Objective: The aim of the study was to determine how orthodontists, general dentists, and laypersons perceived the esthetic appeal of altered lip projection and thickness in male and female individuals across different ethnic groups.

Methods: A 24-question survey was distributed via Qualtrics to orthodontists, general dentists, and laypersons. Participants evaluated digitally altered facial photographs that varied in lip thickness and projection, ranking them based on perceived attractiveness. Images were generated using AI-based modeling and edited to reflect different degrees of lip modification. Statistical analyses, including the Kruskal-Wallis test and Dunn’s post-hoc test with Bonferroni correction, were conducted using SPSS to determine differences in rankings among the three respondent groups.

Results: Ideal lip dimensions varied among orthodontists, general dentists, and laypersons, indicating discrepancies between clinical training and societal preferences. The study also found ethnic and gender-based differences in attractiveness rankings. Caucasian subjects were perceived as most attractive with slightly thick (+1 mm) lips in frontal view and slightly retrusive (-1 mm) lips in profile view. African American subjects showed greater variability in attractiveness rankings, particularly among female subjects. Asian and Hispanic subjects followed similar trends to Caucasians, with average to slightly thick lips being preferred in the frontal view and average to slightly retrusive lips in the profile view.

Conclusion: Results suggest that esthetic preferences for lip thickness and projection have evolved. These findings highlight potential limitations in traditional orthodontic esthetic guidelines, which were largely developed based on Caucasian norms and may not fully reflect the diverse preferences of modern patients. As patient expectations shift, orthodontists should consider individualized treatment planning that integrates both functional and esthetic concerns. Future research should expand sample sizes and incorporate a more diverse range of respondents to further refine population-specific esthetic guidelines in orthodontics.