Oral and maxillofacial surgery
Assessing the influence of lower facial profile convexity on perceived attractiveness in the orthognathic patient, clinician, and layperson

https://doi.org/10.1016/j.tripleo.2011.07.031Get rights and content

Objective

The aim was a quantitative evaluation of how the severity of lower facial profile convexity influences perceived attractiveness.

Study Design

The lower facial profile of an idealized image was altered incrementally between 14° to −16°. Images were rated on a Likert scale by orthognathic patients, laypeople, and clinicians.

Results

Attractiveness ratings were greater for straight profiles in relation to convex/concave, with no significant difference between convex and concave profiles. Ratings decreased by 0.23 of a level for every degree increase in the convexity angle. Class II/III patients gave significantly reduced ratings of attractiveness and had greater desire for surgery than class I.

Conclusions

A straight profile is perceived as most attractive and greater degrees of convexity or concavity deemed progressively less attractive, but a range of 10° to −12° may be deemed acceptable; beyond these values surgical correction is desired. Patients are most critical, and clinicians are more critical than laypeople.

Section snippets

Materials and Methods

Ethical approval was sought and granted for the study (National Research Ethics Service, UK; REC reference 06/Q0806/46), and each subject in the study signed a detailed informed consent form.

Results

All the laypeople and the clinicians were skeletal class I, whereas 96% of the patients were class II or III (Table II). There was no significant difference in perceptions of attractiveness between observers with class II and III jaw relationships (P = .91) but they appeared to differ significantly from those with skeletal class I. When skeletal class was fitted on the patient group alone, no difference was detected between classes II and III (P = .86).

Discussion

The angle of profile convexity was found to have a highly significant association with ratings of attractiveness. The mean rating for attractiveness was greater for images with a straight profile compared with those with any degree of convexity or concavity; no significant differences were found between convex and concave lower facial profiles.

Ratings for attractiveness decreased for every degree increase in the facial profile convexity angle; this effect was slightly more marked for section 1.

Conclusions

  • Convexity of the lower face is perceived as significant at 10° and concavity at −12°; between these values, the lower facial profile contour may be deemed to be within normal limits in terms of observer perception.

  • The greater the angle of profile convexity past 10° convexity and −12° concavity, the more noticeable.

  • From 10° of convexity and −12° of concavity, patients desire treatment.

  • The angle of facial profile convexity has a highly significant association with ratings of attractiveness, with

References (29)

  • J.D. Subtelny

    A longitudinal study of soft tissue facial structures and their profile characteristics, defined in relation to underlying skeletal structures

    Am J Orthod

    (1959)
  • F.B. Naini

    Facial aesthetics: concepts and clinical diagnosis

  • H. Ioi et al.

    Effect of facial convexity on antero-posterior lip positions of the most favored Japanese facial profiles

    Angle Orthod

    (2005)
  • L.G. Farkas

    Anthropometry of the attractive North American caucasian face

  • Cited by (37)

    • Perceived treatment need in patients with different facial profiles

      2020, Journal of the World Federation of Orthodontists
      Citation Excerpt :

      Many studies reported that the PTN of clinicians differed from laypeople and the PTN of laypeople was also dissimilar from patients [7–13]. Clinicians are less tolerant of profile changes, more sensitive in their judgment of facial profiles, have a greater ability to discriminate changes in the profile, and have a tendency to indicate surgery in a greater number of cases compared with laypeople [7,9,10]. In addition, laypeople are less accurate in their perception of their own profile and less critical when assessing attractiveness based on facial profile convexity and mandibular prominence compared with patients [10,12,13].

    • Esthetic perception of facial profile contour in patients with different facial profiles

      2019, Journal of the World Federation of Orthodontists
      Citation Excerpt :

      Facial contour angle was used because it is significantly associated with the rating of attractiveness. As the degrees of convexity or concavity increase, the attractiveness rating decreases [1,2,4]. The participants were asked to review their own facial profiles before responding to the questionnaires to recognize their self-perception, because most people rarely see their faces in this view.

    • Assessing the influence of chin prominence on profile esthetics: A survey study

      2018, Journal of Cranio-Maxillofacial Surgery
      Citation Excerpt :

      As with all facial parameters, a normative value is available for chin prominence. In clinical evaluation, the amount of deviation from the normative value guides the process of deciding to perform surgery (Naini et al., 2012a, 2012b, 2012c, 2012d). Therefore, the aim of this cross-sectional study was to identify the cut-off point from which surgery is desired in a large group of participants by detecting upper and lower limits of the chin prominence for an ideal profile, and by quantitatively evaluating the influence of sagittal chin prominence on the perception of attractiveness in males and females.

    • Clinician, dental student, and orthognathic patient perception of black-and-white silhouette lateral profile dimensions of ideal chin position in a Chinese population

      2018, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
      Citation Excerpt :

      Male and female facial profile silhouette images11,16,22-26 were created by using Adobe Photoshop CS6 software (Adobe Systems Inc., San Jose, CA) based on norms of soft tissue measurements and proportions20 (Figure 1).

    View all citing articles on Scopus
    View full text