The Research Behind an Anatomy-Driven Approach Publications & Research

Ari M. Wes, MD
Last updated: September 2, 2026

The Research Behind an Anatomy-Driven Approach

With more than 50 peer-reviewed publications, Ari M. Wes, MD has studied how facial structure, movement, surgical risk, and long-term outcomes shape plastic surgery. The 20 papers below begin with research most relevant to aesthetic patients, then trace the broader craniofacial and reconstructive foundation behind his approach. Explore the broader PubMed bibliography.

Research cannot predict an individual patient’s result. It can, however, sharpen the questions a surgeon asks about anatomy, movement, risk, and how results change over time. Learn more about training and clinical practice.

Research at a glance

RESEARCH AREA

Facial aesthetics and perception
Aesthetic-surgery safety
Craniofacial anatomy and outcomes
Reconstruction and microsurgery
Surgeon ergonomics

REPRESENTATIVE EVIDENCE

Studies involving 490 lay raters, 476 blinded raters, and dynamic three-dimensional facial imaging
National analyses of 17,774 body-contouring patients and 10,669 plastic-surgery procedures
Multicenter morphology studies and cohorts followed for long-term aesthetic and functional outcomes
A 5,000-free-flap institutional review plus breast-reconstruction outcome studies
A 2024 systematic review of ergonomic practices and interventions

WHY IT MATTERS

Examines how proportion, movement, and surgical change affect facial perception
Identifies measurable risks that can inform counseling, prevention, and follow-up
Connects anatomy and surgical planning with how results evolve over time
Reflects experience evaluating complex reconstruction, perfusion, complications, and cost
Addresses surgeon health and the sustainability of operative practice

Facial aesthetics, perception, and dynamic anatomy

Related WPS resources: facelift surgerydeep-plane facelift, and male facial surgery.

These studies explore how proportion, facial structure, and movement affect the way a face is seen. They have influenced how Dr. Ari Wes thinks about facial balance, but they do not predict an individual patient’s result or suggest that surgery can change someone’s personality.

More Than Meets the Eye: The Effect of Intercanthal Distance on Perception of Beauty and Personality

More Than Meets the Eye: The Effect of Intercanthal Distance on Perception of Beauty and Personality

Journal of Craniofacial Surgery (2018)
PubMed · DOI

What can facial spacing teach us about aesthetic planning?

Beauty is not a single equation. When 490 people viewed digitally altered photographs of 16 women, changing only the space between the eyes affected how they perceived the same face. The study does not propose changing that distance cosmetically. It shows how much our impression of a face depends on the relationship between its features.

Why this matters in practice: Planning should not begin with an isolated measurement or a universal ideal. It should begin with how the eyes, nose, cheeks, jawline, and other features relate to one another—so the result improves balance while preserving the face people recognize as their own.

Orthognathic Surgery Has a Significant Effect on Perceived Personality Traits and Emotional Expressions

Plastic and Reconstructive Surgery (2017)
PubMed · DOI

Can changes in facial structure affect first impressions?

Facial structure can influence more than whether someone is considered attractive. When 476 people viewed photographs of 20 patients before and after jaw surgery, the postoperative images were perceived more favorably across 12 traits and emotions. Surgery did not change anyone’s personality; the study shows how facial balance can shape a stranger’s first impression.

Why this matters in practice: Planning should consider how a structural change affects the whole face—not just one fold, feature, or angle. The aim is natural facial balance and a result that remains recognizably the patient, rather than trying to manufacture a particular social impression.

Quantified Facial Soft-Tissue Strain in Animation Measured by Real-Time Dynamic Three-Dimensional Imaging

Plastic and Reconstructive Surgery – Global Open (2014)
PubMed · DOI

Why should facial aging be evaluated in motion?

Your face is never truly still. Using three-dimensional imaging, this pilot study found more stretching and asymmetry around the mouth and smile lines in participants older than 40. The study involved only 13 adults, but it illustrates something photographs can miss: facial aging changes how tissues move, not only how they look at rest.

