Clinicians and laypeople assessment of facial attractiveness in patients with cleft lip and palate treated with LeFort I surgery or late maxillary protraction

Objective: To assess the changes in the facial attractiveness (FA) in two groups of cleft lip and palate patients with Class III malocclusions treated using LeFort I surgery or late maxillary protraction. Materials and methods: Standardized pre-and post-treatment photographs were taken of 32 patients (17 corrected by orthognathic surgery and 17 by late maxillary protraction). The photographs were randomized and 42 clinicians and 121 laypeople rated them on a 10-point FA scale via a web-based survey. Results: Clinicians’ mean FA values increased from 4.45 to 5.16 [95% CI of mean difference (MD), 0.59–0.82, p < 0.001] in surgical cases and 4.84 to 5.30 (95% CI of MD, 0.35–0.56, p < 0.001) in protraction cases. The laypeople mean FA values increased from 5.07 to 5.54 (95% CI of MD, 0.40–0.53, p < 0.001) in surgical cases and 5.51 to 5.68 (95% CI of MD, 0.11–0.23, p < 0.001) in protraction cases. When patients combined, laypeople rated FA0.64 points higher (95% CI,0.54–0.74,p < 0.001) inpre-treatment and 0.38 points higher (95% CI, 0.27–0.48, p < 0.05) in post-treatment relative to clinicians. Conclusion: Both clinicians and laypeople perceived an improvement of FA after both treatments. Laypeople rated FA higher compared to clinicians