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People generally prefer facial profiles where the upper jaw slightly protrudes, according to a recent survey of public aesthetic preferences. The findings suggest that jaw surgeons and orthodontists should incorporate the aesthetic tastes of everyday people rather than relying entirely on clinical measurements. The study was published in the Journal of Maxillofacial and Oral Surgery.
The human face plays a primary role in social communication and biological signaling. On an evolutionary level, the human brain developed specific neural circuits to read and recognize facial patterns. Facial attractiveness often functions as a biological marker of reproductive fitness, while structural characteristics heavily influence how individuals are perceived by others.
Attractiveness also operates as a social construct that impacts daily interactions. According to psychological concepts like the beauty stereotype, attractive people tend to be perceived as more desirable and likeable. Because facial features carry heavy social weight, reconstructive and cosmetic procedures aim to achieve a balanced, visually pleasing appearance.
Orthognathic surgery, a specialized type of operation that repositions the facial bones, modifies the skeletal support beneath the skin. Surgeons shift the upper jaw, known anatomically as the maxilla, and the lower jaw, known as the mandible, to correct functional issues and improve aesthetic harmony. The soft tissues of the face and the underlying bones are strictly interconnected, meaning any change to the skeleton directly alters the outer profile.
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To plan these operations, medical professionals traditionally rely on cephalometric analysis. This process involves measuring specific landmarks on head X-rays to determine the anatomical position of the facial bones. Clinicians use reference lines, such as the Frankfurt plane, which connects the top of the ear canal to the bottom of the eye socket, to establish a horizontal baseline. They also use the True Vertical Line, a perpendicular line drawn down through the base of the nose, to evaluate whether the jaws project forward or backward relative to the rest of the face.
Clinical tools provide standard geometric angles and distances for what constitutes a harmonious profile. Yet, the mathematical ideals preferred by medical professionals do not always align with the aesthetic tastes of the general public. Previous research on facial profile attractiveness largely focused on the opinions of orthodontists and dentists.
Guido Gabriele, Niccolò Pini, and their colleagues at the University Hospital of Siena in Italy designed this study to capture the perspectives of everyday people. By surveying a random population, the researchers aimed to identify which types of jaw alignments laypeople find most and least attractive.
The researchers created an online survey featuring eighteen profile images. These images consisted of nine male and nine female silhouettes converted into solid black and white shapes. Using silhouettes removed external variables like skin color, facial hair, or eye shape that might influence a viewer’s aesthetic judgment.
The profiles depicted different jaw relationships. Some images showed a normal facial profile, acting as a baseline control group for the study. Others illustrated various combinations of jaw misalignment commonly seen in surgical patients.
The misalignments included a retrognathic maxilla, where the upper jaw is underdeveloped and set back, and a prognathic maxilla, where the upper jaw overdevelops and protrudes forward. The researchers also included images of receding lower jaws, protruding lower jaws, and bimaxillary conditions where both jaws either protruded or receded together.
A group of 135 subjects completed the survey. The participants included 95 men and 35 women ranging in age from eighteen to fifty. Participants rated each profile on a scale from one, meaning unattractive, to five, meaning extremely attractive.
To prevent the visual memory of one image from influencing the viewer’s reaction to the next, the survey inserted a black screen for five seconds between each silhouette. The researchers then compared the scores for each altered profile against the scores given to the normal profiles.
The survey participants evaluated the normal facial profiles as moderately attractive, generally assigning them a score of three out of five. Profiles featuring an upper jaw that protruded forward also received high attractiveness scores. More than thirty percent of the participants gave the protruding upper jaw a rating of four out of five for both the male and female silhouettes.
Conversely, participants rated several misalignments as highly unappealing. Profiles with a protruding lower jaw, often referred to clinically as an underbite, received mostly scores of one or two out of five. Images showing mismatched jaws, such as an upper jaw set back combined with a lower jaw protruding forward, also drew mostly the lowest ratings of one or two from the lay audience.
The aesthetic response to a receding upper jaw depended on the gender of the silhouette. Viewers rated the female profile with a receding upper jaw as strongly unattractive, with sixty-six percent assigning it the lowest possible score. When evaluating the male version of the exact same jaw relationship, viewers gave it average attractiveness scores, treating it as a neutral feature.
Some altered profiles yielded ratings that were not statistically different from the normal baseline. Participants viewed profiles with a receding lower jaw as relatively neutral. Silhouettes featuring both jaws protruding or both jaws set back also received average scores of three out of five from most subjects.
These preferences have direct implications for surgical planning. Common procedures like the Le Fort I osteotomy involve cutting the upper jaw above the teeth to move it forward or backward. A sagittal osteotomy similarly splits the lower jaw to reposition the chin and bite.
Because these bone shifts dictate the final resting position of the lips and chin, surgeons must decide exactly how many millimeters to move the skeleton. The survey suggests that leaving a patient with a slightly protruding upper jaw might yield a more socially desirable outcome than forcing a perfectly flat profile.
The participant pool consisted of 135 subjects, representing a relatively restricted cross-section of the general population. Because the sample contained almost three times as many men as women, the overall aesthetic scores might lean toward male preferences.
The restricted number of participants between the ages of thirty-five and fifty makes it difficult to draw firm conclusions about how older adults perceive facial beauty. A person’s age can heavily influence their cognitive evaluation of faces. Future investigations should incorporate larger, balanced participant groups across wider age ranges. Collecting data from broader demographics will help surgeons adapt to evolving standards of physical appearance.
The study, “The Attractiveness of Facial Profile: A Random Population Survey on the Relationship of Jaws,” was authored by Guido Gabriele, Niccolò Pini, Simone Cicorella, Flavia Cascino, Valerio Ramieri, and Paolo Gennaro.
