Identifying the Most Attractive Lip Proportions

The Perfect Lips

Identifying the ideal proportions for areas of the body and face is a crucial element of aesthetic medicine. However, standards of beauty change over time, across cultures and depending on subjective preference. Beauty is said to be in the eye of the beholder, so how do we identify what is perfect aesthetically for everyone?

A study published in Plastic and Reconstructive Surgery (August 2022) by Sebastian Cotofana, M.D., Ph.D., et al., “In Search of the Most Attractive Lip Proportions and Lip Volume: An Eye Tracking– and Survey-Based Investigation,” sought to identify the most attractive lip shape and volume by examining the aesthetic perception of a variety of lip shapes.

Decoding Patient Desires 

Cotofana, who is with the Department of Clinical Anatomy at the Mayo Clinic College of Medicine and Science, explained how observations of lip augmentation results inspired the study. “Often, I see results which do not look natural because they have too much volume (overfilled) or because the treated lips have lost their natural shape and curves (sausage lips). We need to understand how it came this far because it’s not the patient’s fault.” Practitioners must be able to discern what a patient actually wants versus what they say they want. “When patients say to their practitioner “please increase my lip volume,” they actually mean “please make me as attractive as this celebrity I saw on social media.” The practitioner needs to decode this and understand that patients want more attractiveness, not fullness. Most likely the way to obtain more attractiveness is not via more volume, but more contour or other procedures.”

Internal Representation of Beauty

Cotofana was intrigued by the discovery of the “internal representation of beauty theory.” He explains, “This theory connects neural processing (as assessed by eye tracking analyses) with the rating of beauty. The difference between these pathways is that one is subconscious and uncontrolled whereas the other is conscious and controlled. Lips rated as not beautiful (conscious and controlled) are being inspected longest (subconscious and uncontrolled). This means if viewed objects are not according to the standards of beauty of the observer, they are being inspected longer i.e., the brain needs more visual information to process, represented by longer viewing times.”

Beauty standards, while society-driven, are still subject to our personal preferences. Our conscious and unconscious psychology ultimately decide what we find attractive. “In daily life, if something is extra-ordinary, we stop our normal activities to look at it. We want more information to understand what we see,” Cotofana explains. “It was surprising that lips perceived as less beautiful were inspected longer by the observers. Practitioners need to understand that proportions and ratios are crucial, and they need to be respected. Volume does not correlate with beauty!” Cultural differences must also be considered. Cotofana notes, “The most important aspect is the multi-ethnic approach: What would be the outcome of this study if we would have used Asian or African-American observers?”

The key is for science and industry professionals to work together. “I hope that practitioners and the industry understand that the way into the future is alongside science,” says Cotofana, advising an “evidence-based not eminence-based” approach to produce “safer, individualized and reproducible results.”