The number of obese adolescents is increasing in the Western society. For a deeper understanding of the mechanisms underlying this pathology, the quantitative characteristics of the facial soft tissues should also be investigated. The three-dimensional coordinates of 12 soft tissue facial landmarks were obtained by computerized digitizers in 11 male and 14 female adolescents aged 13-17 years, all with a body mass index larger than 30 kg/m2 (mean 31.67 kg/m2, SD 1.58). From the landmarks, several facial dimensions were calculated. Data were compared with those collected in normal individuals of the same age, ethnicity, and sex by computing z scores. Significant (paired Student's t-test, P < .05) larger dimensions were found for skull base width (girls), mandibular width (both sexes), lower face depth (girls), and mandibular corpus length (girls). In the pooled sample (boys plus girls), the faces of obese adolescents were significantly wider transversally (skull base width, mandibular width), deeper sagittally (mid and lower face depth, mandibular corpus length), and shorter vertically (upper facial height) than those of their normal school companions. "Borderline" obese adolescents possessed some facial characteristics typical of patients with more substantial obesity. The effect of an increased body weight-per-height was therefore present also in subjects not already referred to a medical control.