Dimpleplasty: All Your Questions, Answered

Having grown up with prominent dimples in each of my cheeks, I've often been told they make me look "cute." There was a period of my life when I couldn't stand them because I felt they made my face look rounder, less angular. I've grown into them, mainly because they appear when I smile, and anything that can highlight a smile is a win in my book.

People are born with these indentations of skin, typically found in the side of one or both cheeks. But you can also elect to create dimples if you so desire, with a cosmetic procedure called dimpleplasty. Ahead, board-certified plastic surgeons Samuel Lin, MD, and Steven Williams, MD, explain everything you need to know about creating dimples.

Why Patients Seek Out the Procedure

According to Lin, "natural dimples are a result of a small opening in the muscle in the cheek, called the buccinator muscle." It is this muscle that a plastic surgeon addresses in order to create dimples in a patient who desires them. "In order to access this muscle, the surgeon makes a small incision on the inside of the mouth, which is closed with dissolvable stitches at the end of the procedure," he explains. Williams adds this incision "inside of the mouth is used to pull down the dermis from the inside to create the effect of a dimple. It is a simple outpatient procedure that people recover from quickly."

People typically seek out the procedure for a few different reasons. "Dimples may make the face appear slimmer or more angular," explains Lin. He adds that they "are often regarded as an attractive feature" that adds contours. Some patients are born with a dimple on only one side of their face, he notes; they may elect to add symmetry to their face by surgically creating another dimple.

Ideal Dimplepasty Candidates

Both surgeons agree that similar to any type of elective cosmetic surgery, good health is a prerequisite to the procedure. "They should also have realistic expectations about what a dimpleplasty can achieve," says Williams. In order to facilitate a clear understanding of the desired results, an extensive consultation with a plastic surgeon is suggested. According to our experts, you should ask to see photographs of before and after results, with the understanding that each individual case is different and outcomes can vary due to anatomy.

Finally, Lin notes that people who smoke cigarettes "are not good candidates for this procedure as they may have trouble healing appropriately. Additionally, it is important to reach a state of good dental health before having dimple surgery." 

What to Expect During a Dimpleplasty

Before the surgery, you may need to make some lifestyle changes. "Depending on the type of anesthesia you will have, you may need to fast for a period of time before surgery," explains Lin, referencing patients who elect to undergo general anesthesia. "Additionally, patients should identify a support person who can help them get home from surgery if needed. Finally, those who smoke cigarettes will need to quit several weeks prior to surgery."

When it comes to this procedure, the perfect location is key. Pre-op, you should confirm with your surgeon the exact location of the desired dimple. "The day of surgery the patient would be evaluated and the surgical sites would be confirmed," notes Williams. "Typically a discussion of the exact location of the new dimple to be created would be discussed with the surgeon and marked."

The surgery can be performed under a local anesthetic. If that's the case, according to Williams, it is "typically used intro-orally and externally." However, patients can also elect to be sedated. This decision should be made in advance of the treatment. "Before the surgery, patients will work with their surgeon to decide the type of anesthesia that would be best for them—generally local numbing with or without additional sedation," explains Lin.

The surgeon then begins the procedure, which, according to our experts, can take anywhere from 30 minutes to an hour. "In order to access the buccinator muscle, the surgeon makes a small incision on the inside of the mouth," explains Lin. "The incision is closed with dissolvable stitches at the end of the procedure."

Risks Associated With Dimpleplasty

Williams points out that there are risks associated with this procedure. "The biggest risk from a dimpleplasty is injury to the facial nerve which can cause changes in facial expression," he says. "The most common complication of dimpleplasty is a result that fades over time. Sometimes the scar tissue that forms the dimple can be inadequate and the dimple can fade over time." In other words: In rare cases, the surgery may not be permanent.

Lin notes that other risks include bleeding during or after surgery and the potential risk of infection. Prior to surgery, he recommends you have an "in-depth discussion with your surgeon about potential risks associated with the procedure."

Aftercare

Because the incisions are made inside the mouth, proper oral hygiene is critical. To this end, patients must use "antiseptic mouth wash several times a day while the incisions heal in order to keep them clean," advises Lin. "Immediately following the procedure, patients can expect the inside of their cheeks to remain numb until the local anesthetic wears off," he says, noting that patients should wait until they regain sensation before eating or drinking. "It is recommended to avoid very hot or very cold foods and drinks or anything sharp or spicy at first since these things may irritate the incisions, but there are no strict restrictions on eating or drinking."

Williams says that in the days following surgery, some patients might have to refrain from strenuous activity and modify their diet. "The idea is to minimize possible disruption of the sutures that have created the dimple."

Expect to wait for up to two weeks for the stitches to dissolve and for the incisions to fully heal, according to Lin. He adds that antibiotics may be prescribed to ward off possible infections.

Patients can expect to return to work the day after the operation according to Lin, who notes that outwardly, there will be no "signs of surgery (other than new dimples)" since all of the incisions are made "inside the mouth." He says that final results appear post-op: "As you heal, the dimples will gradually appear more natural." Williams adds that this may take up to six weeks.

The Final Takeaway

A minimally invasive surgery with little post-op care, dimplepasty can help you achieve your desired look and add dimension to your facial structure. Discussing the potential risks with your surgeon as well as the reality of your expectations is key before embarking on any type of cosmetic procedure.