Similarities and Differences in the Perception of Artificially Modified Faces Between Caucasian and Chinese Observers

BACKGROUND: Perception of facial attractiveness is influenced by cultural and ethnic factors. Understanding how different populations perceive facial modifications is important for guiding aesthetic treatments. OBJECTIVES: To compare the perceptions of Caucasian and Chinese observers regarding facial modifications that simulate common aesthetic procedures and to identify potential differences or similarities between these populations. METHODS: In this cross-sectional survey-based investigation, 263 participants (112 Chinese, 151 Polish Caucasian) evaluated experimentally modified images of male and female faces from their own ethnic group. The images were modified to simulate increased lip and cheek volume and lateral elevation of the eyebrows and canthal angle, either alone or in combination. Participants rated each image on attractiveness, unattractiveness, femininity, and masculinity using a 5-point Likert scale. Statistical comparisons were made between ethnic groups and between modified and unmodified images. RESULTS: Both ethnic groups rated faces with multiple modifications as less attractive and more unattractive compared to unmodified faces. Periorbital modifications were rated as least attractive and most unattractive in Caucasian observers, while cheek modifications were rated as least attractive and most unattractive by Chinese participants, particularly women. Increased lip volume decreased attractiveness in both groups but did not significantly alter ratings of masculinity or femininity. CONCLUSIONS: Caucasian and Chinese observers share similar (negative) perceptions toward excessive facial modifications but differ in the specific features they evaluate least attractive. These results indicate that a similar aesthetic perception emerges particularly when multiple facial features are altered.