In traditional Asian folklore, the presence of a dimple suggests good fortune and fertility, while in the West it is more viewed merely as a cute and unusual facial curiosity. For whatever reason, surgical creation of a dimple is often mentioned as a form of Asian body modification, even though dimples seem to occur no more or less commonly in Asians than in others.Dimples have always been considered to be “cute”, however not all of us were blessed with that natural “cute” factor. These changes can be created with cosmetic procedures such as dimple creation surgery. Dimple creation surgery is safe and effective, but also potentially reversible.

Dimple creation surgery can be performed on any cheeks, be it chubby or not. It will be easier if the cheeks are not too chubby.The procedure involves simulating the natural way a dimple is formed, by forming a connection between the skin and the cheek muscle, such that when the muscle contracts, it pulls the skin inwards to form a dimple. The surgical procedure used to create dimple is relatively easy and is commonly done on an outpatient basis.

Before the procedure, the inner (buccal mucosal surface) and outer (skin surface) of the cheek is infiltrated with local anaesthesia. It can be done by a blade or core biopsy instrument, by placing an incision at the buccal mucosa. An adequate amount of the buccal mucosa, submucosal fat and cheek muscle are removed resulting in a small defect, leaving the skin intact. It will create a shallow cylindrical-shaped defect under the skin at the cheek. If a prominent dimple is desired, a more extensive soft tissue defect is created intraorally leaving the skin untouched.This defect is then closed by placing an absorbable suture through the cheek muscle on one side of the defect, then through the dermis layer of the skin and finally through the cheek muscle on the other side of the defect. A surgical knot is tied, which in turn will result in dimpling of the skin even without smiling for several weeks. The skin will, however, gradually flatten out in 2-3 weeks when the suture is absorbed. Once the internal scarring takes place, it will connect the muscle to the skin, creating a dimple when one smiles.

Ideal candidates for dimple creation surgery

  • Individual with a positive outlook and specific goals in mind for the improvement of facial appearance.
  • Physically healthy with no severe or active pre-existing medical conditions

Preoperative evaluation and planning

Communication is vital to achieving the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals, desirable position and shape of the dimple with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different. Therefore, a specific treatment regimen is planned to suit an individual’s need.

The risks and safety information on dimple creation surgery

It is essential for patients to understand that every surgical procedure has its complications and risks involved. However, if a patient is adequately assessed before the surgery and postoperative care is given sufficiently, these risks can be eliminated or reduced. The risks involved in dimple creation surgery are:

  • Bleeding
  • Blood clot
  • Infection
  • Bruises and swelling
  • Asymmetry dimple size, shape and depth
  • Anaesthesia risks
  • Possibility of revision surgery

Postoperative expectations

There is usually minimal swelling and bruises at the cheek after the surgery. The postoperative care is just as uncomplicated and straightforward as the procedure which involves regular mouth rinsing with an oral antiseptic solution and antibiotic intake. Normal activities can be resumed straight after the procedure.

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