The latest literature review on aesthetic and cosmetic dermatology has been written by Wollina et al.^{(2, pdf)}  They address the application of hormone replacement therapy, Botulinum toxin (Botox) for brow lifting, three major approaches toward cellulite treatment, and body sculpting by lipotransfer and laser-assisted lipolysis.

Lipotransfer refers to moving excess fat from one region to another that needs it.  See examples of using autologous fat transfer (autologous means from self) to improve hollowed-out cheeks in older individuals in the article by Wollina et al. 

Laser-assisted lipolysis is a minimally invasive procedure using fine probes that use the heating effect of a laser to destroy fat cells jut beneath the skin, and the debris are then mechanically removed by another fine probe.  This process is for fine tuning fat deposits (see Fig 1) and has implications for treating cellulite though as of right now few physicians use it for treating cellulite.     

Fig 1. Laser-assisted lipolysis of the buttocks region of a woman.  Picture A show the initial appearance and picture B shows the appearance 23 month after treatment.

The kid of fat loss the woman is Fig 1 was looking for wouldn’t be easily achievable by exercise or dieting, and neither would it be recommended to her for the purposes of loosing body fat because she had a healthy amount of body fat to start with.

More articles will follow.

References

1. Draelos, Z. D., The facial rejuvenation algorithm, J Cosmet Dermatol, 5, 195 (2006).
2. Wollina, U., Goldman, A., Berger, U., and Abdel-Naser, M. B., Esthetic and cosmetic dermatology, Dermatol Ther, 21, 118 (2008).

A brief overview of laser and light-based treatment of cellulite was provided by Macrene Alexiades-Armenakas^{(1, pdf)} (information current as of late 2006) –  

Syneron Velasmooth – FDA (U.S. Federal Drug Administration) approved.  Involves infrared radiation, mechanical rollers and suction pressure.  The mechanical stressors add to the thermal (heat) stress.  

Cynosure TriActive – FDA approved.  Involves a laser and massage.

Synergie AMS – FDA approved.  Involves massage.

Thermacool – FDA approved for off-face wrinkle reduction; presumably would help cellulite.  Uses radiofrequency.

Alma Accent – Newer system compared to ‘Thermacool’; uses radiofrequency.  FDA approval was reported as pending.

Cutera ultrasound – FDA approval reported as pending; uses ultrasound for heating.

Ultrashape – FDA approval reported as pending; uses ultrasound for heating.

IllumiMed Photoactive – FDA approval reported as pending; uses light emitting diode for heating.

The common theme behind these approaches is causing mild heat injury to the collagen-rich connective tissue that enmeshes the fat cells immediately beneath the skin, and mechanical stressors may be added in some cases.  Some before and after pictures employing these methods will help illustrate how helpful they are.

Wanitphakdeedecha and Manuskiatti^{(2, pdf)} reported reduction in thigh and abdominal girth as well as improved appearance of the back of the thighs following the use of the Velasmooth system for treating these regions (e.g., Fig 1).

Fig 1. Before (top) and after pictures of reduced girth and smoothened skin following 8 heat-mechanical stressor treatments using the Velasmooth system.⁽²⁾

Sadick and Magro^{(3, pdf)} reported reduced thigh circumference and improved skin appearance in women undergoing thigh treatment using the Velasmooth system (e.g., Fig 2).

Fig 2. The outcome from 12 treatments employing the Velasmooth system spread over 6 weeks.⁽³⁾  Picture 1 shows a pretreatment picture, 2 shows the outcome 4 weeks after final treatment, 3 shows the outcome 8 weeks after final treatment and 4 shows the outcome 12 weeks after final treatment.

Fink et al.^{(4, pdf)} employed intense pulsed-light treatment with a retinyl-based cream (retinyl palmitate) and reported improved skin appearance using the light-based heating treatment alone or the combination treatment (e.g., Fig 3).  Vitamin A-derived retinyl compounds have been shown to improve the health and appearance of aged skin by stimulating increased collagen production.  The authors reported that the addition of the retinyl palmitate cream appears to help produce a better outcome though a definitive conclusion requires more trials.

Fig 3. The outcome from 12 treatments employing intense pulsed-light heating and 5-per-week topical application of retinyl palmitate, spread over 12 weeks.⁽⁴⁾  Before (left) and after pictures of a patient shown in row 1; row 2 shows another patient.

The potential side effects of these treatments include burns since heat is being employed.  Retinyl-based compounds may also cause skin lightening in the applied regions, which would be a problem for dark individuals, and increase skin sensitivity to sunlight.