Why this matters at Wes Plastic Surgery: Dr. Ari Wes evaluates the face both at rest and during expression. Watching a patient smile, speak, and animate helps him understand how the tissues move together and supports a surgical plan intended to preserve natural expression rather than optimize a single frozen view.

Aesthetic-surgery outcomes and patient safety

Related WPS resources: body procedures and breast procedures.

Venous Thromboembolism in Body Contouring: An Analysis of 17,774 Patients from the National Surgical Quality Improvement Databases

Plastic and Reconstructive Surgery (2015)
PubMed · DOI

Among 17,774 body-contouring patients, venous thromboembolism occurred in 0.56%. Incidence ranged from 0.14% in the study’s low-risk group to 2.95% in its high-risk group; age, obesity, trunk contouring, and inpatient admission were associated with increased odds. These findings support individualized risk assessment and prevention.

Complications in Body Contouring Procedures: An Analysis of 1,797 Patients from the 2005 to 2010 American College of Surgeons National Surgical Quality Improvement Program Databases

Plastic and Reconstructive Surgery (2013)
PubMed · DOI

In this national analysis of 1,797 body-contouring patients, 6.3% experienced a minor wound complication, 6.8% experienced major surgical morbidity, and 2.2% experienced a medical complication. The findings highlight the importance of preoperative evaluation, nutritional status, functional status, and detailed risk counseling.

The Impact of Surgical Resident Participation in Breast Reduction Surgery: Outcome Analysis from the 2005–2011 ACS-NSQIP Datasets

Journal of Plastic Surgery and Hand Surgery (2014)
PubMed · DOI

This propensity-matched analysis included 4,328 breast-reduction patients. Resident participation occurred in 56.3% of cases and was associated with higher odds of major surgical complications in the matched cohort, while greater resident experience was associated with lower risk.

Does Breast Reconstruction Impact the Decision of Patients to Pursue Cosmetic Surgery?

Annals of Plastic Surgery (2014)
PubMed · DOI

Of 1,214 breast-reconstruction patients, 113 (9.3%) later underwent cosmetic surgery. Among 42 survey respondents, the most common motivation was improving self-image (61.9%), and body-image satisfaction increased significantly after cosmetic surgery. The study explored how reconstructive and aesthetic goals may intersect for some patients.

Factors Associated with Readmission Following Plastic Surgery: A Review of 10,669 Procedures from the 2011 American College of Surgeons National Surgical Quality Improvement Program Data Set

Plastic and Reconstructive Surgery (2013)
PubMed · DOI

Across 10,669 plastic-surgery procedures, the readmission rate was 4.5%. Postoperative complications were the strongest predictor: patients with surgical complications were six times more likely to be readmitted. The findings support careful risk counseling, discharge planning, and postoperative follow-up.

Craniofacial anatomy, function, and long-term outcomes

These papers represent Dr. Wes’s broader foundation in facial structure, growth, function, and long-term evaluation. Several concern congenital pediatric conditions rather than adult cosmetic surgery. Their relevance here is the larger lesson: anatomy changes over time, and the quality of a surgical result cannot always be judged in its earliest months. Learn more about Dr. Wes.

A Critical Evaluation of Long-Term Aesthetic Outcomes of Fronto-Orbital Advancement and Cranial Vault Remodeling in Nonsyndromic Unicoronal Craniosynostosis

Plastic and Reconstructive Surgery (2015)
PubMed · DOI

Why should surgical results be judged over years rather than months?

A result that looks successful soon after surgery may continue to change for years. In this study of 207 pediatric craniofacial patients, those followed for at least five years were more likely to develop visible contour changes. Although this was not facelift research, it demonstrates why surgical quality cannot be judged from early postoperative photographs alone.

Why this matters in practice: Aesthetic planning should account for how tissues heal and age. Patients should understand that results continue to evolve, and durable balance matters more than an early result designed primarily to look impressive in photographs.

An Evaluation of Complications, Revisions, and Long-Term Aesthetic Outcomes in Nonsyndromic Metopic Craniosynostosis

Plastic and Reconstructive Surgery (2014)
PubMed · DOI

Is avoiding an early complication enough to define a successful result?

