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Facial Plast Surg 2025; 41(04): 503-509
DOI: 10.1055/a-2419-9961
Original Research

Ethnic Considerations When Planning Lip Augmentation

Tiffanie-Marie Borg
1   Plastic Surgery Department, Royal Victoria Infirmary, Newcastle, United Kingdom
,
Jennifer Mackay
1   Plastic Surgery Department, Royal Victoria Infirmary, Newcastle, United Kingdom
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Abstract

Ideal standards of beauty including preferred lip characteristics vary between ethnicities. Although plump, well-defined lips are globally associated with youth, variation exists with regard to the perceived ideal lip volume and proportions between ethnicities. Proportions that may be assessed when planning lip augmentation include the upper-to-lower lip ratio, philtrum length, upper and lower vermilion heights, the ratio between the philtrum height and that of the upper vermilion, and the lip height-to-lip width ratio.

It is important that accurate assessments of patients are made pre- and postaugmentation. However, many aesthetic assessment tools are based on Caucasian models with limited use in other ethnicities. We present a review of the ideal lip characteristics and assessment techniques accounting for ethnicity, with a view to providing practitioners an evidence-based approach to lip assessment and treatment planning for patients of all backgrounds.

Keywords

lip aesthetics - lip proportions - lip augmentation


Publication History

Accepted Manuscript online:
23 September 2024

Article published online:
15 October 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Grube GMA. Plato's theory of beauty. Monist 1927; 37 (02) 269-288
    Search in Google Scholar
  • 2 Joachim HH, Rees DA. Aristotle: the Nicomachean ethics. J Philos 1952; 49 (14) 484-485
    Search in Google Scholar
  • 3 Nascimento M. Aesthetical Beauty of Mathematics and the Pythagorean Theorem. DEStech Transactions on Social Science, Education and Human Science. 2018.
  • 4 Haxby JV, Hoffman EA, Gobbini MI. The distributed human neural system for face perception. Trends Cogn Sci 2000; 4 (06) 223-233
    Search in Google Scholar
  • 5 Little AC, Jones BC, DeBruine LM. Facial attractiveness: evolutionary based research. Philos Trans R Soc Lond B Biol Sci 2011; 366 (1571): 1638-1659
    Search in Google Scholar
  • 6 Todorov A, Olivola CY, Dotsch R, Mende-Siedlecki P. Social attributions from faces: determinants, consequences, accuracy, and functional significance. Annu Rev Psychol 2015; 66: 519-545
    Search in Google Scholar
  • 7 Clifford M, Walster E. The effect of physical attractiveness on teacher expectation. Sociol Educ 1974; 46: 248
    Search in Google Scholar
  • 8 Baldwin DC. Appearance and aesthetics in oral health. Community Dent Oral Epidemiol 1980; 8 (05) 244-256
    Search in Google Scholar
  • 9 Rhodes G. The evolutionary psychology of facial beauty. Annu Rev Psychol 2006; 57: 199-226
    Search in Google Scholar
  • 10 Naini FB, Moss JP, Gill DS. The enigma of facial beauty: esthetics, proportions, deformity, and controversy. Am J Orthod Dentofacial Orthop 2006; 130 (03) 277-282
    Search in Google Scholar
  • 11 Vucinic N, Tubbs RS, Eric M, Vujic Z, Maric D, Vukovic B. What do we find attractive about the face? Survey study with application to aesthetic surgery. Clin Anat 2019
    Search in Google Scholar
  • 12 Park JY, Hwang SW, Hwang K. Anthropometric comparison of painting portraits of beautiful women, femme fatales, and artists' mothers. J Craniofac Surg 2013; 24 (06) 2110-2114
    Search in Google Scholar
  • 13 Auger TA, Turley PK. The female soft tissue profile as presented in fashion magazines during the 1900s: a photographic analysis. Int J Adult Orthodon Orthognath Surg 1999; 14 (01) 7-18
    Search in Google Scholar