Improved treatments can be expected in the future.  For instance, drugs that inhibit collagenase (an enzyme that breaks down collagen) may be of help in combating both cellulite and skin aging, but their application for treating cellulite will be a future discussion.

References

1. Alexiades-Armenakas, M., Laser and light-based treatment of cellulite, J Drugs Dermatol, 6, 83 (2007).
2. Wanitphakdeedecha, R., and Manuskiatti, W., Treatment of cellulite with a bipolar radiofrequency, infrared heat, and pulsatile suction device: a pilot study, J Cosmet Dermatol, 5, 284 (2006).
3. Sadick, N., and Magro, C., A study evaluating the safety and efficacy of the VelaSmooth system in the treatment of cellulite, J Cosmet Laser Ther, 9, 15 (2007).
4. Fink, J. S., Mermelstein, H., Thomas, A., and Trow, R., Use of intense pulsed light and a retinyl-based cream as a potential treatment for cellulite: a pilot study, J Cosmet Dermatol, 5, 254 (2006).

Indications for cosmetic camouflage

Vascular lesions (associated with blood vessels near skin surface)

Vascular malformations (port-wine stains) and hemangiomas
Telangiectasias
Rosacea
Varicose veins

Pigmentary disorders

Vitiligo
Excess pigment production after skin inflammation
Reduced pigment production after skin inflammation
Melasma
Lentigines
Solar lentigo
Nevi
Café au lait spots
Dark circles of the eyes
Tattoos

Scars

Atrophic
Hypertrophic
Stretch marks
Burn scars

Chronic skin diseases

Acne
Scleroderma
Lupus erythematosus

Temporary outcomes after surgery

Laser
Dermabrasion
Chemical peels
Surgical procedures (rhytidectomy, rhinoplasty, etc.)

The elements of a good cover cosmetic

Natural looking.
Opaque.
Greaseless (so that it doesn’t stain clothes).
Waterproof.
Easy to apply.
Long lasting.
100% fragrance free.
Applicable to all skin types.  Be available in different shades to match different skin colors.
Nonirritating.
Nonsensitizing.
Nonphotosensitizing (not making one more sensitive to sunlight).
Noncomedogenic.

Broad types of cover cosmetics

Face in general – foundations, concealers, powders, blushers.
Eyes – Eye foundation, eye shadow, eyeliners, mascaras, eyebrow pencils.
Lips - lipstick, lip liner crayons, foundations, glosses.

The types of foundation cover

Base: Oil-based, water-based, oil-free, water-free.
Finish: matte, semi-matte, moist semi-matte, shiny.  Matte finish is most suitable for cosmetic camouflage.
Form: liquid, mousse, water-containing cream, soufflé, anhydrous (no water) cream, stick, cake, and shake lotion.  The cream form is commonly used for camouflage since it can have more iron oxide for coverage, and is thicker and more occlusive because of the wax.

The base of foundation cover

Oil-based foundations – for dry skin.  Water-in-oil emulsions containing pigments suspended in oil such as mineral oil, lanolin alcohol, vegetable oil (coconut, sesame, safflower), or synthetic esters (isopropyl myristate, octyl palmitate, isopropyl palmitate).  They are stable as they mix with sebum and are easy to apply.  Water evaporates from the foundation after application, leaving the pigment in oil on the face.

Water-based foundations – designed for dry to normal skin.  Oil-in-water emulsions containing large amounts of water and a small amount of oil in which the pigment is suspended in emulsion. Contain primary emulsifiers such as triethanolamine or a nonionic surfactant and secondary emulsifiers such as glyceryl sterate or propylene glycol sterate.  They are less stable than oil-based foundations but are more popular.

Oil-free foundations – for oily skin.  Contain silicone derivatives (dimethicone or cyclomethicone), which are noncomedogenic, instead of animal, vegetable, or mineral oils.

Water-free foundations – different oils (vegetable, mineral, lanolin alcohol, synthetic esters) are mixed with waxes to form a cream where high concentrations of pigment are incorporated. Titanium dioxide with iron oxide, occasionally in combination with ultramarine blue, are the coloring agents used. Waterproof, opaque, well-suited for cosmetic camouflage.

A brief explanation of technical terms – An emulsion is a blend of two or more substances that normally cannot be blended (e.g., water and oil).  In a water-in-oil emulsion, oil surrounds droplets of water (e.g., butter, margarine).  In an oil-in-water emulsion, water surrounds droplets of oil (e.g., milk, cream).  An emulsifier is a substance used for emulsification, i.e., the process that produces an emulsion.  A surfactant (surface acting agent) is used as an emulsifying agent.  Soap is a type of surfactant.

