Associations between palpebral fissure morphology and AI-derived facial attractiveness scores in Asian adults.

OBJECTIVE

Periocular surgery is a common cosmetic procedure in Asia; however, objective population-level quantitative evidence regarding the relationship between periocular morphology and facial attractiveness is limited. We aimed to assess the association between periocular morphology and AI-derived facial attractiveness scores in an Asian population.

METHODS

This study included 3517 Asian adults from the SCUT-FBP5500 database. We constructed and measured 9 periocular measurements and analysed their associations with AI facial attractiveness scores using sex-stratified scoring group comparisons, Spearman correlation analysis, and restricted cubic spline regression analysis. Furthermore, we performed sensitivity analyses using human scoring and age-adjusted models.

RESULTS

The higher-score group was associated with smaller brow-to-lid distance, intercanthal distance and palpebral fissure length, larger outer canthal angle, upper eyelid curvature index, eyelid height, and canthal tilt. Brow-to-lid distance and intercanthal distance showed the strongest inverse associations and highest explanatory values in the restricted cubic spline (RCS) analyses, whereas outer canthal angle and upper eyelid curvature index showed the strongest positive associations with intermediate explanatory values. Weak and less consistent correlations were obtained for lower eyelid curvature index, whereas sex-specific results were observed for inner canthal angle. In the sensitivity analyses using mean human ratings and age-adjusted models, the main pattern was generally supported; however, findings were less consistent for lower eyelid curvature index, inner canthal angle, and palpebral fissure length in men.

CONCLUSION

This study shows a specific association between periocular morphology and facial attractiveness and these findings provide population-level directional guidance for periocular aesthetic assessment.