The purpose of the present study was to determine opinions about beauty and attractiveness, to distinguish the rate of variables among gender and age groups, and to evaluate and determine the most attractive lip surface area (SA) and upper to lower lip ratio.The study was performed in two phases: In phase 1, a set of 10 internet-based frontal facial images were used to generate 5 synthetic images that were distributed to participants, who were asked to choose the most and least attractive image. A total of 312 responses were received in this phase. In phase 2, the images that had been chosen in phase 1 were manipulated to reduce or augment the lip size. Five images had variable lip SA, and three had variable upper to lower lip ratio. A total of 687 responses were received in phase 2.The majority of respondents preferred a more natural lip SA, while in terms of upper to lower lip ratio, 1:2 was considered the most attractive ratio, and 2:1 the least attractive.The lips have a great impact on the perception of beauty. Age, gender, trends, and social media all play a role in determining what is considered to be the most attractive lip SA and upper to lower lip ratio.The lip SA and upper to lower lip ratios determined in this study may provide guidelines for clinicians in the improvement of facial esthetics. Current trends and social media are the gold standard today regarding patient perception of beauty and esthetics.