The procedure for applying cosmetic camouflage

Skin preparation: The skin should be cleansed and moisturized if necessary.

Neutralization/correction of color: If there is a lesion, it may have to be neutralized by using an opposite color.  A green corrector is used for pink or red discoloration, lavender corrector for yellow discoloration and gold corrector for a gray blemish.

Cover cream: It will take some experimentation to find the right shade of cover cream, and sometimes two shades will need to be blended.  Samples should be applied to different parts of the face; the correct sample/blend will barely contrast with surrounding skin color.   The cover cream should be applied by dabbing with the third finger or a synthetic sponge rather than be rubbed onto the skin.  If needed for a more natural look, special theatrical sponges (stipple sponges) can be lightly dabbed on the cover cream to create freckles or beard stubble (men).

Powder application: After the cover cream dries for 5 min (8 – 10 min for dry or aging skin), it is waterproofed and set with a colorless powder.  A setting powder is not needed for very dry skin; its purpose is to absorb excess oil, and a few minutes are all it needs to do so.  Excess powder is removed with a brush or cotton ball.  If scars are present, then a lighter powder is used over a depressed scar since depressed scars appear darker, and conversely, a darker powder is used for elevated scars.

How to remove makeup/cosmetic camouflage

Water and soap will not remove oil-based camouflage makeup easily.  These require a water-in-oil-based cleansing solution to break down and remove the oil and wax coating.  Subsequently, water and soap will do the job.

References

1. Antoniou, C., & Stefanaki, C. (2006). Cosmetic camouflage. J Cosmet Dermatol, 5(4), 297-301.

In the 2^nd study, it was shown that men’s degree of sensation seeking was unrelated to attractiveness ratings of facial femininity in men’s faces.  In the first two studies, men’s ratings were on a 0–7 scale.  To rule out the possibility that men more into sensation seeking were more prone to choose higher numbers to rate faces they found more attractive, in the 3^rd study, the authors examined the number of times men preferred the more feminized faces, and replicated the main find of the first two studies.

So what is the explanation?  The authors favor a condition-dependent hypothesis.  They point out research showing that women find more daring men more appealing, i.e., willingness to indulge in more risky behaviors on the part of men is potentially attractive to women and a potential marker of men’s mate quality.  The extent of femininity of women is also a potential marker of their mate quality.  So the assumption is that those with higher mate value prefer others with higher mate value.  But whereas those with higher perceived mate value are expected to disproportionately seek/direct courtship toward partners with higher mate value, why should they find those of lesser mate value more appealing in a scenario where they are merely asked to rate attractiveness rather than direct courtship toward the choices presented?

I can think of a more likely explanation.  The neurophysiology of overall stronger sensation seeking can be roughly modeled as a need for overall stronger stimuli to engage one’s mind.  Therefore, heterosexual men who need stronger stimuli in general to stimulate their mind disproportionately favor more feminine women and possibly have a stronger interest in women’s attractiveness also.

What may cause stronger sensation seeking?  The authors mention some research on prenatal and adult exposure to testosterone.  If the brain organizes and develops under higher androgen levels, then the odds of sensation seeking are increased.  There is empirical evidence for this in terms of studies basic on finger length ratios and salivary testosterone in men, and also observations that men are more likely to indulge in sensation-seeking activities than women.

References

1. Jones, B. C., DeBruine, L. M., Little, A. C., Conway, C. A., Welling, L. L. M., & Smith, F. (2007). Sensation seeking and men’s face preferences. Evol Hum Behav, 28, 439-446.

One of the most oft-cited idiotic excuses designers use to defend their choice of wafer-thin models on the catwalks, is some variation on the “curves – breasts and thighs and rounded bits - ruin the line of the clothes”/“the design was perfect on paper, it gets distorted by breasts” etc.

What they’re talking about is how the ideal of the design, on paper, works differently when translated into fabric and placed on a real body. Inevitably, when one designs in a 2D paper format, the final result will be different. You’re going from a painting to an object. Yet, rather than accept that the finished piece (a dress, skirt, trouser, what have you), is the real design, and the original illustration is merely a piece of artistic whimsy, designers all too often cling to the illustration as the perfect realisation of the design, with the clothing itself a poor facsimile of what could have been.

