Ear Size and Position Variations Rated by Casual Observers on Artificial Intelligence-Generated Models

Background: Auricular asymmetry affects facial aesthetics; yet, the degree of asymmetry discernible by a casual observer remains poorly defined. Objective: To measure the casual observer’s perception of auricular size, angulation, protrusion, and vertical position. Methods: Artificial intelligence-generated facial images were utilized and unilateral variations created in (1) size, (2) angulation, (3) protrusion, and (4) vertical position. A total of 200 responders reviewed 46 images, rating the ear appearance on a Likert scale of 0–10. Results: Causal observers rated a ≥10% change in size significantly different than baseline ( p < 0.001). Retrograde angulation ≥10° and anterograde angulation at 20° were rated significantly different than baseline ( p < 0.001). Positive asymmetrical protrusion was rated more severely than negative asymmetrical protrusion. The vertical position difference was rated least critically on average compared with baseline. Conclusion: Casual observers more critically perceived auricular size asymmetry and retrograde angulation when compared with protrusion and vertical position asymmetry.