What constitutes beauty and how is it perceived?

Researchers now believe that beauty preferences are partly an effect of a rudimentary cognitive process that appears quite early in life, with humans having a seemingly automatic ability to categorize a person as beautiful or not. Scientific literature supports such physical features as universal criteria for human attractiveness.

"This instantaneous capability of human beauty categorization is partially determined by a function of physical features, such as facial averageness, symmetry and skin homogeneity," explains corresponding author Neelam Vashi, MD, associate professor of dermatology at Boston University School of Medicine and director of the Boston University Cosmetic and Laser Center at Boston Medical Center, writes in a commentary in the journal Clinics in Dermatology.

However, the perception of attractiveness has fluctuated drastically over time. For example, a review of widely viewed images in Western culture over the course of the 20th century provides an example of the evolution of the beautiful female body. While a waist-to-hip ratio has stayed relatively constant, there have been wide variations of body mass index across cultures and time periods. The multifaceted concept of beauty shows that perception can change depending on the individual, society and/or historical period.

In addition, previous studies have attributed beauty and attractiveness to relatively stable face and body characteristics such as shape and symmetry. However, recent studies suggest that what each person perceives as beautiful stems from a complicated process influenced by both their environment and their perceptual adaptation (an experience-based process that reshapes how we perceive our environment). "It is important to note that what each person considers to be 'beautiful' is constantly being updated by his or her own experiences thus contributing to a mental depiction of what attractiveness means to that particular individual," Vashi said.

According to Vashi, for decades, the mass media platform has introduced certain criteria to what establishes beauty, and more recently social media, instant photo sharing and editing apps have further influenced how society adapts to beauty principles. "Unfortunately, a selfie, filtered or not, may not correspond to a patient's reflection in the mirror, and may lead to an unrealistic and unattainable perfect beauty sought through cosmetic surgery and procedures."

Vashi believes true beauty is likely an evolving interplay between time-constant biological traits and the continuous molding that occurs through exposures in our environment. Clinicians should counsel patients on the importance of understanding that each individual has his or her own beauty and unique features and that an individualized and natural approach to cosmetic procedures are key to beauty enhancing procedures.