In a sane world, we would shake our heads and say, “But isn’t the point of designing clothes to design, well, clothes? So if you can’t design a dress on paper that works well when made, you’re not very good at your job. And if you only want to design dresses on paper, go off and be a painter, or a full-time illustrator.”

But this is fashion. So instead, as we’ve seen, we blame the models for distorting the design/ruining the line/stretching the fabric. That’s not exactly what I want to examine here: we’ve discussed designers’ wacky views of women’s bodies on the catwalk fairly often; let’s now move the discussion over to how they imagine women’s bodies.

Ever noticed that the women in fashion illustrations have something in common, both with each other, and with catwalk models? Let’s take a look:

Ceci n’est pas des femmes

Now, fashion illustrators are not typically the designers themselves, but it is easy to show that the blame does not lie with the illustrators since they are doing what they are asked to do.  This is illustrated well by the following comment left by Milla at the toofatforfashion.blogspot.com site from which the previous excerpt is taken from –

I am a plus size woman and I am studying fashion design and aspire to have my own plus size line or work with a plus size label.

I am presently taking fashion illustration and design in school.

The teacher DOES NOT ALLOW US TO DRAW LARGER WOMEN.

I tried because that is how I drew then before I took the class and every time we draw the croquis ( the figures) non thin we get ducked points and grades.... I have so far this semester gotten away with drawing one black illustration ( she looks like Tina Turner ) But she also penalizes us for that.

She said this out loud in class:

“You are drawing them like size 18s. Size 18 IS NOT FASHION”. I AM a Size 18 and I almost cried my eyes out because it was so discriminatory and offensive.

I tried complaining to other teachers and to the chairperson of the department but they supported the illustration teacher.

Now I am forced to draw skinny figures or I fail. And I need the class because I am applying to Central St. Martins in London so I can become a big time plus size designer....

Hugs,
Milla

The good news is that awareness of the role played by homosexual fashion designers is spreading since one indirectly referenced it and another explicitly laid the blame on this group in the comments on the article.  There were two opposing commentators, Caz and Downtown Venus.  Caz described this notion as simplistic, a bit homophobic and alleged that homosexual men are not more misogynistic than heterosexual men.   

However, misogyny is not an issue.  Women come in diverse shapes.  A skinny woman is not less of a woman compared to an overweight woman, and if the industry loves the very thin ones, then it does not follow that the dominant individuals somehow dislike women in general.  Since women are their major customers, why would they dislike women as a group?  The dominant designers just favor a narrow subset of women’s physiques.  Their choices reflect their personal aesthetic preferences, which lean toward the looks of boys in their early adolescence.

Here are some examples of illustrations that strongly contrast with the typical fashion illustration, and they are taken from the realms of video games, pin up art, fantasy art and comic book superheroines –

Legend: Shown from top to bottom: Lara Croft (Tomb Raider video game), pinup by Alberto Vargas, pinup by Carlos Cartagena, fantasy art by Lorenzo Sperlonga, Red Sonja, Starfire (Teen Titans), and She-Hulk (note feminine curves in spite of the muscularity required of the character).

The reader can guess what the typical fashion illustration would look like if heterosexual men dominated the fashion industry.  A reader emailed me the following –

Anyhow, one thing that occurred to me as possible examples of what men find attractive in women are possibly superheroines - their figures (if not always their faces) are hyper-feminine (to the point of fantasy, but that illustrates the point really); faces of some you might categorize as “masculine” (I suppose drawn that way because they look “tougher”, but even the ones with stern looks tend to have more femininely-drawn faces when in “streetcloths” rather than battle scenes). Some of them are heavily muscled, but not a majority - even of the ones known for skill in melee combat. Virtually all are very busty/busomy, have slender waists, wide hips, and rounded fundiments. The only exceptions being ones depicted as being young (thus girlish figures rather than womanly).

See also “Most Common Super Power” trope at tvtropes:
http://tvtropes.org/pmwiki/pmwiki.php/Main/MostCommonSuperPower

Compare Starfire of the Teen Titans comics with Starfire of the ugly TV show version - Starfire of the comic is hawt, Starfire of the cartoon show is nawt, plus is a moron).

Girlfriends of male superheroes display this even better (since they don’t have “masculine” strength and don’t need to look stern/determined in combat - which isn’t to say that a real woman can’t look stern/determined, but the shortcut way for an artist to draw someone looking that way, when they don’t have an actress of the caliber of Vivien Leigh playing Scarlett in a scene of determination, is to make their face look somewhat manly) - typically being very feminine.

