Upper Lip Lift History Is Associated With Perioral Visual Attention During Smile Observation: An Eye-Tracking Case-Control Study.

IMPORTANCE: Individuals with a history of localized facial aesthetic surgery may show different patterns of visual attention toward procedure-relevant facial regions. However, little is known about whether a history of upper lip lift surgery is associated with altered visual attention and aesthetic judgment during smile observation. OBJECTIVE: To compare gaze patterns and aesthetic ratings of smiling faces between women with and without a history of upper lip lift. METHODS: This case-control eye-tracking study included 30 women with a history of isolated upper lip lift and 30 age-matched women without facial aesthetic surgery. Participants viewed standardized smiling faces under 2 conditions: harmonious smiles and digitally edited smiles with reduced perioral youthfulness. Fixation duration, time to first fixation on the perioral region, and visual analog scale aesthetic ratings were recorded. RESULTS: Compared with controls, women with a history of upper lip lift showed longer fixation duration on the perioral region under both smile conditions. They also demonstrated a shorter time to first fixation on the perioral region when viewing smiles with reduced perioral youthfulness. Aesthetic ratings did not differ significantly between groups for harmonious smiles, but the upper lip lift group gave lower ratings to smiles with reduced perioral youthfulness. CONCLUSIONS: Upper lip lift history was associated with greater perioral visual attention and lower aesthetic ratings of smiles with reduced perioral youthfulness. These findings suggest heightened sensitivity to perioral aesthetic features among women with prior upper lip lift.