Evaluation of the beauty standards for forehead morphology in Black women: Implications in surgical and non-surgical forehead contouring

Abstract

Owing to its importance in gender perception, forehead feminizing cranioplasty represents one of the most impactful components of facial feminization surgery. However, aesthetic standards for these procedures are informed largely by Caucasian beauty standards, which may not fully reflect those of other populations. This study evaluated the differences in forehead shape between conventionally beautiful Black and similarly identified Caucasian women. Two lists published by an independent publication (StyleCraze), “26 Most Beautiful African Women” and “52 Most Beautiful Women in the World,” were used to identify Black and White women for comparison. Side profile images of the women were analyzed and compared using elliptical and piecewise linear models via multiple anatomic slope, angle, and eccentricity measurements. Black women were found to have a reduced forehead eccentricity (0.91 vs. 0.94, Cohen’s d=0.88), indicating greater roundness of the forehead. In the piecewise linear model, there was a more acute angle of the inferior forehead in the Black women (160.72° vs. 170.01°, Cohen’s d=1.57); this region, in particular, was responsible for the increased roundedness of the forehead in the Black models. Thus, the forehead shape in conventionally beautiful Black women has significant differences compared to similarly identified Caucasian women. Surgical planning for feminizing cranioplasty in this population should consider this underlying morphological variation for optimal cosmetic outcomes. Furthermore, we demonstrated a novel methodology using elliptical and piecewise linear models to approximate the curved surface of the forehead, which may provide a basis for future studies.