These characters - especially the ones created decades ago - were created by heterosexual males for an audience of “red-blooded men”. Few if any real women have figures to match them, but the point is that’s a fantasy-extreme depiction of the figure hetro men find most attractive/sexy. Hardly any of them look the least bit like supermodels. Supermodels are much more likely to look like adolescent boys from a crack den than have a figure like Linda Carter's (TV's Wonder Woman - what a figure).

See also “Jessica Rabbit”.

Pertaining to overweight physiques, Downtown Venus blames “individual lack of aesthetic sensibility to larger body shapes,” but this is characteristic of the great majority of the Western population, i.e., even if the fashion industry were dominated by heterosexual men or heterosexual women, most fashion illustrations would not depict overweight women.  What should be noted is that high-fashion models are not just very thin, they also tend to be masculine, and the industry has a penchant for using girls in their mid-teens to market to adult women.  The combination of these features makes female models come close to resembling boys in their early adolescence.

Girls bearing an uncanny resemblance to adolescent boys are few in number just as very feminine women are uncommon, and big fashion designers are in a much better position to find models with the looks they like compared to my ability to come up with feminine beauty since I don’t have much of a choice other than heavily relying on nude models, and the best looking women don’t pose nude.  Still, there are striking contrasts shown within this site, but they don’t even compare to the contrast in the realm of fantasy, as illustrated by fashion illustrations vs. superheroines, pinups and fantasy art.

The French try to target proana websites and the promotion of extreme thinness

– Charles Bremner and Marie Tourres (April 10, 2008)

Promoting extreme thinness will become a criminal offence punishable with jail in France under a government-backed law that was tabled today to combat anorexia nervosa.

The world’s first use of the law to tackle eating disorders is broadly aimed at the media and fashion world, but especially at the websites and blogs of the so-called pro-ana movement.

While many are support groups, others promote starvation as a “lifestyle choice”, with girls and young women posting their wasting images as “thinspiration” for others.

Fines of up to €30,000 and a two-year prison sentence will be imposed on offenders who “provoke a person to seek excessive thinness by encouraging prolonged restriction of nourishment” to the point of risking of death or damage to health. The prison term is raised to three years with a €45,000 fine if the person dies.

Some experts and fashion leaders oppose the bill, which is expected to be passed by parliament within months.

“You do not solve this kind of problem with the law but with understanding,” said Jean-Paul Gaultier, the designer. Didier Grumbach, head of the French Couture Federation, said that it was not up to the state to legislate on beauty and aesthetic criteria.

Some critics of the measures said that the Government was acting after the event because the big fashion and cosmetics companies had already changed their ways and stopped employing the sickly stick-figured models that were in favour a few years ago.

The homosexuals want the anorexia problem to be solved with understanding, not legislation.  And the “understanding” is that the fashion industry has nothing to do with making anorexic figures chic and providing thinspirations (thin inspirations) for the proana (pro anorexia) movement.  The homosexuals say they don’t want the “state to legislate on beauty and aesthetic criteria”...the matter should be left to their fine aesthetic tastes (also this).  The homosexuals say the legislation is not needed because the big fashion houses have “already changed their ways and stopped employing the sickly stick-figured models that were in favour a few years ago”...tell this to Ali Michael.

Attempting to outlaw proana sites is mostly a useless endeavor since the websites could be set up in a region outside the reaches of French law.  There are also many sites on losing excess body fat that proana girls can turn to.  This website itself discusses the basics of losing excess body fat, and the information could also be used to lose a healthy amount of body fat.   But the law will be affecting the fashion industry.  First it was Italy, the location of Milan, and now it looks like France and hence another fashion capital of the world, Paris, will be affected.

Personally I agree that the legislation isn’t the right way of going about it.  A better method is to provide public education that contrasts most people’s optimal aesthetic preferences with the fashion ideal and explains why there is a notable discrepancy.  Armed with this knowledge, there will be far fewer girls and women trying to lose body fat that they don’t need to from both a health and an aesthetics perspective.  Let the fashion industry use very thin models provided that it uses naturally very thin women and does not force its models to diet.

Sir:

I congratulate Dr. Munhoz and colleagues¹ on their modification of the central wedge technique, which I reported in 1998.² I applaud them for emphasizing the importance of preserving the natural labial borders to maintain a normal appearance and to prevent a possibly painful scar.

