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Introduction: Facial attractiveness has recently been considered an indicator of underlying immunocompetence. However, studies examining this relationship have yielded mixed findings. Previous research suggested that these discrepant findings could be due to the common influence of lifestyle factors upon both rated facial attractiveness and health. Methods: Young men (N = 162) provided standardized facial photos with a neutral expression subsequently rated by eight women for overall attractiveness. Saliva was assayed for immunoglobulin A, testosterone (T) and cortisol (C), and body fat was measured using a skinfold caliper. Self-reports of poor health, and lifestyle factors that could influence health status (age, sleep habits, smoking, drinking alcohol, family stress, and exercising) were collected. Results: Results showed that symptoms of poor health and skinfold negatively predicted facial attractiveness. There was a modest but statistically non-significant T x C interaction where higher T lower C men trended toward having more attractive faces. A sequential mediation model examining the influence of lifestyle showed support for an indirect effect on facial attractiveness. Specifically, skinfold and poor health symptoms mediated the links between exercise, stress, and facial attractiveness. Discussion: These findings suggest links between facial attractiveness and immunocompetence could be linked to some common lifestyle and hormonal variables, but that more comprehensive research involving lifestyle indicators (such as nutrition) are necessary.

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The present study employed dictator game and ultimatum game to investigate the effect of facial attractiveness, vocal attractiveness and social interest in expressing positive ("I like you") versus negative signals ("I don't like you") on decision making. Female participants played against male recipients in dictator game and ultimatum game while played against male proposers in ultimatum game. Results showed that participants offered recipients with attractive faces more money than recipients with unattractive faces. Participants also offered recipients with attractive voices more money than recipients with unattractive voices, especially under the positive social interest condition. Moreover, participants allocated more money to recipients who expressed positive social interest than those who expressed negative social interest, whereas they would also expect proposers who expressed positive social interest to offer them more money than proposers who expressed negative social interest. Overall, the results inform beauty premium for faces and voices on opposite-sex economic bargaining. Social interest also affects decision outcomes. However, the beauty premium and effect of social interest varies with participants' roles.

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OBJECTIVE: The aim of this study was to further guide the diagnosis and treatment programs for clinical facial contouring with injectable fillers by studying the facial contour parameters and proportion preferences consistent with Asian aesthetics. METHODS: A total of 89 subjects (42 males and 47 females aged 20-60 years) who met the inclusion criteria were enrolled in this study. The subjects were grouped by age, sex, and external contour attractiveness score, and the external contour aesthetic parameters and proportions of the subjects in different groups were measured and analysed. RESULTS: The upper facial breadth and lower facial breadth decreased with age, with significant differences between the 50-60-year age group and other age groups (P < 0.01). The nasomental angle showed a decreasing trend with age, with significant differences between the 40-49-year age group and the 20-29-year and 30-39-year age groups (P < 0.05). Males and females were significantly different in calva height, total head height, lower facial height, and calva height to total head height ratio (P < 0.05). With increasing age, the external contour attractiveness scores of males and females both showed decreasing trends, with significant differences between the 50-60-year age group and other age groups (P < 0.05). CONCLUSION: The calva height and the cranioauricular angle have a significant impact on external contour attractiveness. In general, temporal depression, cheek sagging, lateral cheek depression, and an ill-defined mandibular border will occur due to ageing, collagen loss, ligament laxity and sagging, and soft tissue atrophy and sagging, reducing the attractiveness of the external contour. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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OBJECTIVE: In many medical disciplines, facial attractiveness is part of the diagnosis, yet its scoring might be confounded by facial expressions. The intent was to apply deep convolutional neural networks (CNN) to identify how facial expressions affect facial attractiveness and to explore whether a dedicated training of the CNN is able to reduce the bias of facial expressions. MATERIALS AND METHODS: Frontal facial images (n = 840) of 40 female participants (mean age 24.5 years) were taken adapting a neutral facial expression and the six universal facial expressions. Facial attractiveness was computed by means of a face detector, deep convolutional neural networks, standard support vector regression for facial beauty, visual regularized collaborative filtering and a regression technique for handling visual queries without rating history. CNN was first trained on random facial photographs from a dating website and then further trained on the Chicago Face Database (CFD) to increase its suitability to medical conditions. Both algorithms scored every image for attractiveness. RESULTS: Facial expressions affect facial attractiveness scores significantly. Scores from CNN additionally trained on CFD had less variability between the expressions (range 54.3-60.9 compared to range: 32.6-49.5) and less variance within the scores (P ≤ .05), but also caused a shift in the ranking of the expressions' facial attractiveness. CONCLUSION: Facial expressions confound attractiveness scores. Training on norming images generated scores less susceptible to distortion, but more difficult to interpret. Scoring facial attractiveness based on CNN seems promising, but AI solutions must be developed on CNN trained to recognize facial expressions as distractors.

