Abstract: Using Andrews Six Elements to develop multiple treatment options for adult skeletal class II patients and study the influence of different treatments on facial profile attractiveness. The secondary aim was to assess differences in preference between orthodontists and laypeople. Methods　Input the facial profile photos and lateral cephalometric radiographs of a Chinese woman suffering from skeletal class II to the Dolphin Imaging program.Using Andrews Six Elements to develop orthodontic camouflage treatment,genioplasty with different advancement ranges and orthognathic surgery.The digital images were modified to obtain these treatments comprising 6 profile silhouette by the Dolphin Imaging program and Photoshop software.These images were rated by clinicians and laypersons. Results　Both two groups agreed that the bimaxillary surgery plan based on Andrews Six Elements was the most attractive in profile,the picture with genioplasty (advancement of 8 mm) took the second place. The initial image score of the clinician group was lower than that of the non-professional group, while the image of bimaxillary surgery got higher scores in the clinician group than the non-professional group. Conclusions　For skeletal class II patients with mandibular retrusion,bimaxillary surgery with Andrews six elements is the best treatment to improve the the profile aesthetics.Genioplasty with the most appropriate advancement range can be got by using Andrews Six Elements.There is aesthetics difference between orthodontists and laypeople.

Key words: Andrews Six Elements, skeletal ClassⅡ, soft tissue profile, aesthetic evaluation