Two analyses using soft tissue landmarks (Arnett\u27s Soft Tissue Cephalometric Analysis, STCA and Andrews\u27 Six Elements Diagnostic System, 6E) were compared for their ability to generate esthetic profiles in lateral repose and smiling. Photographs of 23 subjects were digitally altered to represent the STCA and 6E surgical predictions and presented to panels of professionals and lay people for rating on a visual analog scale (0-50). Professionals and lay people agreed that the 6E simulated profiles were significantly preferred to the Arnett simulated profiles in both smiling and repose. Overall the 6E profiles were rated higher (more esthetic) on the VAS compared to the Arnett profiles for both professionals (mean Delta 3.75 +/- 0.96) and laypeople (mean Delta 2.33 +/- 0.37). These results suggest that surgical predictions using the Six Elements Diagnostic System can generate profiles that are more acceptable in smiling and repose to both professionals and lay people
