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Top 3 Plastic Surgeons

An independent publication on aesthetic and plastic surgery

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The Lead · Procedure Deep-Dive

Pacemakers, Defibrillators, and Cosmetic Surgery: Why Electrocautery Can Silence a Pacemaker or Trigger a Shock, What the Device Plan Should Look Like, Which Radiofrequency and Muscle-Stimulation Treatments Are Off Limits, and How Breast and Chest Surgery Works Around the Pocket

Millions of people live with a pacemaker, an implantable defibrillator, or another cardiac device, and many of them are exactly the age at which facelifts, eyelid surgery, and skin tightening start to sound appealing. Most can have cosmetic surgery safely. But the electrical cautery used in nearly every operation can confuse these devices, several popular energy-based skin treatments list them as a contraindication, and surgery on the chest wall has to respect a pocket and a set of leads that were never meant to be disturbed. Here is how electrical interference actually happens, what a proper pre-operative device plan includes, which aesthetic treatments are and are not compatible, how breast and chest procedures are adapted, and what should happen before the patient goes home.

October 13, 2026

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By The Editorial Desk

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17 min

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A woman in her late twenties with dark shoulder-length hair, wearing a soft grey crewneck sweater, standing in a bright room beside a window with dried pampas grass behind her, resting her fingertips at her chin and smiling slightly toward the camera

Procedure Deep-Dive

Perioral Dermatitis: Why a Rash Around the Mouth Gets Worse With Hydrocortisone, How Heavy Creams and Post-Procedure Ointments Set It Off, What Actually Clears It, and When to Postpone Lip Filler, Peels, and Lasers

Perioral dermatitis is a stubborn eruption of small red bumps around the mouth, the sides of the nose, and sometimes the eyes, and it is one of the most commonly mistreated rashes in dermatology because the cream most people reach for first, a steroid, makes it look better for a week and then much worse. It also turns up in cosmetic patients more often than they expect, after occlusive aftercare ointments, nasal steroid sprays, and a season of new serums. Here is what it is, what triggers it, why stopping the steroid causes a flare, which prescriptions have evidence behind them, how it is told apart from cold sores, acne, and rosacea, and how it changes the timing of lip filler, peels, and laser work.

October 13, 2026 · 15 min

A Black man in his early thirties with a closely trimmed short beard, wearing a plain charcoal crewneck sweater, standing in a softly lit room with a pale wall and an arched doorway, hand raised with fingers curled beneath his chin, looking toward the camera

Procedure Deep-Dive

Razor Bumps and Ingrown Hairs: What Pseudofolliculitis Barbae Actually Is, Why Closer Shaving Makes It Worse, Which Creams and Lasers Help on Darker Skin, and How to Handle Hair Removal Before and After Surgery

Razor bumps are not acne and not a hygiene problem. They are a foreign-body reaction to a person's own hair, curling back or slicing sideways into the skin after a close shave, and they leave dark marks and sometimes raised scars that outlast the bumps by months. Here is how pseudofolliculitis barbae works, who gets it, why the five-blade razor is part of the problem, what the evidence says about shaving technique, retinoids, eflornithine, and laser hair removal on deeper skin tones, how to tell it apart from folliculitis and its look-alikes, and why surgeons want clippers, not razors, anywhere near an incision.

October 13, 2026 · 15 min

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Procedure Deep-Dive

Enlarged Pores: Why They Look Bigger With Oil, Sun, and Age, Why Nothing Truly Shrinks Them, Which Retinoids, Lasers, and Microtox Injections Make a Visible Difference, and When One Big Pore Is Something Else

Visible pores on the nose, cheeks, and forehead are one of the most common reasons people book a facial, buy a serum, or ask a dermatologist about lasers, and one of the most heavily marketed problems in skin care. Pores do not open with steam or close with ice, and no product changes how many a person has. What changes is how much oil they hold, how much support the skin around them has, and how much light they catch. Here is what makes pores look large, which prescriptions and in-office treatments have evidence behind them, what pore strips and extractions actually remove, how deeper skin tones change the plan, and which 'big pores' are really a different diagnosis.

October 12, 2026 · 15 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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