Abstract
INTRODUCTION: The use of cosmetics, particularly lipstick, has historically enhanced facial appeal. This study evaluates laypeople's perceptions of the attractiveness and employability of two female models from different age groups, each with varying malocclusions, both with and without lipstick. MATERIALS AND METHODS: This cross-sectional study involved 77 lay participants who assessed digitally edited photographs of young and older female models with varying malocclusions (IOTN 1, 3 and 5), each shown with and without red lipstick. Eye-tracking technology and questionnaires were used to evaluate perceptions of attractiveness and employability. Data were analysed using one-way ANOVA and post hoc tests, and Pearson's chi-squared test. RESULTS: IOTN 1 with lipstick was rated 49.71 ± 25.74 and without lipstick 47.88 ± 25.44. These were significantly higher than IOTN 3 with lipstick (40.62 ± 24.16; p = 0.015), IOTN 3 without lipstick (39.23 ± 23.85; p = 0.002), IOTN 5 with lipstick (34.25 ± 24.77; p < 0.001) and IOTN 5 without lipstick (31.39 ± 23.30; p < 0.001). Employability ratings also varied significantly when comparing IOTN 1 and IOTN 5 images (p < 0.001). Eye-tracking heat maps revealed that the mouth was the primary area of visual focus across all conditions, regardless of lipstick use. CONCLUSION: Malocclusion significantly impacts visual attention and attractiveness perception, with the mouth being the primary focus. While lipstick influences attention dispersion, it does not shift the main focus from the mouth. Heat map analysis confirmed that the mouth area remains the primary focus across all images, regardless of lipstick use.