What do the famous faces of Ariana Grande, Brad Pitt, Miranda Kerr, and Mario Lopez have in common? They all have dimples. Technically speaking, those small indentations in the cheeks that appear when some people smile are a genetic abnormality. Aesthetically speaking, many consider dimples to be an attractive facial feature. “Women and men are enticed by a dimple and wish to have one,” says Douglas Monasebian, MD, DMD, a New York City-based board certified plastic and maxillofacial surgeon.
For those who like the look of dimples but weren’t born with them, there is a cosmetic surgery called dimpleplasty that can create them in one or both cheeks. “I have performed this procedure on both sexes and on all ages,” Dr. Monasebian notes. So, what do you need to know about dimpleplasty? The experts break it all down.
What Are Cheek Dimples?
Dimples are indentations in the skin that can be found on different parts of the body (think: cheeks, chin, buttocks). Today, we’re talking about the cheeks. Fovea buccalis (a.k.a. cheek dimples) are the small depressions in the lower cheek that make their appearance when some people smile. “A dimple is simply an anatomic defect in the cheek of the face,” Dr. Monasebian shares.
All you need to do is consider the faces of your friends and family to realize that not everyone is born with this facial trait. Dimples “can be hereditary or acquired and can change as we age,” says David Shafer, MD, a board certified plastic and reconstructive surgeon in NYC. They can also occur on one or both sides of the face. “Depending on the anatomy, various shapes and locations of dimples can form,” he adds.
Cheek dimples are formed by differences in the muscles and skin of the face. “Dimples occur due to gaps between the muscles around the mouth,” Dr. Shafer says. They are most often caused by changes in the zygomaticus major, the muscle responsible for movement in the lower face. While the muscle typically runs from the cheekbone to the corner of the mouth, it can separate into two bundles. Both bundles are connected to the mouth, but one is also tethered to the skin above it – that’s what causes the dimple. It does not pose any functional or medical threat.
Just as no two faces are the same, no two dimples are the same. “There are different types of cheek temples that vary depending on the ethnicity and sex of the patient,” Dr. Monasebian explains. “Dimples can be of varying length, depths, and angles.” As such, the dimples created via dimpleplasty can be customized (more on that below).
What Is Dimpleplasty?
In simplest terms, a dimpleplasty is a cosmetic surgery with the goal of creating permanent dimples in the cheek. “Dimpleplasty is a surgical procedure to purposely form an adhesion between the overlying skin and the underlying muscle,” Dr. Shafer explains. It’s an outpatient procedure that typically takes under an hour to complete.
The procedure can be performed ‘awake’ with the patient numbed with a local anesthetic or under a mild sedation. “The incision is on the side of the mouth, so there are no visible incisions on the outside of the skin,” Dr. Shafer notes. Through the intraoral incision, the surgeon will remove any tissue (as needed) and place an absorbable suture at the site of the desired dimple. “The goal of dimpleplasty is to artificially cause internal adhesions, or scars, between the muscle and skin, so the tethered skin dimples as the muscle contracts,” he explains.
Depending on the aesthetic goals of the patient, dimpleplasty can be performed on either side or both sides of the face.
Dimpleplasty Recovery & Results
The results of dimpleplasty are immediate and permanent, though they evolve during the healing process. “I do advise the patient that, during the first few weeks, the dimple will be present at both rest and during smiling and talking,” Dr. Monasebian explains. “With time, the resting dimple will fade and they will have the dimple more when they smile, which is how a natural dimple appears.” Dr. Shafer agrees. “The result may look more pronounced at first and can fade over time,” he says. “Everyone continues to age, as can areas of dimpling.” In most cases, “a dimpleplasty ages naturally with the patient,” he adds.
In terms of recovery, the most common effects are temporary swelling and bruising. Most patients can return to work or school within a few days. Because of the intraoral incision(s), you’ll need to stick to a liquid diet for the first five days after surgery. Normal eating, activity, and dental care can usually be resumed within the first one to two weeks.
It's important to remember that every surgery has risks. Dr. Shafer explains that longer-term adverse effects include scarring (“how we make the incision is inside the mouth, so this is minimized,” he notes), hyperpigmented skin due to trauma, and infection. “As with any surgery, once there is an incision it can’t be removed,” he cautions. “If there is scarring, there are treatments that can help, such as laser and special injectables.”
Achieving a Lasting Result
Dimpleplasty truly is a personalizable procedure. “The cheek dimple can be customized with respect to its location, depth, and length,” Dr. Monasebian says. “In addition, I can create a dimple on both sides or just on one side or even match an existing dimple.” That’s right: If you were born with one dimple but would prefer symmetry, a plastic surgeon can add a dimple to match.
As with any cosmetic surgery, it’s imperative to find a board certified plastic surgeon who specializes in the procedure you are interested in. In the case of dimpleplasty, it’s important they understand your anatomy and aesthetic goals, in addition to understanding and accounting for how the dimple will evolve. “I usually over-correct the formation of the dimple because it will fade initially,” Dr. Monasebian shares. “I have to rely on the body to heal the dimple adequately.” And then there is the role of Father Time. “The dimple will age as the skin ages,” he notes. “The procedure will not alter the skin, so the patient’s skin will normally age as they age.”
At the end of the day, it’s all about achieving a safe and optimal result. “Like most of the aesthetic procedures I perform, patients are looking to enhance themselves,” Dr. Monasebian explains. “I strive for natural-looking plastic surgery, and it is in this manner that I create dimples.” The net-net: “As with any elective surgery procedure, if there is no harm for the patient and the patient feels better by having the dimple, I discuss with them all the risks and benefits and proceed with the dimple creation,” he says.
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