Background <p>Lips significantly influence facial aesthetics, driving the growing demand for lip augmentation procedures, particularly the bullhorn lip lift. As aesthetic medicine becomes more diverse with globalization, understanding how ethnicity affects aesthetic perceptions of lips is increasingly important.</p> Objectives <p>To examine the philtrum length and lip proportions in the context of different ethnic backgrounds, recognizing the increasing globalization of beauty standards.</p> Methods <p>Five frontal facial images of females from diverse ethnic groups—African, Asian, Caucasian, Latino, and Middle Eastern—were generated using Midjourney and were edited to simulate various degrees of philtrum shortening and corresponding changes in the upper vermillion height and maxillary incisor show. An online survey was then conducted to gather participant feedback on the aesthetic appeal of the lips in each image, using a 5-point Likert scale.</p> Results <p>A total of 570 respondents participated in the study. Overall, the most preferred lips were those with a 1 mm incisor show in African and Asian images, while lips with a 0.5 mm incisor show were favored in Caucasian and Latino images, and 0 mm in Middle Eastern images. The least favored lips were predominantly those with a 4 mm incisor show. Preferences across age and ethnic groups primarily favored the 0 mm, 0.5 mm, and 1 mm incisor shows.</p> Conclusions <p>This study provides valuable insights into the complex relationship between philtrum length and the perception of beauty. The findings emphasize the importance of achieving a balanced aesthetic that aligns with the patient’s cultural background and personal preferences.</p> Level of Evidence V <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors&#xa0;<a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>