  • 14 Baudouin JY, Tiberghien G. Symmetry, averageness, and feature size in the facial attractiveness of women. Acta Psychol (Amst) 2004; 117 (03) 313-332
    Search in Google Scholar
  • 15 American Society of Plastic Surgeons. 2018 Plastic Surgery Statistics Report. ASPS National Clearinghouse of Plastic Surgery Procedural Statistics; 2018
    Search in Google Scholar
  • 16 Laing Buisson. Cosmetic Surgery UK Markeyt Report. 1st Edition. 2019. Accessible at: https://www.laingbuisson.com/press-releases/is-the-trend-for-cosmetic-surgery-changing/
  • 17 Rhee SC, Dhong ES, Yoon ES. Photogrammetric facial analysis of attractive Korean entertainers. Aesthetic Plast Surg 2009; 33 (02) 167-174
    Search in Google Scholar
  • 18 Ricketts RM. Divine proportion in facial esthetics. Clin Plast Surg 1982; 9 (04) 401-422
    Search in Google Scholar
  • 19 Edler RJ. Background considerations to facial aesthetics. J Orthod 2001; 28 (02) 159-168
    Search in Google Scholar
  • 20 Levin EI. Dental esthetics and the golden proportion. J Prosthet Dent 1978; 40 (03) 244-252
    Search in Google Scholar
  • 21 Lombardi RE. The principles of visual perception and their clinical application to denture esthetics. J Prosthet Dent 1973; 29 (04) 358-382
    Search in Google Scholar
  • 22 Ricketts RM. The golden divider. J Clin Orthod 1981; 15 (11) 752-759
    Search in Google Scholar
  • 23 Ricketts RM. The biologic significance of the divine proportion and Fibonacci series. Am J Orthod 1982; 81 (05) 351-370
    Search in Google Scholar
  • 24 Farkas LG, Hreczko TA, Kolar JC, Munro IR. Vertical and horizontal proportions of the face in young adult North American Caucasians: revision of neoclassical canons. Plast Reconstr Surg 1985; 75 (03) 328-338
    Search in Google Scholar
  • 25 Farkas LG, Sohm P, Kolar JC, Katic MJ, Munro IR. Inclinations of the facial profile: art versus reality. Plast Reconstr Surg 1985; 75 (04) 509-519
    Search in Google Scholar
  • 26 Farkas LG, Kolar JC. Anthropometrics and art in the aesthetics of women's faces. Clin Plast Surg 1987; 14 (04) 599-616
    Search in Google Scholar
  • 27 Kawakami S, Tsukada S, Hayashi H, Takada Y, Koubayashi S. Golden proportion for maxillofacial surgery in Orientals. Ann Plast Surg 1989; 23 (05) 417-425
    Search in Google Scholar
  • 28 Marquardt SR. Dr. Stephen R. Marquardt on the Golden Decagon and human facial beauty. Interview by Dr. Gottlieb. J Clin Orthod 2002; 36 (06) 339-347
    Search in Google Scholar
  • 29 Wiener RC, Wiener Pla RM. The occurrence of phi in dento-facial beauty of fine art from antiquity through the Renaissance. Eur J Esthet Dent 2012; 7 (04) 440-452
    Search in Google Scholar
  • 30 Bashour M. An objective system for measuring facial attractiveness. Plast Reconstr Surg 2006; 118 (03) 757-774 , discussion 775–776
    Search in Google Scholar
  • 31 Kim YH. Easy facial analysis using the facial golden mask. J Craniofac Surg 2007; 18 (03) 643-649
    Search in Google Scholar
  • 32 Veerala G, Gandikota CS, Yadagiri PK. et al. Marquardt's facial golden decagon mask and its fitness with South Indian Facial traits. J Clin Diagn Res 2016; 10 (04) ZC49-ZC52
    Search in Google Scholar
  • 33 Anand S, Tripathi S, Chopra A, Khaneja K, Agarwal S. Vertical and horizontal proportions of the face and their correlation to phi among Indians in Moradabad population: a survey. J Indian Prosthodont Soc 2015; 15 (02) 125-130
    Search in Google Scholar
  • 34 Holland E. Marquardt's phi mask: pitfalls of relying on fashion models and the golden ratio to describe a beautiful face. Aesthetic Plast Surg 2008; 32 (02) 200-208
    Search in Google Scholar
  • 35 Alam MK, Mohd Noor NF, Basri R, Yew TF, Wen TH. Multiracial facial golden ratio and evaluation of facial appearance. PLoS One 2015; 10 (11) e0142914
    Search in Google Scholar