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Perceiving facial attractiveness is an important behaviour across psychological science due to these judgments having real-world consequences. However, there is little consensus on the measurement of this behaviour, and practices differ widely. Research typically asks participants to provide ratings of attractiveness across a multitude of different response scales, with little consideration of the psychometric properties of these scales. Here, we make psychometric comparisons across nine different response scales. Specifically, we analysed the psychometric properties of a binary response, a 0-100 scale, a visual analogue scale, and a set of Likert scales (1-3, 1-5, 1-7, 1-8, 1-9, 1-10) as tools to measure attractiveness, calculating a range of commonly used statistics for each. While certain properties suggested researchers might choose to favour the 1-5, 1-7 and 1-8 scales, we generally found little evidence of an advantage for one scale over any other. Taken together, our investigation provides consideration of currently used techniques for measuring facial attractiveness and makes recommendations for researchers in this field.

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BACKGROUND: Aesthetic facial bone surgery and facial implantology expand the boundaries of conventional facial surgery that focus on facial soft tissue. This study aimed to reveal novel aesthetic facial measurements to provide tailored treatment concepts and advance patient care. METHODS: A total of n=101 study participants (46 females and 55 males) were presented with 120 patient portraits (frontal images in natural head posture; 60 females and 60 males) and asked to assess the facial attractiveness (scale 0-10; "How attractive do you find the person in the image?") and the model capability score (MCS; scale 0-10; "How likely do you think the person in the image could pursue a modelling career?"). For each frontal photograph, defined facial measurements and ratios were taken to analyse their relationship with the perception of facial attractiveness and MCS. RESULTS: The overall attractiveness rating was 4.3 ± 1.1, while the mean MCS was 3.4 ± 1.1. In young males, there was a significant correlation between attractiveness and the zygoma-mandible angle (ZMA)2 (r= - 0.553; p= 0.011). In young and middle-aged females, MCS was significantly correlated with facial width (FW)1-FW2 ratio (r= 0.475; p= 0.034). For all male individuals, a ZMA1 value of 171.79 degrees (Y= 0.313; p= 0.024) was the most robust cut-off to determine facial attractiveness. The majority of human evaluators (n=62; 51.7%) considered facial implants a potential treatment to improve the patient's facial attractiveness. CONCLUSION: This study introduced novel metrics of facial attractiveness, focusing on the facial skeleton. Our findings emphasized the significance of zygomatic measurements and mandibular projections for facial aesthetics, with FI representing a promising surgical approach to optimize facial aesthetics. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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As a booming branch of online retailing, live-streaming e-commerce can present abundant information dimensions and diverse forms of expression. Live-streaming e-commerce has enabled online retailers to interact with customers face-to-face, resulting in widespread instances of emotional and impulse buying behavior. Prior research in live-streaming e-commerce has suggested that live streamers' characteristics, especially the live streamer's face, can affect customers' purchase intentions. The present research used questionnaire surveys and an eye tracking experiment to investigate the impact of live streamer's facial attractiveness on consumer purchase intention for search-based and experience-based products. The questionnaire survey analyzed 309 valid questionnaires and revealed that attractive faces are the key influencing factor driving consumers' impulse purchase intentions. Moreover, consumers' emotional experience plays a partial mediating role in the process of live streamers' faces influencing purchase intention. The eye tracking experiment further explored the mechanism of a live streamer's facial attractiveness on consumers' purchase intentions of search-based products and experience-based products from the perspective of visual attention by analyzing 64 valid sets of data. The results showed that attractive faces attract more consumers' attention and, therefore, increase their purchase intention. Furthermore, there is a significant interaction between product type, the live streamer's facial attractiveness, and consumers' purchase intentions. In the case of unattractive live streamers, consumers are more likely to buy search-based products than experience-based products, while the purchase intention does not vary between search-based products and experience-based products in the case of attractive live streamers. The present study provides evidence for 'beauty premium' in live-streaming e-commerce and sheds light on the design of the match between live streamers and different types of products.

