Is a symmetrical face really attractive?

Facial symmetry plays an important role in facial attractiveness and is one of the major criteria used to determine attractiveness in humans. In craniomaxillofacial surgery, facial symmetry is one of the main considerations. The aim of this study was to determine anthropometric measurements quantitatively and investigate the relationship between facial symmetry and attractiveness in a local Malay population. The study included 30 photographed Malay individuals and 100 photograph assessors, all aged between 18 and 26 years. The assessors indicated their preferences regarding the more attractive face on original and manipulated (symmetrical face) photographs. None of the photographed subjects had a perfectly symmetrical face (asymmetry index (AI) of 0%); 33.3% of the photographed subjects had an AI in the range of 1.6-2.0%. The majority of assessors chose the manipulated symmetrical face as the most attractive (manipulated photograph selected in 91.2% of cases). As facial symmetry is considered a critical factor in attractiveness, it is beneficial to consider balance and symmetry prior to facial reconstruction. The AI values found in this study may be useful as guidance to determine the normal minimum balance of facial symmetry. No AI values indicating perfect symmetry were observed for the unedited facial anthropometric measurements. However, the projection of a perfectly symmetrical face does influence the perception of facial attractiveness.