The authors used inferior wedge resection and superior pedicle flap reconstruction to perform a labia minora reduction. Although I agree that a wedge technique is preferable, I do not believe the inferior wedge gives a better result, for several important reasons. Women seeking this operation desire removal of the most bulky and protruding tissue. Removal of an inferior wedge leaves the bulky superior tissue as the labial edge. Often the inferior edge of the labium is the thinnest and least protuberant portion, as illustrated in their Figures 1 and 5. Removal of this area, therefore, is counterproductive. In contrast, a central wedge can be placed to remove the most objectionable portion of each labium. Perhaps the authors chose the superior pedicle as a solution to the difficulty in approximating the thicker upper labium, which is attached to a thick, convoluted, lateral clitoral hood to the thinner inferior labial edge. Approximating the inferior flap to the frenulum extension of the clitoris as it ends at the upper labial edge will solve this alignment quandary. Also, the outer wedge excision should then be curved laterally and anteriorly (“hockey stick” ) to excise this redundant lateral labium and excess lateral clitoral hood (if desired by the patient).³ Therefore, the internal and external V excisions are shaped differently, with the intervening subcutaneous tissue preserved while the leading labial edge is precisely re-approximated. Only enough subcutaneous tissue is excised to produce a good cosmetic result. This allows for better subcutaneous closure, which is necessary to prevent wound dehiscence and fistula formation.

The hockey stick lateral wedge excision allows for elimination of much of the unsightly lateral hood, which is a major aesthetic and often functional concern for these women; this issue is not addressed by these authors. In addition, the central wedge flaps are extremely healthy, with wide vascular bases that eliminate the tip necrosis problems seen with the superior flap technique. Therefore, a more predictable and better aesthetic outcome results with a central wedge excision combined with a lateral hockey stick V excision. A more detailed description of my technique and results will be forthcoming shortly.

Gary J. Alter, M.D.
Department of Plastic Surgery
UCLA School of Medicine
416 North Bedford Drive, Suite 400
Beverly Hills, Calif. 90210
altermd [@] altermd.com

References

1. Munhoz, A., Filassi, J., Ricci, M., et al. Aesthetic labia minora reduction with inferior wedge resection and superior pedicle flap reconstruction. Plast. Reconstr. Surg. 118: 1237, 2006.
2. Alter, G. J. A new technique for aesthetic labia minora reduction. Ann. Plast. Surg. 40: 287, 1998.
3. Alter, G. J. Central wedge nymphectomy with a 90-degree Z-plasty for aesthetic reduction of the labia minora. Plast. Reconstr. Surg. 115: 2144, 2005.

References

1. Munhoz, A. M., Filassi, J. R., Ricci, M. D., Aldrighi, C., Correia, L. D., Aldrighi, J. M., and Ferreira, M. C., Aesthetic labia minora reduction with inferior wedge resection and superior pedicle flap reconstruction, Plast Reconstr Surg, 118, 1237 (2006).
2. Alter, G. J., Aesthetic labia minora reduction with inferior wedge resection and superior pedicle flap reconstruction, Plast Reconstr Surg, 120, 358 (2007).
       

Fig. 1. Attractiveness ratings as a function of body mass index (BMI; weight in kilograms divided by square of height in meters).  In figure a, the Sabah men’s ratings are represented by the stars and red, dotted line, and the Kuala Lumpur men are represented by the triangles and blue, solid line.  In figure b, the Sabah men’s ratings are represented by the stars and red, dotted line, and the British men are represented by the squares and green, solid line.

Fig. 2. Attractiveness ratings as a function of waist-to-hip ratio (WHR).  In figure a, the Sabah men’s ratings are represented by the stars and red, dotted line, and the Kuala Lumpur men are represented by the triangles and blue, solid line.  In figure b, the Sabah men’s ratings are represented by the stars and red, dotted line, and the British men are represented by the squares and green, solid line.

Judgments by men in Britain and Kuala Lumpur were similar.  The optimum BMIs for the three groups were 20.35 (Kuala Lumpur), 20.74 (Britain) and 25.15 (Sabah).  Sabah men had a liking for heavier women.  Men in Kuala Lumpur preferred women with lower WHRs.  A similar trend can be seen in the British sample, but the find wasn’t statistically significant.  In the Sabah men, there was also no statistically significant relation between attractiveness ratings and women’s WHRs.  For the stimuli used, BMI was much more strongly related to attractiveness than WHR.

The authors noted that the cross-cultural comparisons using photos of women in front view (another study) resulted in similar finds to that in the present study, and then had this to say–

Why, then, did Marlowe et al. (2005) find a preference for lower profile WHR among the Hadza of Tanzania than among American men? The answer may lie in the stimuli they used. In their line drawings,WHR and body weight were covaried: the line drawings with lower WHRs (more protruding buttocks) also appear to have heavier body weights, and Hadza men may consequently be showing a preference for heavier figures rather than, or in conjunction to, lower profileWHRs. In other words, the apparent preference for low profile WHRs found by Marlowe et al. (2005) could be explained by a preference for a heavier body mass, low WHRs or both.

