Abstract
BACKGROUND: Relatively little research has been done on the application of objective tools in guiding Ethnic Plastic Surgery in Asian patients. The evolutionary psychology theory of koinophilia, or love of average features, presents the basis for a solution to build a foundation for crowd-sourced East Asian aesthetic standards. OBJECTIVES: The authors hypothesize that the averaged composite face in a cohort will be viewed as significantly more attractive than their respective cohort. METHODS: Cohorts were created based on the gender of the individual in the photograph (40 females and 40 males of East Asian descent). Two surveys were created, 1 for the female cohort and the other for the male. The surveys assessed the aesthetic preference of each photograph using a Likert scale ranging from 1 to 7. Surveys were distributed using the popular crowdsourcing program Amazon Mechanical Turk (Amazon, Seattle, WA). RESULTS: The authors received 875 respondents for the male cohort survey and 876 respondents for the female cohort survey. For both the female and male cohorts, the composite images had a statistically significantly higher rating (P < .001) than the mean of the other images. Among other significant demographic findings, when considering both ethnicity and location of residence, Asian raters living in Asia preferred the composite significantly more than Asian raters living in North America (P < .001). CONCLUSIONS: Raters' preference for the composite average face is in concordance with the evolutionary psychology literature. Thus, this study affirms the utility of using facial composites to guide surgeons in identifying aesthetic standards for patients of East Asian descent.