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Top 3 Plastic Surgeons

An independent publication on aesthetic and plastic surgery

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A woman in her early sixties with short silver hair and fair, lightly sun-weathered skin, wearing a plain linen shirt, seated on a wooden bench on a shaded porch with potted plants behind her in soft afternoon light, smiling slightly toward the camera

The Lead · Procedure Deep-Dive

Actinic Keratoses and Cosmetic Work: Why the Rough Spot Matters More Than the Brown One, What Fluorouracil, Imiquimod, and Photodynamic Therapy Actually Do, When a Peel or Laser Counts as Treatment, and Why the Biopsy Comes Before the Resurfacing

Most adults with years of sun on their face have actinic keratoses, the rough, scaly patches that feel like sandpaper before they are easy to see. They are not cancer, but they mark skin where squamous cell carcinoma is more likely to appear, and they sit in exactly the places people want lasered, peeled, lifted, and filled. Here is what the treatments do, how they fit around cosmetic plans, and what to ask before anyone burns off a spot that was never looked at under a microscope.

October 19, 2026

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By The Editorial Desk

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16 min

Top Stories

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A man in his late forties with salt-and-pepper hair and a grey beard, wearing a navy crewneck sweater, seated at a wooden kitchen table by a window with potted plants on the sill, holding a glass of water and looking calmly at the camera

Procedure Deep-Dive

Fatty Liver Disease and Cosmetic Surgery: What a Raised Liver Enzyme on Pre-Op Labs Actually Means, Why Cirrhosis Changes the Math on Elective Surgery, Which Painkillers and Supplements the Liver Cannot Handle, and Why Liposuction Does Nothing for the Fat That Matters

Roughly a third of adults have fat in their liver, and a large share of the people booking liposuction, tummy tucks, and mommy makeovers are among them. Most will never know until a routine pre-op panel comes back with an ALT flagged high. That result is rarely a reason to cancel, but it is a reason to ask one more question: how much scarring is there? The answer decides everything from whether elective surgery is sensible at all to how much acetaminophen, lidocaine, and sedation is safe in recovery. Here is what matters, and what to ask before booking.

October 19, 2026 · 15 min

A woman in her late twenties with a chin-length dark brown bob, wearing a buttoned oatmeal ribbed turtleneck cardigan and jeans, seated on a wooden chair beside a bright window and a white radiator, hands clasped over one knee, looking toward the window

Procedure Deep-Dive

Montgomery Glands and Bumps on the Areola: Why the Small Raised Dots Are Normal, When a Lump Behind the Nipple Needs an Ultrasound, What Can and Cannot Be Done About Bumps and Areolar Hair, and Which Changes Call for a Biopsy Instead of a Cosmetic Fix

Almost everyone has small raised bumps on the areola, and a surprising number of people book a consultation to have them removed. Most of those bumps are Montgomery glands, a normal structure with a job to do, and removing them is a small operation with real tradeoffs in scarring and pigment. Here is what the glands are, why they change with pregnancy, hormones, and breast surgery, how a Montgomery cyst in a teenager is usually managed, what the options are for prominent bumps and areolar hair, and which changes on the nipple and areola belong in front of a dermatologist or breast surgeon rather than a cosmetic one.

October 19, 2026 · 15 min

A woman around thirty with shoulder-length dark hair, wearing an oversized taupe knit sweater and cream trousers, seated on a white armchair beside a window with potted plants and a radiator, hands folded over her knee, gazing toward the light

Procedure Deep-Dive

Labia Majora Augmentation and Reduction: Why the Outer Labia Deflate or Enlarge With Age, Weight Loss, and Menopause, What Fat Grafting and Filler Can and Cannot Restore, How a Majoraplasty Removes Excess Without Leaving a Gap, and Which Lumps and Swellings Need a Diagnosis Before Any Cosmetic Plan

Most of the public conversation about genital cosmetic surgery is about the inner labia. The outer labia, the labia majora, change too, and they change in both directions: some deflate and wrinkle after menopause, childbirth, or major weight loss, while others carry excess fat and skin that bulges in fitted clothing. The procedures sold for them range from fat grafting and off-label filler to surgical reduction and radiofrequency devices the FDA has warned about. Here is what the labia majora are, why they change, what each option can realistically do, where the complications come from, and why a one-sided swelling or a shrinking, itchy vulva is a diagnosis to make before anyone talks about rejuvenation.

October 18, 2026 · 14 min

The City Guides

Top surgeons, city by city.

Short, considered editorial picks for the cities where aesthetic medicine has the highest concentration of practitioners doing distinct work. We add a city when we have done the reporting, not before.

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§ 01 · Editorial Standards

Choosing a plastic surgeon is among the few decisions that cannot be appealed. It deserves real reporting, not advertising dressed as a recommendation.

Top 3 Plastic Surgeons is an independent publication covering aesthetic and plastic surgery: the procedures, the advances in technique, and the surgeons doing the most considered work in the field. We report on it. We do not sell placement within it.

We do not accept paid placement, and we do not rank by advertising spend or by the volume of five-star reviews a practice can solicit. Our reporting draws on board records, peer interviews, outcomes data, and direct patient testimony, revisited as the field changes.

§ 05 · The Letter

One letter, every Sunday.

Each issue carries one new surgeon profile, one dispatch from the reporting desk, and an editor's note on whatever question we could not stop thinking about that week. No sponsors. No partner content. No reason to exist except the subject.

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