title: Assessing the influence of asymmeftry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician, and layperson.
abstract: OBJECTIVE
  The purpose of this investigation was to undertake an objective and quantitative evaluation of how severity of asymmetries affecting the mandible and chin point influence perceived attractiveness.
  
  
  METHODS
  The mandible and chin point of idealized male and female frontal facial images were altered in 5-mm increments from 0 to 25 mm and to the left and right, to represent horizontal, vertical, and combined asymmetry affecting these regions. These images were rated on a 7-point Likert scale by a preselected group of orthognathic patients before treatment, clinicians, and laypeople.
  
  
  RESULTS
  In relation to a 5-mm asymmetry, observers progressively decreased attractiveness ratings and increased the desire for surgery for greater asymmetries. Clinicians and patients were found to be more critical than laypeople. The desire for surgery decreased by 3% for each year increase in age, was 53% less for men, and 45% greater for white observers.
  
  
  CONCLUSIONS
  Asymmetry of 10 mm is perceived as being significant; at 5 mm and below, it is largely unnoticed. The greater the degree of asymmetry greater than 10 mm, the more noticeable and the greater the desire was for correction. Clinician and patient ratings were similar and more critical than ratings of laypeople. A desire for surgery was negligible for 5 mm of asymmetry but increased considerably at 10 mm and continued to increase with greater degrees of asymmetry. The highest-rated images showed perfect bilateral symmetry, whereas the lowest-rated images showed significant degrees of mandibular and chin asymmetry.
authors.affiliation: Kingston and St George's Hospitals and St George's Medical School, London, UK. Farhad.Naini@yahoo.co.uk
authors.forename: Farhad B
authors.initials: FB
authors.lastname: Naini
authors.forename: Ana Nora A
authors.initials: AN
authors.lastname: Donaldson
authors.forename: Fraser
authors.initials: F
authors.lastname: McDonald
authors.forename: Martyn T
authors.initials: MT
authors.lastname: Cobourne
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002680:Chin / Q000473:pathology*; D004954:Esthetics; D005145:Face / Q000033:anatomy & histology; D005146:Facial Asymmetry / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000145:classification; D008334:Mandible / Q000473:pathology*; D008875:Middle Aged; D020380:Needs Assessment; D056948:Orthognathic Surgical Procedures / Q000523:psychology*; D044469:Racial Groups; D012649:Self Concept; D012737:Sex Factors; D013515:Surgery, Oral; D055815:Young Adult