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In the mind of the beholder the personality and facial attractiveness of others are interrelated. However, how these specific properties are processed in the neurocognitive system and interact with each other while economic decisions are made is not well understood. Here, we combined the ultimatum game with EEG technology, to investigate how alleged personality traits and the perceived facial attractiveness of proposers of fair and unfair offers influence their acceptance by the responders. As expected, acceptance rate was higher for fair than unfair allocations. Overall, responders were more likely to accept proposals from individuals with higher facial attractiveness and with more positive personality traits. In ERPs, words denoting negative personality traits elicited larger P2 components than positive trait words, and more attractive faces elicited larger LPC amplitudes. Replicating previous findings, FRN amplitudes were larger to unfair than to fair allocations. This effect was diminished if the proposer's faces were attractive or associated with positive personality traits. Hence, facial attractiveness and the valence of personality traits seem to be evaluated independently and at different time points. Subsequent decision making about unfair offers is similarly influenced by high attractiveness and positive personality of the proposer, diminishing the negative response normally elicited by "unfair" proposals, possibly due a "reward" effect. In the ERPs to the proposals the effect of positive personality and attractiveness were seen in the FRN and P300 components but for positive personality traits the effect even preceded the FRN effect. Altogether, the present results indicate that both high facial attractiveness and alleged positive personality mitigate the effects of unfair proposals, with temporally overlapping but independent neurocognitive correlates.

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(1) Background. The aim of the present protocol is to assess whether self-perception of tooth colour and facial attractiveness correlates with gender and mood state. (2) Study protocol. The protocol foresees a cross-sectional clinical study, developed by Sapienza University of Rome, Italy, Department of Oral and MaxilloFacial Sciences, and 15 UNID (Unione Nazionale Igienisti Dentali-National Union of Dental Hygienists)-affiliated clinical centers in Italy. The protocol consists of a clinical visit, during which photographic documentation of the face and smile is collected with spectrophotometric evaluation of tooth colour. During the visit, two validated questionnaires are filled in. The first one is filled by the operator for the collection of data on: i) patient's face and smile colorimetric characteristics; ii) patient's and operator's evaluations of the dental colour and smile attractiveness. The second one is completed by the patient for the assessment of his/her mood state. (3) Conclusions. This protocol highlights the importance in aesthetic dentistry of a gender-specific approach and the limitations of gender-neutral models, revealing the existing gender differences in aesthetic self-perception. In addition, the colour-matching relationships between facial and dental colour characteristics will be explored. This approach improves the accuracy and personalization of aesthetic assessments in dentistry, by addressing personalized and gender-specific needs. A gender-inclusive methodology that takes a more nuanced and culturally aware approach to aesthetic dentistry is a useful adjunct to modern clinical practices.

