Three-dimensional soft-tissue facial anthropometry and dermatologist-rated attractiveness among Thai women: implications for facial aesthetic and orthognathic treatment planning

<title>Abstract</title> <p>Purpose Facial attractiveness is multifactorial and relevant to facial aesthetic assessment, orthognathic planning, and minimally invasive facial rejuvenation. This study characterized three-dimensional soft-tissue facial anthropometric measurements associated with dermatologist-rated attractiveness among women from Thailand's three major ethnic groups. Methods This clinic-based study included 131 Thai women who self-identified as Thai-Indian, Thai-Thai, or Thai-Chinese. Standardized photographs from five angles were processed using the LifeViz® Mini system to generate three-dimensional facial images. Three board-certified dermatologists independently assessed facial attractiveness. Participants rated attractive by at least two dermatologists were classified into the dermatologist-rated high-attractiveness group; the remaining participants formed the reference group. Facial landmarks, proportions, angles, and curvature measurements were compared between groups. Results The dermatologist-rated high-attractiveness group showed significantly smaller horizontal soft-tissue measurements than the reference group, including interalar width (19.443 vs. 19.945 mm, P = 0.009), bigonial width (52.446 vs. 53.561 mm, P = 0.008), and auricular width (65.044 vs. 66.642 mm, P = 0.007). Significant vertical differences were also observed, whereas no significant differences were found along the z-axis. Conclusion In this clinic-based cohort, higher dermatologist-rated attractiveness was associated with a narrower nasal base and slimmer lower facial contour, with selected vertical differences around nasal and lower-face landmarks. These findings may support population-specific facial assessment and treatment planning when interpreted as descriptive associations rather than prescriptive beauty standards.</p>