Procedure

Natural dimples usually occur on both sides of the face, and are generally present only when the face is animated, often to an unnaturally exaggerated degree. A natural dimple is usually formed when there is a small defect in the cheek musculature (most often the buccinator muscle). The skin overlying this small defect is stuck down to the underlying connective tissue when the muscle contracts with smiling; it splits apart and allows the overlying skin to indent.

It is possible to create a dimple or dimples by a minor plastic surgical procedure under local anaesthetic as an office procedure as a day case. As such, there is a huge demand now for surgically created dimples both from women and men. The results of this cosmetic procedure are usually permanent. The location and size of the dimple is a personal choice, which will be further evaluated with Mr. Vadodaria in your consultation.

Natural dimples picture

Dimple creation surgery is, in itself, a fairly simple one and is commonly done under local anesthesia on an outpatient basis. You will be awake and comfortable during the entire dimple surgery process. Special arrangements can be made if you would rather be asleep for the dimple creation surgery. The dimple surgery takes about 20 minutes to perform and you can go home right away after the procedure. Usually normal activities can be resumed straight after the procedure. Implants are not used.

A punch biopsy instrument is placed against the buccal mucosa (inner cheek) and circular motions are made to cut through the mucosa, submucosal fat, and cheek muscle. A circular core composed of these tissues is removed, leaving the skin intact, which will create a shallow cylindrical-shaped defect under the skin.

This 'defect' then is closed by placing an absorbable suture through the inner skin of cheek (muscle) on one side of the defect, then through the dermis layer of the skin and finally through the inner skin of 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.

The skin will, however, flatten out in a week or two. The internal scarring which takes place will connect the muscle to the skin, creating a dimple when one smiles.

The surgery can be performed on any kind of cheek, be it chubby or not. It would be easier if the cheeks are not too chubby. If someone wants dimples that are very prominent, a bigger punch biopsy will be used to be able to remove a bigger core of soft tissue.

Recovery and Post operative care

There is usually minimal swelling following the procedure, and the after care is just as simple and uncomplicated as the procedure. The after care usually involves regular mouth rinsing with antiseptic solution and a course of antibiotics.

You can go back to work the next day, but avoid strenuous activities like contact sports and exercise that can injure your face. The healing period is between 7 to 10 days. After a few weeks, you will notice that the operated area is already taking shape; the dimples or the cleft chin is becoming more apparent while you smile (during active animation of facial muscles) and feels natural like you are born with it. Final results can be seen after a month.

Risks and complications

As in any operation, there are risks involved in the form of infection, bleeding, scarring, under/over correction, revisional surgery and weakness of the involved muscles although extremely rare. There are minimal complications with dimple formation aside from a little bit of swelling and bruising. You should be able to resume your normal activities the following day. Some complications can occur with dimple creation surgery:

  • Persistence of unwanted dimples without facial animation
  • Long term effects are unknown since dimple creation is a relatively new procedure
  • Failure of surgery means complete disappearance of this surgically created dimple/dimples and may warrant further surgery.  Hospital fees are payable by the patient.

Although occurring in less than 5% of cases, if the surgically created dimple on the cheek or the chin becomes shallower or completely disappears then it can be done again. There will not be any surgeons fees but hospital fees and admin fees are payable.

Pre-operative care

Before the operation, make sure you follow these rules:

  • Do not have anything to eat or drink at least 6 hours prior to your surgery.
  • Stop smoking at least 2 weeks before and 2 weeks after surgery. This is particularly important for patients undergoing Breast Reduction, Tummy tuck or Facelift surgery.
  • Stop Alcohol 1 week prior to surgery.

Avoid the following oral preparations at least 2 weeks prior to and 2 weeks after surgery:

Any mixture containing:

- Vitamin E
- Effamol G
- Evening Primrose Oil
- Salmon Oil
- Codliver Oil
- Ginseng
- Imedeen
- Garlic

Antiinflammatory medications:

- Piroxicam
- Indocid
- Nurofen
- Ibuprofen
- Surgam
- Voltarol
- Naproxen
- Froben
- Lederfen

Anticoagulants (medications to thin your blood):

- Aspirin/salicylates
- Anadin
- Disprin
- Codis
- Or any cold or Flu medication i.e Lemsip etc.
- Do not wear any eye or face makeup on the day of surgery as this interferes with the surgery.

Things to do beforehand:

Do take paracetamol if experiencing any pains or discomfort for any reason prior to surgery.

Do take any regular medication (i.e. blood pressure tablets) prior to and up to the day of surgery- you can use up to 20-30mls of water to help swallow any tablets even within the 6 hour pre operative fasting period mentioned above in the Don’ts.

Do Take Arnica tablets.

Arnica is a herbal remedy that has gained a considerable reputation in recent years in helping to decrease bruising and swelling and to promote healing after surgery and trauma. It is now used routinely in many branches of surgery and I recommend it for all patients. It is available from larger pharmacies and health food shops without prescription.

Do shower or bath on the morning or evening prior to surgery, cleansing your entire body.

On the day of surgery please remove any contact lenses, nail polish, jewellery and all makeup whilst at home. Do wear comfortable, front opening and loose clothing to the hospital.

Post-operative care

  • Please make sure not to drink/eat any hot or cold substance till the effect of local anaesthetic wears off completely and you have recovery of tactile sensation in your mouth to avoid any thermal burns or cold sore.
  • Please make sure to observe your oral hygiene at least for a period of 15 days following your procedure.
  • Please rinse your mouth using Corsodyl mouthwash after having any food or drink for a period of 15 days following your procedure.
  • Please make sure to complete the course of antibiotics as prescribed by Mr Vadodaria.
  • You can take Paracetamol as per the prescription for pain control. Please inform Mr Vadodaria if you cannot manage to control pain with the help of Paracetamol.
  • Please inform Mr Vadodaria’s practice if you have increasing pain, swelling, bruising or any abnormal discharge from the sight of operation. Please inform us that you have received the early post op appointment between 5-10 days for removal of stitches if required and inspection of the wound.

Summary

Dimple creation surgery is a relatively easy way to form a dimple either in the cheeks or chin, under short local anaesthetic as a day case, for those people who have always wanted one.

Shailesh Vadodaria title text

Consultant Aesthetic, Plastic and Reconstructive Surgeon.

Shailesh VadodariaM.B.B.S, M.S
(Gen. Surgery)
M.Ch (Plastic Surgery)
FRCS (Plastic Surgery)

Contact us

 020 7078 4378

9 Harley Street, London, W1G 9AL.

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