Since then he has undertaken thousands of facial surgery procedures and is now the head of department of Facial and Head and neck Surgery with a special interest in cosmetic facial surgery for which he is the regional trainer. Mr Guest has  published in peer reviewed journals on Head and Neck cancer, Facial Deformity, Reconstructive Surgery, Cosmetic Facial  Surgery and has an international reputation as an invited speaker on Aesthetic and Cosmetic facial plastic surgery. He is a regional trainer for facial aesthetic surgery and runs nationally recognised courses in facial plastic surgery. Mr Guest is also the lead clinician for Head and Neck Cancer for the United Bristol Healthcare Trust, and is the site specific cancer lead. He is on the national executive committee of the Association of Facial Plastic Surgeons.