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The position and inclination of the incisors play a crucial role in achieving optimal outcomes in orthodontic and orthognathic surgical treatment, given their impact on facial aesthetics. Background/objectives: Due to numerous distorting factors that affect the reliability of the ANB angle, the aim of the present work is to evaluate a more constant parameter over time, the anterior nasal spine (ANS), and explore whether aligning the incisal margin of the upper incisors with the anterior nasal spine could be a reliable indicator for achieving appropriate labial support in pre-surgical orthodontic preparation. Methods: From a pool of 500 cone beam computed tomography (CBCT) scans, 50 CBCT examinations displaying a Class 1 skeletal pattern (ANB = 2° ± 2°) with an intermediate (3.2-4 mm) or mixed (4-6 mm) sagittal maxillary position (MX), as determined by the 3D multiplanar total face approach (TFA), were selected and compared with CBCT examinations randomly chosen from the initial pool. Moreover, 12 landmarks were identified, and measurements were automatically obtained, using software, and recorded. Mean and standard deviation values were calculated for each sample. A comparison was made between the two samples, aligning the results with the morphological analysis of the anterior nasal spine and the sagittal position of the upper maxilla. Results: In Class 1 subjects, the distance between the incisal margin and the plane passed in relation to the anterior nasal spine should range between -1 mm and 1 mm, aligned with or slightly ahead of the anterior nasal spine or slightly ahead of this limit. Conclusions: The anterior nasal spine can serve as a reliable reference point for planning the position of the upper incisors, with excessive proclination or retroclination from this reference point deemed unacceptable.

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BACKGROUND: Facial appearance plays a significant role in the success of social interactions. There is a limited amount of evidence investigating the influence of combined orthodontic-orthognathic surgical treatment on the social judgments of lay people. OBJECTIVE: The aim of this study was to investigate whether changes in facial appearance following orthognathic surgery alter the social judgements made by lay people. ETHICAL APPROVAL: Ethical approval was granted from the University of Sheffield School of Clinical Dentistry Research Ethics Committee on 17th August 2020 (Reference: 033775). MATERIALS AND METHODS: This cross-sectional, web-based survey involved clinical photographs of six Caucasian female patients pre- and post-combined orthodontic-orthognathic treatment. Three patients had a pre-treatment class 2 skeletal pattern, and three patients had a pre-treatment class 3 skeletal pattern. Staff and students at the University of Sheffield, UK were invited to evaluate five personality traits: (i) friendliness, (ii) intelligence, (iii) attractiveness, (iv) self-confidence, and (5) trustworthiness using a 5-point Likert scale. The trait scores were summed to obtain a total social judgement score, and a paired t-test was used to compare the total scores from pre- and post-treatment images. RESULTS: There were 261 responses to the survey of which 181 (75%) were completed fully. The total social judgement scores from after treatment images were higher compared with the pre-treatment images (mean diff 1.6; P < .001) indicating more positive social judgements. The improvements in perceived social judgments were more notable for class 3 patients (mean diff 2.7) compared to class 2 patients (mean diff 0.7). CONCLUSION: Social judgement scores were higher (more positive) from post-treatment images of patient faces than their pre-treatment images. The findings highlight the possible indirect benefits combined orthodontic-orthognathic surgical treatment may have on an individual in a social setting.

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Various facial colour cues were identified as valid predictors of facial attractiveness, yet the conventional univariate approach has simplified the complex nature of attractiveness judgement for real human faces. Predicting attractiveness from colour cues is difficult due to the high number of candidate variables and their inherent correlations. Using datasets from Chinese subjects, this study proposed a novel analytic framework for modelling attractiveness from various colour characteristics. One hundred images of real human faces were used in experiments and an extensive set of 65 colour features were extracted. Two separate attractiveness evaluation sets of data were collected through psychophysical experiments in the UK and China as training and testing datasets, respectively. Eight multivariate regression strategies were compared for their predictive accuracy and simplicity. The proposed methodology achieved a comprehensive assessment of diverse facial colour features and their role in attractiveness judgements of real faces; improved the predictive accuracy (the best-fit model achieved an out-of-sample accuracy of 0.66 on a 7-point scale) and significantly mitigated the issue of model overfitting; and effectively simplified the model and identified the most important colour features. It can serve as a useful and repeatable analytic tool for future research on facial impression modelling using high-dimensional datasets.

