Abstract:
It is perceived that fuller lips are more attractive, and hence lip augmentation has become common in esthetic plastic surgery. Numerous materials have been used, including collagen, autologous adipocytes, and more recently Restylane; however, little data exist on what comprises esthetically beautiful lips. Photographs of 28 models from fashion magazines were scanned to obtain digital images. These were selected strictly, using only exactly anterior-facing pictures. Using image analysis software, a range of defined lengths, angles, the lip area, and perimeter were measured. Lengths were expressed as a ratio of the intercanthal distance. A group of 14 nonmodel hospital employees were used as controls, with images obtained using a digital camera, and the same measurements were calculated. Results were compared for the two groups, and statistical analysis was performed using the Student's t-test. Overall lip width was not significantly different between the two groups (models, 15.7 units; nonmodels, 15.9 units). Both upper- and lower-lip height was significantly greater in models than in nonmodels (models, 2.1 and 3.6 units; nonmodels, 1.6 and 2.7 units, respectively), as was the upper-lip height laterally at the point of the angle of cupid's bow. Correspondingly, the angles of both upper and lower lips were also greater in models (models, 30.0° and 47.3° nonmodels, 23.2° and 37.6°, respectively). We have assumed the model group to have esthetically beautiful lips. Our quantitative measurements have confirmed that this population has fuller lips compared with nonmodel controls, as determined by the lip height and angles.

Excepts

Introduction: The face is divided into thirds, with the lips comprising the key esthetic feature of the lower third, with the upper lip especially having a significant effect on the esthetic judgment of the face. Traditionally, fuller lips have been considered more beautiful; indeed, Peck and Peck3 suggested that the esthetically attractive Caucasian face demonstrated fuller lips than the norm. Links have been made with voluptuousness, sensuality, and youthfulness, such signs of fertility being strong evolutionary influences on what is considered attractive. Resulting from this, there has been a gradual increase in lip prominence among models in the last century, and currently, lip augmentation procedures have become common in esthetic plastic surgery. Many techniques have been developed, all of which aim to provide fuller, larger lips. Very little exists in the literature as to what comprises beautiful lips, and the few studies that have focused on lip esthetics have concentrated on profile views or measurements.
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In general, the facial features of models are more attractive than those employed in other occupations. By comparing measurements of models with those of a group of nonmodels, we aimed to examine the esthetic properties of lips and the perioral region from the frontal view and to determine whether the data obtained could be used in our clinical practice.
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Discussion:
We have used a straightforward method to quantitatively evaluate the relative proportions of the perioral region in a group of models and then compare them with a control group of normal subjects. Women have been highlighting their lips since ancient times with face paints or rouge, lipsticks now being a major part of the cosmetics industry. It is well documented that lips become thinner and less well defined as a result of the aging process, and youthful and beautiful lips are therefore considered to be those that appear full and rounded. Esthetic surgery can provide fuller lips through various augmentation procedures; however, there is very little scientific data concerning lip beauty. In our group of models, certain lengths and angles were significantly greater than in the controls, and these were all measurements that can be directly related to the degree of lip fullness or size. The upper- and lower-lip heights in particular, in conjunction with larger upper- and lower-lip angles, suggest full, rounded lips.
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We have not found any previous studies in the literature that examine lip measurements from the frontal view. Peck and Peck proposed that the esthetic Caucasian face had fuller lips than normal, and Sutter and Turley measured a series of lengths and angles from profile photographs, finding slightly fuller lips in Caucasian models than in controls. This was less apparent in African-American models when compared with African-American controls. There appears to be a trend for Caucasian models to have increasingly fuller lips during the last century, as demonstrated by Auger and Turley again from profile photographs. Interestingly, this was also found to hold true for male Caucasian models. It appears, therefore, from the literature that the lips of models, and hence extrapolating from this, those lips considered to be beautiful, are larger and fuller. This has been confirmed by our data examining frontal views.
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Conclusions:
In summary, we have confirmed the commonly held belief that fuller lips are more esthetically beautiful by comparing model lips with those of nonmodels, using image analysis software to analyze AP facial photographs. By applying a similar technique to a series of patients undergoing augmentation procedures, we have highlighted a number of key clinical issues surrounding lip augmentation by using quantitative data.
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