  • 36 Packiriswamy V, Kumar P, Rao M. Identification of facial shape by applying golden ratio to the facial measurements: an interracial study in Malaysian population. N Am J Med Sci 2012; 4 (12) 624-629
    Search in Google Scholar
  • 37 Jang KS, Bayome M, Park JH, Park KH, Moon HB, Kook YA. A three-dimensional photogrammetric analysis of the facial esthetics of the Miss Korea pageant contestants. Korean J Orthod 2017; 47 (02) 87-99
    Search in Google Scholar
  • 38 Zhao Q, Zhou R, Zhang X. et al. Morphological quantitative criteria and aesthetic evaluation of eight female Han face types. Aesthetic Plast Surg 2013; 37 (02) 445-453
    Search in Google Scholar
  • 39 Hoefflin SM. The definition of facial beauty. In: Panfilov DE. ed. Aesthetic Surgery of the Facial Mosaic. Berlin, Heidelberg: Springer; 2006: 43-51
    Search in Google Scholar
  • 40 Ioi H, Kang S, Shimomura T. et al. Effects of vermilion height on lip esthetics in Japanese and Korean orthodontists and orthodontic patients. Angle Orthod 2014; 84 (02) 239-245
    Search in Google Scholar
  • 41 Laupacis A, Keown P, Pus N. et al. A study of the quality of life and cost-utility of renal transplantation. Kidney Int 1996; 50 (01) 235-242
    Search in Google Scholar
  • 42 Dobke M, Chung C, Takabe K. Facial aesthetic preferences among Asian women: are all oriental Asians the same?. Aesthetic Plast Surg 2006; 30 (03) 342-347
    Search in Google Scholar
  • 43 Heidekrueger PI, Szpalski C, Weichman K. et al. Lip attractiveness: a cross-cultural analysis. Aesthet Surg J 2017; 37 (07) 828-836
    Search in Google Scholar
  • 44 Burusapat C, Lekdaeng P. What is the most beautiful facial proportion in the 21st century? Comparative study among Miss Universe, Miss Universe Thailand, neoclassical canons, and facial golden ratios. Plast Reconstr Surg Glob Open 2019; 7 (02) e2044
    Search in Google Scholar
  • 45 Kempa J, Alfertshofer M, Chua D, Timler W, Cotofana S, Kasielska-Trojan A. Influence of ethnicity on aesthetic preference for lip characteristics in Caucasian male and female faces. J Plast Reconstr Aesthet Surg 2024; 95: 185-189
    Search in Google Scholar
  • 46 Bisson M, Grobbelaar A. The esthetic properties of lips: a comparison of models and nonmodels. Angle Orthod 2004; 74 (02) 162-166
    Search in Google Scholar
  • 47 Popenko NA, Tripathi PB, Devcic Z, Karimi K, Osann K, Wong BJF. A quantitative approach to determining the ideal female lip aesthetic and its effect on facial attractiveness. JAMA Facial Plast Surg 2017; 19 (04) 261-267
    Search in Google Scholar
  • 48 Sito G, Consolini L, Trévidic P. Proposed guide to lip treatment in Caucasian women using objective and measurable parameters. Aesthet Surg J 2019; 39 (12) NP474-NP483
    Search in Google Scholar
  • 49 Sforza C, Laino A, D'Alessio R, Grandi G, Binelli M, Ferrario VF. Soft-tissue facial characteristics of attractive Italian women as compared to normal women. Angle Orthod 2009; 79 (01) 17-23
    Search in Google Scholar
  • 50 Jayaratne YS, Deutsch CK, Zwahlen RA. A 3D anthropometric analysis of the orolabial region in Chinese young adults. Br J Oral Maxillofac Surg 2013; 51 (08) 908-912
    Search in Google Scholar
  • 51 Gao Y, Niddam J, Noel W, Hersant B, Meningaud JP. Comparison of aesthetic facial criteria between Caucasian and East Asian female populations: an esthetic surgeon's perspective. Asian J Surg 2018; 41 (01) 4-11
    Search in Google Scholar
  • 52 Wong WW, Davis DG, Camp MC, Gupta SC. Contribution of lip proportions to facial aesthetics in different ethnicities: a three-dimensional analysis. J Plast Reconstr Aesthet Surg 2010; 63 (12) 2032-2039
    Search in Google Scholar
  • 53 Samizadeh S. The ideals of facial beauty among Chinese aesthetic practitioners: results from a large national survey. Aesthetic Plast Surg 2019; 43 (01) 102-114