Avoiding an early complication is not the same as achieving a result that holds up over time. This study followed 147 pediatric craniofacial patients and found more contour changes among those seen beyond five years. It was not a study of cosmetic surgery, but the distinction between immediate safety and lasting quality applies broadly.

Why this matters in practice: A technically uncomplicated operation is only one part of success. A result must also remain balanced as swelling resolves, scars mature, tissues settle, and natural aging continues. That distinction is central to an honest conversation about what a good long-term result means.

Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment

Plastic and Reconstructive Surgery – Global Open (2023)
PubMed · DOI

This multicenter study characterized the facial and cranial morphology associated with unilateral lambdoid craniosynostosis, including displacement of the ear, nasal root, and chin.

A Quantification of Scalp Thickness Before and After Posterior Vault Distraction Osteogenesis

Plastic and Reconstructive Surgery (2022)
PubMed · DOI

This study quantified changes in scalp soft-tissue thickness after cranial-vault distraction, connecting skeletal movement with the behavior of the overlying soft-tissue envelope.

Forces Exerted in Craniofacial Distraction Osteogenesis

Journal of Craniofacial Surgery (2022)
PubMed · DOI

This study measured the mechanical forces involved in craniofacial distraction, adding quantitative evidence to the planning and execution of controlled skeletal movement.

Long-Term Speech Outcomes Following Midface Advancement in Syndromic Craniosynostosis

Journal of Craniofacial Surgery (2020)
PubMed · DOI

This study examined long-term speech outcomes after midface advancement, emphasizing that facial surgery should be evaluated for functional as well as structural results.

Strabismus in Unicoronal Craniosynostosis: Effect of Orbital Dysmorphology and Fronto-Orbital Advancement and Remodeling

Plastic and Reconstructive Surgery (2020)
PubMed · DOI

This research connected three-dimensional orbital anatomy and craniofacial reconstruction with ocular-alignment outcomes.

Quality of Life in Adults with Nonsyndromic Craniosynostosis

Plastic and Reconstructive Surgery (2018)
PubMed · DOI

This study extended outcome assessment beyond operative measurements to examine long-term quality of life in adults born with nonsyndromic craniosynostosis.

Reconstructive surgery and microsurgery

Related WPS resource: breast procedures.

5000 Free Flaps and Counting: A 10-Year Review of a Single Academic Institution’s Microsurgical Development and Outcomes

Plastic and Reconstructive Surgery (2018)
PubMed · DOI

This 10-year institutional review examined the evolution, scale, and outcomes of a high-volume microsurgical program across 5,000 free-flap reconstructions.

Intraoperative Perfusion Management Impacts Postoperative Outcomes: An Analysis of 682 Autologous Breast Reconstruction Patients

Journal of Plastic, Reconstructive & Aesthetic Surgery (2015)
PubMed · DOI

This study evaluated the relationship between intraoperative perfusion management and postoperative outcomes in 682 autologous breast-reconstruction patients.

Propensity-Matched, Longitudinal Outcomes Analysis of Complications and Cost: Comparing Abdominal Free Flaps and Implant-Based Breast Reconstruction

Journal of the American College of Surgeons (2014)
PubMed · DOI

This longitudinal, propensity-matched study compared complications and costs between autologous abdominal free-flap and implant-based breast reconstruction.

Surgical ergonomics

Ergonomic Practices and Interventions in Plastic and Reconstructive Surgery: A Systematic Review

Journal of Plastic, Reconstructive & Aesthetic Surgery (2024)
PubMed · DOI

This systematic review evaluated ergonomic risks and interventions in plastic and reconstructive surgery, addressing surgeon health and the sustainability of operative practice.

Frequently asked questions about Dr. Wes’s research

How These Papers Were Chosen

Rather than reproduce an entire academic bibliography, this page highlights 20 studies chosen for their relevance to aesthetic patients, clinical importance, strength of evidence, scale, recency, and breadth. Facial aesthetics and surgical safety appear first, followed by the craniofacial and reconstructive research that informs a broader understanding of anatomy and long-term outcomes.