In the course of each plastic surgeon’s training, he or she will come across particular procedures that are not learned from the textbook but rather from a particular plastic surgery teacher. In some cases, a board-certified cosmetic plastic surgeon may invent a new procedure. Making cheek dimples is one of the procedures I learned from one of my professors and not from a book. It is a surgery that not many plastic surgeons perform, and it’s cute but can be problematic! Been there, done that! I no longer perform it!Still here is some information for those of you that need to know.

The cheek dimples are an attachment of the overlying cheek skin to the muscles of the cheek. In many ways, it is the same as cellulite indentation. The same process, but on a different cheek! The idea of cheek dimple creation is to attach a segment of the cheek skin to the muscles by suture long enough for a natural scar to form between the two.

Planning cheek dimple  surgery

I have the patient actually help me in positioning the dimple where they want it. Smiling will naturally create dimples, and the position of the “un-smiling” dimple is usually easy to determine in this manner. The skin is marked and the inner and outer layers of the cheek are marked.

Performing the cheek dimple surgery

Care is taken to avoid the area where the salivary gland of the cheek, the parotid gland, exits the lining of the mouth. This area has a little bump on it and is clearly visible. The surgeon must avoid this area, otherwise the duct can be cut and cause major problems. This is the most important part of the surgery. The muscles are then separated as I create a connection between the mucosal lining of the mouth and the underlying skin. These two surfaces are then sutured with an absorbable suture and the incision in the mouth is closed.

Healing after making dimples

The healing process after dimple creation usually involves swelling in the cheeks for a few days to a couple of weeks. There is an area of hardness directly under the dimple until the scar tissue softens up after about two months. Patients need to take care of oral hygiene by swirling peroxide in the mouth three times a day. Ice will help with the swelling as well. Not stretching the mouth too much is important to prevent disrupting the sutures.

Creating dimples is a small procedure that can be performed by your cosmetic plastic surgeon in the office as long as they have been trained in the surgery. Many plastic surgeons have not, so be sure to find one that knows a trick or two if you want this procedure done.  You should also carefully consider the risks of the surgery including nerve damage to the face nerves, infection (common in the mouth) and loss of the results after some time. You may end up having the surgery but the dimples may just disappear!

2020 update- I have stopped doing this procedure over the past few years. Frankly too many people get infections that then destroy the surgery.

Morad Tavallali, M.D., FACS

Leave a Reply