Senior Editor · Editorial Staff

Orson Wickham

Leads the publication's coverage of plastic surgery and edits every story for accuracy and plain English.

13 dispatches by Orson Wickham

Industry · June 8, 2026

Outpatient Surgical Facility Accreditation: What Patients Should Actually Ask

Most cosmetic surgery in the United States happens outside a hospital, in an office or an ambulatory surgery center, and the single best predictor of whether that room is safe is its accreditation. AAAASF, AAAHC, and Joint Commission are not interchangeable logos. They are three distinct standards, and the difference between an accredited facility and an unaccredited back room is, in the data, the difference between a routine recovery and a catastrophe. Here is what the credentials mean and the exact questions to ask before you let anyone put you under.

Procedure Deep-Dive · June 7, 2026

Biostimulatory Fillers vs Hyaluronic Acid: Why the Two Injectables Work Nothing Alike

Biostimulatory fillers vs hyaluronic acid is framed in most clinics as a menu choice, as if you are picking between two flavors of the same thing. You are not. One puts volume under your skin the moment the needle comes out. The other puts nothing visible in and instead provokes your own body to build collagen over months. Confusing the two is how patients end up disappointed by the right product used for the wrong reason.

Industry · June 7, 2026

Nutrition Before Plastic Surgery: The Pre-Op Variable Patients Underestimate

Pre-operative nutrition is the part of the surgical plan patients rarely hear about and surgeons increasingly insist on. Protein status, iron levels, and a handful of micronutrients do more to determine how an incision heals than almost anything a patient can buy at the pharmacy after the fact. The honest read is that nutrition is not a wellness add-on around plastic surgery. It is a measurable input to wound healing that the better practices now screen for before they pick a date.

Industry · June 6, 2026

BIA-ALCL: Where the Risk Picture Stands Now

Breast implant-associated anaplastic large cell lymphoma is a rare cancer of the immune system that develops in the scar capsule around a breast implant, and it has reshaped how surgeons talk about implant surface. The honest read is that the risk is real, it is concentrated almost entirely in textured implants, and it is highly treatable when caught early. What patients are owed is not reassurance but a specific conversation about surface, surveillance, and what to watch for.

Procedure Deep-Dive · June 6, 2026

Do Breast Implants Need to Be Replaced Every 10 Years? The Rule That Was Never a Rule

The idea that breast implants need to be replaced every ten years is one of the most durable myths in cosmetic surgery, and it costs patients money and operating-room time they may not owe. Here is what actually drives a replacement decision, what the FDA genuinely recommends, and why the age of the device is one of the least useful numbers in the conversation.

Procedure Deep-Dive · June 5, 2026

Fat Transfer to the Breast: What the 'Natural Alternative' Actually Delivers

Fat transfer to the breast gets sold as the natural alternative to implants, and the phrase does real work in a consultation room. It is also where most of the misunderstanding starts. Here is what the procedure can honestly do, the size ceiling nobody likes to lead with, and why the entire result hinges on a variable the surgeon only partly controls: how much of the transferred fat actually survives.

Procedure Deep-Dive · June 2, 2026

Old Stretch Marks That Will Not Fade: Why the Silver Ones Are the Hard Ones

Old stretch marks are sold the same creams as new ones, which is most of the problem. The faded silver kind have finished healing, lost their collagen, and stopped responding to anything you can buy at a counter. Treating them is possible, but only with tools that reach the dermis, and only if your expectations start from honest ground.

Industry · May 30, 2026

What Energy-Based Skin Tightening Actually Does

Radiofrequency, microfocused ultrasound, and laser devices promise to tighten skin without surgery, and the marketing around them has run well ahead of the evidence. The honest version is narrower and more useful: these tools produce real but modest changes for the right candidate, and they cannot do what a lift does. Knowing where the line sits is the entire decision.

Procedure Deep-Dive · May 29, 2026

VASER Lipo vs Traditional Liposuction: What the Ultrasound Actually Changes

VASER and traditional liposuction remove fat through different mechanisms. The marketing treats the difference as a tier upgrade. The honest version is that one tool buys precision in the superficial layer, and that precision only matters for a specific kind of patient and a specific kind of result.

Procedure Deep-Dive · May 28, 2026

Buttock Implants vs Fat Grafting: Two Different Materials, Two Different Risk Profiles, and the Body Type That Quietly Decides for You

Buttock implants and fat grafting both add volume to the same place, but they use different materials, carry different risks, and are not equally available to every patient. Here is what each procedure actually does, why your body fat percentage narrows the choice before you do, and the honest tradeoff between a predictable result and a natural one.

Procedure Deep-Dive · May 23, 2026

Injectables Before a Big Event: How Long You Actually Need, and Why a Week Is the Floor Not the Target

Booking Botox or filler the week of a wedding is the most common timing mistake in aesthetic medicine. Here is how long injectables before a big event actually take to look right, why the published week-before advice is a minimum, and the one decision good timing can never rescue.

Procedure Deep-Dive · May 20, 2026

The Lower Face at Forty: How Surgeons Read the Early Jawline

Early jowling is not a single problem. It is three distinct changes happening at slightly different rates, and the procedure that addresses one of them is the wrong answer for the other two.

Editorial Standards · May 1, 2026

Board Certification Is the Floor. Here Is What We Look for Above It.

Every surgeon we list is board-certified. So is every surgeon we declined. The credential is necessary and almost entirely uninformative. What comes next is the actual reporting.

All dispatches