The current preferred female lip ratio.
BACKGROUND
Perception of beauty is influenced by the individual's demographic background and characteristics. However, objective measurements and ratios remain the foundation for aesthetic evaluations. This study aimed to elucidate if there exists a universally applicable ideal upper to lower lip ratio.


METHODS
An interactive online survey was designed. Modifiable ranges of lip ratios were achieved via digital alteration, enabling participants to change the ratio of a single female model's lips. The questionnaire was translated into multiple languages and sent to more than 9000 plastic surgeons and the general public worldwide. Demographic data were collected and analysis of variance was used to investigate respective lip ratio preferences.


RESULTS
A total of 1011 responses from 35 different countries (response rate of 14%) was gathered. The majority of survey takers (60%) chose the 1.0:1.0 lip ratio as most attractive. No differences were found in respect to lip ratio preference and the self-reported ethnicity. However, interesting preferences prevailed when analyzing the subgroups regarding lower lip size.


CONCLUSIONS
Age, gender, country of residence, and profession significantly impact individual upper to lower lip ratio preferences. However, a 1.0:1.0 lip ratio can apparently be considered most pleasing in females.
Department for Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich, Germany. Electronic address: paul@heidekrueger.net.
Paul I
PI
Heidekrueger
United Nations Population Fund, Technical Division, Population and Development Branch, New York, NY, USA. Electronic address: sabrinajuran@gmail.com.
Sabrina
S
Juran
Department of Plastic Surgery, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA. Electronic address: cszpalski@icloud.com.
Caroline
C
Szpalski
Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital of St. John of God Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: Lorenz.Larcher@sabes.it.
Lorenz
L
Larcher
Division of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA. Electronic address: reuben_ng@hotmail.com.
Reuben
R
Ng
Department for Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich, Germany. Electronic address: p.niclasbroer@gmail.com.
P Niclas
PN
Broer
D000328:Adult; D000367:Age Factors; D000368:Aged; D001504:Beauty; D005260:Female; D006801:Humans; D008046:Lip / Q000033:anatomy & histology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012737:Sex Factors; D013518:Surgery, Plastic / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
Ethnic and cultural background; Facial analysis; Lip aesthetics; Lip ratio; Lip shape; Perception of beauty