title: Facial attractiveness: is the whole more than the sum of its parts?
abstract: BACKGROUND
  In order for aesthetic surgery to participate in the movement toward evidence-based medicine, a system that quantifies aesthetic outcomes must be developed based on reliable and reproducible data. Previous studies have investigated the attractiveness of averaged (or composite) faces. Data has shown that these faces are deemed more attractive than their constituent faces.
  
  
  OBJECTIVE
  The authors seek to elucidate the mechanism behind the phenomenon in which more attractive faces included in a composite increase the overall attractiveness rating.
  
  
  METHODS
  Ten composites, five male and five female, were generated with resources provided by the www.faceresearch.org research group. The five composites contained the top two, three, and five most attractive faces, a composite of all faces, and the five least attractive faces. An online survey was conducted in which participants were asked to rank each of the five faces in order of attractiveness.
  
  
  RESULTS
  Analysis of variance (ANOVA) on ranks was performed on the data provided by the 245 participants. Attractiveness increased from the top two to the top three to the top five composite faces, and then decreased from the top five to all faces to the bottom five composite faces. This trend was present and statistically significant (with a P value <.05) across all genders, ages, and races.
  
  
  CONCLUSIONS
  This study provides statistically significant evidence that averaging more attractive faces, specifically the top 10% of a population, renders a more attractive composite face. This optimal composite face could potentially be a standard to which aesthetic surgical outcomes could be objectively compared.
authors.affiliation: Division of Plastic Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Safa E
authors.initials: SE
authors.lastname: Sharabi
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hatef
authors.forename: Larry H
authors.initials: LH
authors.lastname: Hollier
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004954:Esthetics; D019317:Evidence-Based Medicine; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D012928:Social Desirability; D011795:Surveys and Questionnaires