington Hospital Center, spending 6 years there.

Then, in July of 1999, Dr. Ruff and his family moved to San Diego to complete his plastic surgery residency at the University of California, San Diego Medical Center (UCSD). Dr. Ruff’s experiences as a resident at UCSD provided him with a wealth of innovative skills. “It was as if I walked out of UCSD with a virtual toolbox of reconstructive and cosmetic skills. I have a deep appreciation for the tutelage I received from my talented mentors and for the unique residency program at UCSD. I believe this program was a key factor in my development toward becoming a complete surgeon.”

Throughout his residencies, Dr. Ruff has been recognized for exceptional skill and compassionate care as a plastic surgeon. He was awarded the Gould Award from Washington Hospital Center and the Chairman’s Prize at UCSD.

Dr. Ruff was appointed Assistant Professor of Clinical Plastic Surgery by the Georgetown University Office of Faculty and Academic Affairs based on recommendation of the Department Chair and Committee on Appointments and Promotions of the School of Medicine. In addition, he has been featured on ABC’s Bachelor in Paradise and Fox 5 News.


In 2001, after graduating from UCSD, Dr. Ruff returned home to the Washington, D.C. area and went into practice. When asked about his philosophy on being a successful cosmetic surgeon, Dr. Ruff responded, “In the cosmetic surgery field, patients come looking for help to feel better about some aspect of themselves. Plastic surgeons who become cosmetic surgeons without adequate training have a limited skill set to offer their patients. This puts the patient at a disadvantage as their outcome is ultimately affected. I can provide my patients with both my non-invasive and fully aggressive surgical skill sets. My skills, coupled with my continual aspirations to possess a thorough knowledge of the latest technologies and techniques in my industry provide my patients with optimal outcomes.

Additionally, I believe that a key component of my success as a cosmetic surgeon is my ability to listen. Sometimes in talking to a patient, I realize that what bothers them the most is not necessarily what they initially pointed out. I spend a lot of time working to understand how a patient sees her or himself. When I can put myself in my patients’ shoes, and work to see them through their own eyes, then I can truly create what is in their mind’s eye. Patients are not a blank slate. They do not come into my office, and I do what I think is right. Instead, I strive to achieve what the patient sees through my hands by choosing the right medical treatment. I also find that it is just as important to tell a patient when his or her expectations are not possible or appropriate. Communication with my patients is key. My goal is for patients to feel as if they are talking to a friend when they come to me with their concerns. I love my job. I believe that as long as you enjoy what you do, and everyone around you is happy, then you know that you are doing the right thing.”

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Dr. Ruff was featured on the French television network TF1 to discuss jaw filler on men. In recent years, there's been a surge in the demand for cosmetic procedures among men. One particular trend has been catching the eye of many: the rise in men opting for jawline fillers. Many of them express a desire for a more defined and chiseled jawline, which they believe enhances their overall appearance and boosts their confidence. Filler is a great non-surgical option. During this new segment, Dr. Ruff explains this increase in popularity. Click here to watch the full interview.

Videos of Dr. Ruff:

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Giving Back

Philanthropy is critical to our mission. Dr. Ruff was exposed to the very personal benefits of helping others early on through his grandfather. At EVMS, he experienced the joy felt by cleft lip and palate patients treated through Operation Smile, which is based in Norfolk. As a plastic surgery resident at UCSD, he was fortunate to accompany the Interface UCSD medical mission group on 8 trips to Mexico to perform reconstructive procedures on children in underserved areas. “The community of giving that exists among the people who went on these trips is truly inspiring. The communities that we helped embraced us, and their generosity for what we did was overwhelming.” Today Dr. Ruff continues this mission through his work with The Future of Nicaragua Foundation, spending nearly 2 weeks each year treating those in remote and underserved areas. He also founded Wrinkle Erase for the Cause, a non-profit event that raises money for breast cancer research. In the past 4 years during the month of October, he has raised $150,000 that has gone toward research. “I have been blessed with certain talents and skills, and it is my responsibility to use those for the benefit of those in need,” says Dr. Ruff.

Patient Testimonial:

"5 Stars!! I will start by saying that Dr. Ruff deserves these 5 stars. After getting married I gained some love weight. By love weight I mean I went from 145lbs to 225lbs. Needless to say I had a huge stomach. My self‐confidence was hit hard since my whole life I was pretty slim. I expressed my concern to my primary doctor and he referred me to Dr. Ruff. I was very nervous since I had never had any other surgery. I went in for my consultation with Dr. Ruff and immediately felt very comfortable. He is very knowledgeable and his staff is great. They are like a family. After my consultation I made my appointment to get liposuction on my mid‐section and flanks. I am a full time student so I was a little concerned about recovery. I did not want to miss school so I had the procedure done during spring break. The procedure was completed right in the office and I ended up getting a room at the hotel across the street for my follow up the next day. The whole experience was very seamless. I came in with reasonable expectations of results but I have been blown away. It has now been about 4 months after the procedure and I have lost over 50 lbs. (still losing weight). My waist shrunk from a 38 to a 32 and 32 is a little big. My body couture is amazing. I see muscles I haven't seen in a while. Everybody is amazed at how great I look. They even say they can notice it in my face and arms. I always respond I didn't have anything done there. lol. Needless to say the procedure was SUPER worth it. I haven't really been exercising as I should but I do watch what I eat now. I am writing this because if you are thinking about getting liposuction done then definitely go see Dr. Ruff for a consultation. He is the BEST! I am now always without a shirt and my confidence is back. Thank you Dr. Ruff and team for a seamlessly pleasant experience and a boost of confidence I needed!"

- Gerald P.

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