    Search in Google Scholar
  • 54 Kashmar M, Alsufyani MA, Ghalamkarpour F. et al. Consensus opinions on facial beauty and implications for aesthetic treatment in Middle Eastern women. Plast Reconstr Surg Glob Open 2019; 7 (04) e2220
    Search in Google Scholar
  • 55 Yehezkel S, Turley P. Changes in the African American Female Profile as Depicted in Fashion Magazines During the 20th Century. Am J Orthod Dentofacial Orthop 2004; 125 (04) 407-417
    Search in Google Scholar
  • 56 Harley Academy. Racial considerations for lip filler proportions. Accessed June 16, 2024 at: https://www.harleyacademy.com/aesthetic-medicine-articles/racial-considerations-for-lip-filler-proportions/
  • 57 Zankl A, Eberle L, Molinari L, Schinzel A. Growth charts for nose length, nasal protrusion, and philtrum length from birth to 97 years. Am J Med Genet 2002; 111 (04) 388-391
    Search in Google Scholar
  • 58 Ramirez OM, Khan AS, Robertson KM. The upper lip lift using the ‘bull's horn’ approach. J Drugs Dermatol 2003; 2 (03) 303-306
    Search in Google Scholar
  • 59 Perenack J. Treatment options to optimize display of anterior dental esthetics in the patient with the aged lip. J Oral Maxillofac Surg 2005; 63 (11) 1634-1641
    Search in Google Scholar
  • 60 Virdi SS, Wertheim D, Naini FB. Normative anthropometry and proportions of the Kenyan-African face and comparative anthropometry in relation to African Americans and North American Whites. Maxillofac Plast Reconstr Surg 2019; 41 (01) 9
    Search in Google Scholar
  • 61 Meyer R, Kesselring UK. Aesthetic surgery in the perioral region. Aesthetic Plast Surg 1976; 1 (01) 61-69
    Search in Google Scholar
  • 62 Luthra A. Shaping lips with fillers. J Cutan Aesthet Surg 2015; 8 (03) 139-142
    Search in Google Scholar
  • 63 Raphael P, Harris R, Harris SW. Analysis and classification of the upper lip aesthetic unit. Plast Reconstr Surg 2013; 132 (03) 543-551
    Search in Google Scholar
  • 64 Kwon SH, Choi JW, Kim HJ. et al. Three-dimensional photogrammetric study on age-related facial characteristics in Korean females. Ann Dermatol 2021; 33 (01) 52-60
    Search in Google Scholar
  • 65 Farkas LG, Deutsch CK. Anthropometric determination of craniofacial morphology. Am J Med Genet 1996; 65 (01) 1-4
    Search in Google Scholar
  • 66 Aldridge K, Boyadjiev SA, Capone GT, DeLeon VB, Richtsmeier JT. Precision and error of three-dimensional phenotypic measures acquired from 3dMD photogrammetric images. Am J Med Genet A 2005; 138A (03) 247-253
    Search in Google Scholar
  • 67 Staller S, Anigbo J, Stewart K, Dutra V, Turkkahraman H. Precision and accuracy assessment of single and multicamera three-dimensional photogrammetry compared with direct anthropometry. Angle Orthod 2022; 92 (05) 635-641
    Search in Google Scholar
  • 68 Anas IY, Bamgbose BO, Nuhu S. A comparison between 2D and 3D methods of quantifying facial morphology. Heliyon 2019; 5 (06) e01880
    Search in Google Scholar
  • 69 Wong JY, Oh AK, Ohta E. et al. Validity and reliability of craniofacial anthropometric measurement of 3D digital photogrammetric images. Cleft Palate Craniofac J 2008; 45 (03) 232-239
    Search in Google Scholar
  • 70 Aung SC, Ngim RC, Lee ST. Evaluation of the laser scanner as a surface measuring tool and its accuracy compared with direct facial anthropometric measurements. Br J Plast Surg 1995; 48 (08) 551-558
    Search in Google Scholar
  • 71 Brons S, van Beusichem ME, Bronkhorst EM. et al. Methods to quantify soft-tissue based facial growth and treatment outcomes in children: a systematic review. PLoS One 2012; 7 (08) e41898
    Search in Google Scholar
  • 72 Hajeer MY, Millett DT, Ayoub AF, Siebert JP. Applications of 3D imaging in orthodontics: part I. J Orthod 2004; 31 (01) 62-70
    Search in Google Scholar