The use of extractions for orthodontic treatment has been somewhat a controversial subject and there have been divisive opinions about it. Extractions may be necessary to provide space on the arch to relieve crowding but they have do have an effect on the soft tissue of a patient too. While some may consider this insignificant, others try to predict the outcome and use this property when planning an orthodontic treatment. The purpose of this thesis was to assess the facial aesthetic changes in people that were treated with premolar extractions and to see if these changes were significant. Orthodontic treatment with extractions of 4 premolars caused significant soft tissue changes in the following; retraction of the upper lips in the range of 0.1 to 2.7 mm and retraction of the lower lips in the range of 0.6 to 3.1 mm in relation to the E-line, nasolabial angle reduction in the range of 2.6 to 4.67°. The perception of improved aesthetics, immediately after treatment, was prevalent more so in patients who underwent four premolar extractions compared to those who had non-extraction treatment.