The Hadza are a sub-Saharan African population.  Swami et al.⁽¹⁾ have referred to these stimuli used by Marlowe et al. (2005).⁽²⁾

The answer that Swami et al. are looking for does not lie in the nature of the stimuli used but in anatomical differences between European and sub-Saharan African women.  Sub-Saharan women have wider waists plus narrower hips in front view, and more protruding backsides compared to European women.  So aesthetic preferences regarding waist-hip proportions may differ along these lines.  In another rural population from Bakossiland, Cameroon (Sub-Saharan Africa), men’s optimum female WHR in back view was 0.8, clearly higher than among European men.

In the second study,^{(3, pdf)} photos of British women in front view were shown to adolescent males in London, a high SES group from Apia (Upolu, Samoa) and a low SES group from Savai’i, Samoa.  The optimum BMIs reported by the males were 20.87 (Britain), 21.29 (Apia) and 21.30 (Savai’i).  Males from Savai’i had higher ratings for overweight women.  Males from Britain and Apia preferred women with lower WHRs, but this was not documented among the Savai’i group.  Traditionally, a large body size has been favored in Samoan women,^{(4, link)} but exposure to Western culture has resulted in some change.

So these two studies offer additional evidence for the impact of Western culture, but this should not be taken as people’s preferences being heavily shaped by culture.  Most Westerners strongly prefer above average femininity in women and a body size clearly larger than what is seen among the typically masculine and very thin high-fashion models, women with the highest status among models.  Instances of culture appearing to mold preferences are any of the following: 1) intrinsic majority preferences manifesting as culture, 2) peculiarities associated with high socioeconomic status, 3) trivial issues and 4) a people more clearly realizing latent preferences upon contact with another people/culture.

References

1. Swami, V., and Tovee, M. J., The relative contribution of profile body shape and weight to judgements of women's physical attractiveness in Britain and Malaysia, Body Image, 4, 391 (2007).
2. Marlowe, F., Apicella, C., and Reed, D., Men's preferences for women's profile waist-to-hip ratio in two societies, Evol Hum Behav, 26, 458 (2005).
3. Swami, V., Knight, D., Tovee, M. J., Davies, P., and Furnham, A., Preferences for female body size in Britain and the South Pacific, Body Image, 4, 219 (2007).
4. Pollock, N. J., Cultural elaborations of obesity - fattening practices in Pacific societies, Asia Pacific J Clin Nutr, 4, 357 (1995).

Some experiments have shown that people can tell apart attractive from non-attractive faces in a tenth of a second.  Olson and Marshuetz^{(1, pdf)} showed that people can beat chance in distinguishing attractive from non-attractive faces in as little as 13 milliseconds (a millisecond is a thousandth of a second).  The abstract:

Those who are physically attractive reap many benefits—from higher average wages to a wider variety of mate choices. Recent studies have investigated what constitutes beauty and how beauty affects explicit social judgments, but little is known about the perceptual or cognitive processing that is affected by aesthetic judgments of faces and why beauty affects our behavior. In this study, the authors show that beauty is perceived when information is minimized by masking or rapid presentation. Perceiving and processing beauty appear to require little attention and to bias subsequent cognitive processes. These facts may make beauty difficult to ignore, possibly leading to its importance in social evaluations.

A study that showed rapid judgment of aesthetically pleasing waist-hip proportions in women was previously addressed.

Differences in and attractiveness of women’s gait across the menstrual cycle

Provost et al.^{(2, pdf)} investigated whether women’s gait (how they walk) changes across the menstrual cycle and how men’s attractiveness ratings of women’s walk changes accordingly.  They assessed the gait of young women not on hormonal birth control pills by placing reflective markers on their bodies and following the movement of the markers.  Analysis of the movement of these markers revealed that women in the fertile phase of their menstrual cycle (late follicular phase) could be distinguished, to some extent, from women in the non-fertile phase of the menstrual cycle, but it wasn’t clear what exactly the difference was.  The authors also assessed the walking patterns of women on hormonal birth control and found that it was not distinguishable from the gait of women not on hormonal birth control and during the fertile phase of their menstrual cycle. 