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Facial first impressions influence jurors in both laboratory experiments and real courtrooms. Often, more attractive defendants are perceived as less guilty and receive more lenient sentences. However, the type of crime under consideration, as well as the ecological validity of the stimuli presented, may determine the nature of this bias. Here, extending previous work, we considered three crime types (robbery, sexual assault, and murder) and utilised short video clips of male defendants, accompanied by real-world crime descriptions. Crucially, we varied attractiveness by presenting a large set of identities, in comparison with the typical use of one "high" and one "low" attractive face. Using null hypothesis significance testing, we found no evidence that either attractiveness or crime type influenced guilt perceptions. Taking a Bayesian perspective, our results provided some evidence that more attractive defendants were rated as less guilty of murder but more guilty of sexual assault, with no bias observed for robbery. Importantly, however, none of these effects had high certainty and all were small in size. By comparing the extremes of attractiveness, we again found inconclusive evidence of any attractiveness effects, with small differences in all cases. The implications for this departure from previous findings are discussed in terms of ecological validity and the need to consider attractiveness as a continuous rather than binary measure.

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In today's age of social media and smartphones, portraits-such as selfies or pictures of friends and family-are very frequently produced, shared and viewed images. Despite their prevalence, the psychological factors that characterize a 'good' photo-one that people will generally like, keep, and think is especially aesthetically pleasing-are not well understood. Here, we studied how a subtle change in facial expression (smiling) in portraits determines their aesthetic image value (beyond a more positive appearance of the depicted person). We used AI-based image processing tools in a broad set of portrait photographs and generated neutral and slightly smiling versions of the same pictures. Consistent across two experiments, portraits with a subtle smile increased both spontaneous aesthetic preferences in a swiping task as well as improving more explicit aesthetic ratings after prolonged viewing. Participants distinguished between aspects associated with image beauty and the depicted person's attractiveness, resulting in specific interactions between variables related to participant traits, image content, and task. Our study confirms that a subtle-and in this case fully artificial-smile reliably increases the aesthetic quality of portraits, illustrating how current image processing methods can target psychologically important variables and thereby increase the aesthetic value of photographs.

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The COVID-19 pandemic has led people to predict facial attractiveness from partially covered faces. Differences in the predicted and observed facial attractiveness (i.e., masked and unmasked faces, respectively) are defined as reward prediction error (RPE) in a social context. Cognitive neuroscience studies have elucidated the neural mechanisms underlying RPE-induced memory improvements in terms of monetary rewards. However, little is known about the mechanisms underlying RPE-induced memory modulation in terms of social rewards. To elucidate this, the present functional magnetic resonance imaging (fMRI) study investigated activity and functional connectivity during face encoding. In encoding trials, participants rated the predicted attractiveness of faces covered except for around the eyes (prediction phase) and then rated the observed attractiveness of these faces without any cover (outcome phase). The difference in ratings between these phases was defined as RPE in facial attractiveness, and RPE was categorized into positive RPE (increased RPE from the prediction to outcome phases), negative RPE (decreased RPE from the prediction to outcome phases), and non-RPE (no difference in RPE between the prediction and outcome phases). During retrieval, participants were presented with individual faces that had been seen and unseen in the encoding trials, and were required to judge whether or not each face had been seen in the encoding trials. Univariate activity in the ventral striatum (VS) exhibited a linear increase with increased RPE in facial attractiveness. In the multivariate pattern analysis (MVPA), activity patterns in the VS and surrounding areas (extended VS) significantly discriminated between positive/negative RPE and non-RPE. In the functional connectivity analysis, significant functional connectivity between the extended VS and the hippocampus was observed most frequently in positive RPE. Memory improvements by face-based RPE could be involved in functional networks between the extended VS (representing RPE) and the hippocampus, and the interaction could be modulated by RPE values in a social context.

