Summary: The two-stage study analyzed the correlation between lower face proportions and facial aesthetics in patients with II class of malocclusion evaluated by lay people.

Background and objectives: One hundred adults rated the attractiveness of a series of frontal and profile photos, representing 40 faces with normal, reduced or increased lower face proportions.

Methods: The sequence of 40 images included frontal and profile photos of control group, consisting of 10 adults with the Eastman normal lower facial height (LFH) relative to total facial height (TFH) of 55% and 30 images of patients with II class of malocclusion with LFH decreased or increased from the Eastman norm. First stage of the survey included pre-operative photos of patients with II class of malocclusion and photos of control group. Second stage of the survey took place in 2 weeks after the first and was evaluating the post-operative photos of the same patients with the control group photos left unchanged. The observers rated the attractiveness of each survey participant photos on visual analogue scale (VAS) of 1–5.

Results and Conclusions: The first stage of the current study found that the photos, representing faces with Eastman normal value for LFH/TFH were considered as most attractive by 83% of the lay observes. This finding was strongly supported during the second stage by the changes in beauty evaluation of the same patients before and after the surgery. The post-operative measurement values located close to the mean and it resulted in higher scores for patients with II class of malocclusion in the second stage. Attractiveness rating decreased as the LFH/TFH proportions diverged from the results of control group. Images with reduced LFH were considered to be more aesthetically acceptable (mean rate 3.8) in comparison with the images with an increased LFH (mean rate 2.7).