Korean J Orthod.  2018 Jan;48(1):23-29. 10.4041/kjod.2018.48.1.23.

Disparity in opinions on lip protrusiveness in contemporary African American faces

• Battle Y
• Schneider
• Magder L
• Pae EK

• KMID: 2441438
• DOI: http://doi.org/10.4041/kjod.2018.48.1.23

Abstract

OBJECTIVE
In accordance with the changing demographics in the United States, orthodontists working on various ethnic populations should be more conscious when using the standardized profile analyses for the African American patient. The objective of this study was to examine whether the perception of lip protrusiveness in modern African American faces has changed. For this purpose, we investigated the most favorable African American lip profile using the opinions of 10 experienced and 10 newly trained younger orthodontists.
METHODS
Attractiveness was converted to a number on visualized analog scales. Comparative ranks on 16 African American profiles, with focus on lip protrusiveness and thickness, were made among the groups. Mixed-effects linear regression models were fit and group differences were estimated.
RESULTS
Younger orthodontists favored a more protrusive lip profile, and the variance in their perceptions was narrower than those of older orthodontists. Measurements related to upper lip protrusion showed the strongest correlation to attractiveness (r = −0.82). The association with attractiveness decreased linearly as the protrusiveness of the upper lip increased. Steiner's E-line was the most influential reference for determining the level of attractiveness for the older orthodontists, whereas upper lip protrusion was the most influential factor for the young orthodontists.
CONCLUSIONS
An adequate level of lip protrusiveness and thickness should be essential for maintaining attractive esthetics in African American patients. Yet, a new set of standards for prominent lips in this population is necessary to reflect the current trend in the concept of a beautiful face in the modern world.

Keyword

African American; Esthetics; Generation gap; Lip protrusiveness

MeSH Terms

Demography
Esthetics
Humans
Intergenerational Relations
Linear Models
Lip*
Orthodontists
United States
Weights and Measures

Figure

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  Figure 1 Four examples of modified profilograms excluding the upper third of the face but showing the facial complexion for African American orthodontic patients. In this way, degrees of lip protrusiveness can be perceived without bias associated with skin color.

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  Figure 2 Visual analog scale used to score facial attractiveness for the different African American facial profiles included in this study.

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  Figure 3 Cephalometric variables for assessing lip protrusiveness (A) and profiles of the most attractive female (#6F) and male (#5M) faces (B) in the present study. A, 1, upper lip to E-line (mm); 2, lower lip to E-line (mm); 3, upper lip protrusion (linear measurement between Sn and the upper lip margin, mm), where Sn indicates the subnasale; 4, lower lip protrusion (linear measurement between Sn and the lower lip, mm); 5, upper lip thickness (distance between the upper lip and labial surface of the maxillary incisor in mm); 6, lower lip thickness (distance between the lower lip and labial surface of the mandibular incisor in mm). Pog indicates soft-tissue pogonion. Sn indicates subnasale. B, Note that skin colors are similar, but prominence in the chin button differs between the profiles.

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