The ins and outs of creating dimples with plastic surgery

There's no denying that there is just something so enrapturing about the perfect set of dimples. With just a simple smile, dimples can add a playful and youthful feel to your appearance. For some people without them, the allure of dimples is something that has appealed to them for many years. Dimples can now become a reality for those not born with them, courtesy of a procedure known as the "dimpleplasty."

What is dimpleplasty, and how is it performed? Are the results of this procedure actually permanent? Will dimpleplasty be effective on all types of patients? To gather the answers to these questions and more, we reached out to ASPS Member Surgeons Philippe Capraro, MD, and Manish Shah, MD.

Basics of the dimpleplasty procedure

Dimpleplasty has experienced a notable increase in patient requests and overall popularity in recent years.

"Over the years, there has been a steady increase in patient requests for this procedure," said Dr. Shah. "It is gaining in popularity, but not many people know that they can have dimples even if they weren't born with any."

The procedure is appealing to patients because it is minimally invasive with little downtime.

"I would say that this is a moderately common procedure at our practice," said Dr. Capraro. "We complete dimpleplasties in our in-office surgical suite in under 30 minutes using local anesthesia, which is a big draw for people looking for a slight, but noticeable, facial enhancement."

So, what patients most commonly seek out dimpleplasty?

"Out of all the patients I see for this procedure, there's about a 90 to 10 split between women and men, respectively," said Dr. Capraro. "Usually, they tend to be in their 20s and 30s, but there are always outliers."

However, patients of varying backgrounds seek out this procedure.

"My patients are typically in their 20s to 40s, mostly female," said Dr. Shah. "The procedure is especially popular in patients of color."

There are several ways to perform the procedure, depending on the surgeon and patient preference.

"My current technique involves an approach from inside the mouth along the cheek in which I use a dermal biopsy punch to make a tunnel towards the skin," said Dr. Shah. "I will suture imbricate the cheek mucosa (the inner lining of the cheeks) to the deep dermis to create a focal scar that pulls in with smiling, causing a dimple."

However, that may not be the same way it's performed by another surgeon.

"I begin by marking a point at the intersection of the vertical line below the eyelid and a horizontal line across from the bottom of the earlobe," said Dr. Capraro. "This consistently provides great positioning for the dimple. I then mark the inside of the mouth at the Stensen duct. This duct is essential for saliva production, so marking it helps ensure that we are not creating any possibility for complications down the line.

"From here, we get to the actual procedure, which is very simple and brief," continued Dr. Capraro. "Following the point we marked for the dimple's creation through to the inside of the mouth, we remove a small amount of mucosa (the inner lining of the cheek and some muscle. Using a straight needle and permanent sutures, we go through this opening and up through the skin. The needle is then reinserted back down through the initial hole to then come up again close by and again looped back down to the inside of the mouth. This technique creates the classic dimple shape while burying the suture and keeping healing primarily to the mouth, rather than on the face."

Following dimpleplasty, the recovery process is relatively straightforward and without complication.

"Recovery tends to be fairly easy," said Dr. Shah. "I place patients on a liquid diet. They are required to use dilute mouthwash to clean the internal sutures after eating or drinking anything. I ask them to reduce mouth motion by reducing their chewing, talking, smiling, laughing, etc. This reduces tension on the stitches internally. They ice their cheeks to reduce swelling and take antibiotics orally for one week. They can go back to work within a week in most cases. They can return to all activities at about two weeks postop."

Best practices for patients pursuing dimpleplasty

The most crucial step in successfully undergoing a dimpleplasty is to find the right board-certified plastic surgeon to complete your procedure.

"For this and any other plastic surgery procedure, please do research to find a board-certified plastic surgeon," said Dr. Capraro. "During your search, be prepared to go through websites and surgeon biographies. You should be able to clearly see their experience with the procedure through before and afters and trust the person completing your surgery."

Many patients who undergo dimpleplasty may find the immediate results following the procedure a little jarring. The dimples will initially look deeper and more noticeable, but it's important to remember that the dimples will naturally soften over time.

"I do like to inform patients that for the first four to six weeks of healing, the dimple will look very fake," said Dr. Capraro. "When doing this procedure, we tighten more on the excessive side to account for the relaxation of the tissues during healing. It's important to keep in mind that this is just part of the process!"

Many aesthetic procedures can be considered temporary or semi-permanent, but dimpleplasty results are permanent.

"I recommend that patients be completely sure that they want to have a dimple, because it is a permanent result and cannot be reversed," said Dr. Shah.

Those who love the allure of dimples no longer have to dream about having them. A dimpleplasty performed by a board-certified plastic surgeon can create the dimples. Patients not blessed at birth with dimples can now have them to brighten their smile for the rest of their lives.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.