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Background: There is an agreement among individuals from different cultures in how they judge the cuteness of a face. There are observations suggesting that some preferences may be neurobiological rather than cultural. Most of the studies conducted use adult faces with a neutral expression; however, the mechanisms involved in rating cuteness are not exactly the same as those involved in the perception of attractiveness. Furthermore, it is not always taken into account that emotional expressions influence the impression on the beauty of a face. The objective of the study is to evaluate the influence of the different emotions on the perception of cuteness of children's faces. Materials and Methods: We included 60 adults and 21 children who observed 150 photographs of children's faces expressing the six basic emotions and had to rate facial cuteness. Results: Participants gave the highest cuteness score to faces with happy emotions (mean [M] = 6.89, 95% confidence interval [CI] 6.48-7.30) and the lowest to those that expressed negative emotions (M = 5.32, 95% CI 4.87-5.78, t(160) = 5.08, P <.001). This was evidenced in adults and children of both genders, regardless of the gender of the stimulus. Conclusions: In our study, we found that facial expression generates an impact on the perception that a subject has on the cuteness of the face. The faces that show happiness were scored as more cute compared to those that expressed anger, disgust, or sadness. We suggest that expression of positive emotions, like a smile, could increase the conducts associated with caring, placing the child in a more favorable situation for the future.

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INTRODUCTION: The aim of this study was to investigate the relationship between levels of facial attractiveness and the perception of different types of malocclusion. METHODS: A preliminary questionnaire was used to assign photographs of three female patients to low, moderate, and high facial attractiveness designations. Seven modified photographs for each smile photograph of each of these three patients were created. The evaluated photographs were as follows: P0: at rest position, P1: ideal smile, P2: - 2-mm (low) smile line, P3: + 4-mm gummy smile, P4: + 6-mm gummy smile, P5: maxillary anterior crowding, P6: median diastema, P7: polydiastema. An eye tracking device and a questionnaire were used to collect data from orthodontists, dentists, orthodontic patients, and laypeople. RESULTS: Total fixation duration varied depending on the type of malocclusion, the level of facial attraction, and the participants' occupations. In general, orthodontists and dentists had higher total fixation duration scores than orthodontic patients and laypersons. The maxillary anterior crowding photograph had the lowest visual analysis scale score at each attractiveness level (low, medium, and high). Visual analysis scale scores became similar at each attractiveness level only in the P4 photographs, and thus the difference in facial attractiveness disappeared. CONCLUSION: While a worsening of the ideal smile had a smaller impact on aesthetic perceptions in an individual with low facial attractiveness, it had a significant negative impact on a person with high facial attractiveness. Anterior crowding and diastema had a more negative impact on facial attractiveness than low or high smile lines.

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The pandemic has made wearing masks commonplace, prompting researchers to investigate their effects on interpersonal perception. Findings indicate masks obstruct face identification and expression recognition, with lower face cues being most affected. When judging attractiveness, masks can enhance the appeal of less attractive faces, but reduce the appeal of more attractive faces. Trust and speech perception outcomes are inconclusive. Future studies could focus on individual differences in how masks influence our perception of others.

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Although decades of research have identified facial features relating to people's evaluations of faces, specific features have largely been examined in isolation from each other. Recent work shows that considering the relative importance of these features in face evaluations is important to test theoretical assumptions of impression formation. Here, we examined how two facial features of evolutionary interest, facial attractiveness and facial-width-to-height ratio (FWHR), relate to evaluations of faces across two cultures. Because face evaluations are typically directly measured via self-reports, we also examined whether these features exert differential effects on both direct and indirect face evaluations. Evaluations of standardized photos naturally varying in facial attractiveness and FWHR were collected using the Affect Misattribution Procedure in the United States and Turkey. When their relative contributions were considered in the same model, facial attractiveness, but not FWHR, related to face evaluations across cultures. This positive attractiveness effect was stronger for direct versus indirect evaluations across cultures. These findings highlight the importance of considering the relative contributions of facial features to evaluations across cultures and suggest a culturally invariant role of attractiveness when intentionally evaluating faces.

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