Visual Perception and Self-Assessment of Facial Pleasantness in Brazilian Adolescents with and Without Cleft lip and Palate

Objective To evaluate the visual perception and self-perception of facial pleasantness in adolescents with and without cleft lip and palate (CLP). Design Cross-sectional observational study. Setting Center for care and research in craniofacial anomalies. Participants Adolescents, aged 12 to 18 years, with (n = 79) and without (n = 158) CLP. Main Outcome Measure Visual perception and self-perception of facial pleasantness were measured using images of adolescents’ faces with and without CLP and self-assessment questions. Results Participants with CLP rated images of adolescents as having higher facial pleasantness compared to those without CLP (P < .001, Cohen's d = 0.63). Overall, both groups reported similar satisfaction with their facial appearance with no to low frequency of concerns. Non-CLP rated their own facial appearance (P < 0.001). The CLP group reported higher levels of discomfort regarding facial appearance as having lower pleasantness (P < .001, Cohen's d = 0.08), and worried more frequently about their appearance (P < .001, Cohen's d = 0.56). CLP group reported higher (P < .001) frequency of facial appearance concerns, impact on daily life, interference in interpersonal relationships, and dissatisfaction with facial appearance with small to medium effect sizes (Cohen's d = 0.14 to 0.57). Across both groups, female participants exhibited higher concerns about facial appearance compared to males (P < .001) with modest effect sizes (Cohen's d = 0.16 to 0.47). Conclusion Participants with CLP rated others’ facial appearance as more pleasant than those without CLP. While adolescents with/without CLP both reported few concerns about their facial appearance, participants with CLP and females had higher concerns. Psychosocial support may be beneficial for adolescents with/without CLP.