Objectives:One of the decision factors for the premolar extraction in orthodontic practice is the facial profile. The understanding about the preference of facial profile is essential for the accurate diagnosis and treatment planning because the perception of the facial profile is rather subjective. Methods:The present study was designed to compare the esthetic effects of premolar extraction and nonextraction treatments through the evaluation of facial profile by dentists and laypersons. The pre- and posttreatment lateral headfilms of one hundred orthodontic cases, 50 extraction and 50 nonextraction, were used for the present study. The drawings of pre- and posttreatment facial profiles were evaluated by 50 dentists and 50 laypersons. After obtaining the mean score for each case, these scores were compared according to raters or extraction and nonextraction. Results:Following results were obtained through the statistical analyses including comparison between groups, and correlation between scores and initial lower lip protrusion. 1. Premolar extraction group showed more improvement of facial profile compared to nonextraction groups. 2. The perception of facial profile preference did not present the significant differences between dentists and laypersons. 3. Nonextraction group showed no correlation between the facial profile improvement and the degree of initial lower lip protrusion. 4. Extraction group presented with a strong positive correlation between the facial profile improvement and initial lower lip protrusion. Conclusions:The results of the present study suggest that the premolar extraction is more beneficial than the nonextraction treatment in terms of facial profile improvement.