Objective: This study aims to evaluate the correlation between soft tissue adaptation and the retraction of incisors in Class II Division 1 malocclusion patients treated with fixed appliances and premolar extractions. Materials and Methods: Thirty-one patients underwent orthodontic treatment with fixed edgewise mechanics and four premolar extractions. Cephalometric analyses were conducted to assess soft tissue changes relative to incisor movements. The correlation of soft tissue landmarks with horizontal and angular changes of incisors was analyzed using Spearman’s correlation coefficient. Statistical significance was set at p <
0.05. Results: Strong positive correlations were observed between the retraction of the maxillary incisor tip (U1-y) and upper lip (Ls-y, r = 0.887, p <
0.001) and lower lip (Li-y, r = 0.765, p <
0.001) positions. Point A (A-y) also showed a strong positive correlation with U1-y (r = 0.907, p <
0.001). No significant correlation was found between nasolabial angle and U1-y. Changes in upper incisor inclination relative to the NA plane were negatively correlated with the nasolabial angle (r = -0.474, p = 0.007). Mandibular incisor retraction (L1-y) demonstrated significant positive correlations with lower lip (Li-y, r = 0.757, p <
0.001), upper lip (Ls-y, r = 0.810, p <
0.001), point B (B-y, r = 0.785, p <
0.001), and Pogonion (Pog-y, r = 0.749, p <
0.001). Conclusions: Soft tissue adaptation is closely correlated with the horizontal retraction of both upper and lower incisors. These findings emphasize the importance of evaluating soft tissue responses in orthodontic treatment planning to optimize aesthetic outcomes.