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The shape and size of the lips, particularly in females, is an important feature of the lower third of the face. This is very apparent when one looks at the tremendous popularity aesthetic lip augmentation, primarily done by injectable fillers, has enjoyed over the past two decades. Despite their popularity and the tens of milions of lip augmentation procedures that have been done, the end goal of increased lip size has always been based on patient and/or surgeon preference.

In the February 2017 Online First edition of the JAMA Facial Plastic Surgery Journal, an article was published entitled ‘A Quantitative Approach to Determining the Ideal Female Lip Aesthetic and Its Effect on Facial Attractiveness’. This was a clinical study to evaluate what lip dimensions are the most attractive in Caucasian females. Using synthetic morphed frontal digital images of the faces of twenty young women five varied lip surface areas for each face were created.  (amounts of lip augmentation) Those one hundred faces were then assessed for attractiveness. (phase 1) Additional image evaluations were done manipulating upper to lower lip ratios while maintaining the most attractive surface area from phase 1. (phase 2) Lastly the surface area from the most attractive faces was used to determine the total lip surface area relative to the lower facial third.

Their results showed that an increase of just over 50% in the total lip surface area with a linear dimension equal to roughly 10% of the lower face and an upper to lower lip ratio of 1:2 was found to be the most attractive.

While lip dimensions and ratios derived in this study provide some guidelines for lip augmentation efforts, in the end the only aesthetic criteria that matters is in how the patient perceives their own lip size and shape. Probably more important than size is lip symmetry and a well-defined vermillion-cutaneous junction particularly across the cupid’s bow region of the upper lip.

Dr. Barry Eppley

Indianapolis, Indiana

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