The authors then had male raters judge the attractiveness of the gaits of the women not on hormonal birth control, without telling them what the purpose of the study was or providing information on what phase of the menstrual cycle the women were in.  Men tended to rate women’s walk during their non-fertile phase more appealing than during their fertile phase.  In contrast, a previous study had reported that the faces of women were rated more attractive while they were in the fertile phase of their menstrual cycle than when they were in the non-fertile phase.^{(3, pdf)}  One possible explanation of these finds is that advertising fertility to potential rapists is a liability, and if women were to make themselves more appealing by their walk while they were at the greatest likelihood of conceiving, then potential rapists could pick up on the cues from a distance, but subtly advertising greater likelihood of conception in features that can be assessed from close interaction only, such as the face, will be helpful to an intimate male partner.  More research will be needed to address this issue.  The authors cite other research consistent with ovulation not being concealed in women but also not being prominently advertised.

The differences in gait documented in this study were unlikely to be consciously altered by women, but boy do some women know how to walk and make men gawk!  Recently, a friend of mine (male) and I went to a scooter place to look at some scooters.  The cute-faced saleslady was dressed in a tight sleeveless T-shirt and short shorts.  Her breasts were ready to pop out of the T-shirt and did she have a teeny-tiny waist!  Then she turned around to lead us and damn...all we could do was look at the jiggle and wiggle of her backside.  I can barely recall what kind of scooters the place had.  We wondered what in the world this woman was doing working for around minimum wage at the scooter place, but then what is this site about?  One day women like her will have mainstream modeling opportunities without having to pose nude or sleep around.

References

1. Olson, I. R., and Marshuetz, C., Facial attractiveness is appraised in a glance, Emotion, 5, 498 (2005).
2. Provost, M. P., Quinsey, V. L., and Troje, N. F., Differences in Gait Across the Menstrual Cycle and Their Attractiveness to Men, Arch Sex Behav (2007), DOI 10.1007/s10508-007-9219-7.
3. Roberts, S. C., Havlicek, J., Flegr, J., Hruskova, M., Little, A. C., Jones, B. C., Perrett, D. I., and Petrie, M., Female facial attractiveness increases during the fertile phase of the menstrual cycle, Proc Biol Sci, 271 Suppl 5, S270 (2004).

Fig 1. Guess which nose belongs to men and which to women; average nose shapes.  See text for details.

When the sex-specific nose averages were presented individually, the judges could generally not assign the correct sex to them.  In Fig. 1, the first two images on the left represent the average for women and the other two the average for men.  The differences are discernible in comparison; e.g., women have less projecting noses and a lower nasion (more on the nasion)

The authors made 3 composite images of a) both men and women who were satisfied with their noses (optimal), b) average noses (average) and c) those who were dissatisfied with their noses (unpleasant) (Fig. 2).

Fig 2. The columns depict averages for women (left) and men.  Top row depicts the averages for those satisfied with their noses, the middle row depicts the averages for the entire sample and the last row depicts the averages for those dissatisfied with their noses.

Those most dissatisfied with their noses had a nasal hump and lower tip rotation (which, taken to an extreme, will lead to a hooked-nose appearance) and heavier nose tip cartilage.  The study confirms a dislike for hooked noses and broad nasal tips in Europeans.

The authors also had the 3 composite nose averages for each sex rated for attractiveness by the judges.  The judges rated the women’s averages as optimal > average > unpleasant, and men’s averages as average > optimal > unpleasant.
   
The noses that went toward the averages/composites belonged to 311 individuals, which comprised of 128 men and 128 women that were selected randomly from Germany and Australia.

Among the women, 41.0% had a nasal hump, 42.9% had a straight profile, 11.8% had a concave profile and 4.3% did not fit in any of these categories.  Among the men, 36.4% had a nasal hump, 43.2% had a straight profile, 15.4% had a concave profile and 4.9% did not fit in any of these categories.  The nasal features found in the optimal composites were found in 15.4% of women and 43.2% of men.

See the article for miscellaneous measurements pertaining to optimal noses for men and women in the neighborhood of average height.  These will be handy for those considering rhinoplasty (nose job) though better articles on the topic have been addressed at this site before.  This study was from the perspective of the plastic/cosmetic surgeon and did not concentrate on documenting the subtlety of sex differences in nose shapes for anthropological purposes.

References

1. Springer, I. N., Zernial, O., Nolke, F., Warnke, P. H., Wiltfang, J., Russo, P. A., Terheyden, H., and Wolfart, S., Gender and nasal shape: measures for rhinoplasty, Plast Reconstr Surg, 121, 629 (2008).