A Quantitative Approach to Determining the Ideal Female Lip Aesthetic and Its Effect on Facial Attractiveness.

IMPORTANCE: Aesthetic proportions of the lips and their effect on facial attractiveness are poorly defined. Established guidelines would aid practitioners in achieving optimal aesthetic outcomes during cosmetic augmentation. OBJECTIVE: To assess the most attractive lip dimensions of white women based on attractiveness ranking of surface area, ratio of upper to lower lip, and dimensions of the lip surface area relative to the lower third of the face. DESIGN, SETTING, AND PARTICIPANTS: In phase 1 of this study, synthetic morph frontal digital images of the faces of 20 white women ages 18 to 25 years old were used to generate 5 varied lip surface areas for each face. These 100 faces were cardinally ranked by attractiveness through our developed conventional and internet-based focus groups by 150 participants. A summed ranking score of each face was plotted to quantify the most attractive surface area. In phase 2 of the study, 4 variants for each face were created with 15 of the most attractive images manipulating upper to lower lip ratios while maintaining the most attractive surface area from phase 1. A total of 60 faces were created, and each ratio was ranked by attractiveness by 428 participants (internet-based focus groups). In phase 3, the surface area from the most attractive faces was used to determine the total lip surface area relative to the lower facial third. Data were collected from March 1 to November 31, 2010, and analyzed from June 1 to October 31, 2016. MAIN OUTCOMES AND MEASURES: Most attractive lip surface area, ratio of upper to lower lip, and dimension of the lips relative to the lower facial third. RESULTS: In phase 1, all 100 faces were cardinally ranked by 150 individuals (internet-based focus groups [n = 130] and raters from conventional focus groups [conventional raters] [n = 20]). In phase 2, all 60 faces were cardinally ranked by 428 participants (internet-based focus groups [n = 408] and conventional raters [n = 20]). The surface area that corresponded to the range of 2.0 to 2.5 × 104 pixels represented the highest summed rank, generating a pool of 14 images. This surface area was determined to be the most attractive and corresponded to a 53.5% increase in surface area from the original image. With the highest mean and highest proportions of most attractive rankings, the 1:2 ratio was deemed most attractive. Conversely, the ratio of 2:1 was deemed least attractive, having the lowest mean at 1.61 and the highest proportion of ranks within 1 with 310 votes (72.3%). CONCLUSIONS AND RELEVANCE: Using a robust sample size, this study found that the most attractive lip surface area represents a 53.5% increase from baseline, an upper to lower lip ratio of 1:2, and a surface area equal to 9.6% of the lower third of the face. Lip dimensions and ratios derived in this study may provide guidelines in improving overall facial aesthetics and have clinical relevance to the field of facial plastic surgery. LEVEL OF EVIDENCE: NA.

The virtual focus group: a modern methodology for facial attractiveness rating.

BACKGROUND: Traditional focus groups have been essential to facial aesthetics research. Although they are currently the criterion standard in acquiring facial attractiveness ratings, they retain many shortcomings. This study's objectives were twofold: to determine whether attractiveness scores obtained from a social network site correlate with those from the traditional focus group method; and to evaluate whether this methodology could be a superior tool in evaluating facial attractiveness. METHODS: Forty facial portraits were rated for attractiveness scores using three different subject recruitment methods: traditional live focus groups (n = 123 raters), Internet-based rating (n = 857 raters), and a novel method using a combination of focus groups and a social network site (i.e., Facebook) (n = 1775 raters). Each facial image was scored on a 10-point Likert scale. Regression analysis compared each approach to the traditional method. RESULTS: The methods varied in terms of data accrual time, rater demographics/ages, researcher's accessibility, necessity for subject incentives, researcher labor, and rater effort/accuracy. A strong correlation (0.922) existed between the online social network-based rating and focus group method. A minimum of 992 raters achieved stabilization of the attractiveness scores using social network-based rating. CONCLUSIONS: This study shows significant advantages to using a social network site-based method over both Internet-based rating and traditional focus groups for evaluating facial attractiveness. The main benefits include exponential increase in raters, minimized researcher time/labor, rater scores comparable to those of the focus group method, nonnecessity of rater monetary incentives, and selectable demographics/ages of raters.

Nasal tip projection and facial attractiveness.

OBJECTIVES/HYPOTHESIS: Six nasal tip projection (NTP) ratios from Goode, Simons, Baum, Powell, and Crumley guide clinical and academic practice on quantifying NTP, but none have been empirically correlated with facial attractiveness. This study's objectives were to determine: 1) if there is a correlation between these ratios and facial attractiveness; and 2) which of the six ratios has the greatest linkage to overall facial attractiveness. STUDY DESIGN: Basic research study. METHODS: There were 300 digital portraits of women (ages 18-25 years) randomly paired and morphed to create 300 synthetic lateral facial images rated by 78 raters in the community. NTP ratios were measured in each portrait. RESULTS: None of the ratios correlated with facial attractiveness. For the Baum, Powell, and Simons ratio, facial attractiveness increased as NTP deviated 1 and 2 standard deviations from the ideal, whereas facial attractiveness decreased as NTP deviated from the Goode and Crumley ideal ratios. The most attractive faces had NTP ratios consistent with previous expert opinion findings. CONCLUSIONS: To our knowledge, this is the first study to empirically correlate these six landmark NTP ratios with facial attractiveness. Although there was no correlation with any of the six ratios, the ideal ratios proposed by Goode and Crumley impacted facial aesthetics the most. Although the ideal ratios are useful in establishing rhinoplasty guidelines, they should only be used as a part of the management in achieving an aesthetic face on the whole, as they may not be robust enough to correlate with overall facial attractiveness.