Dimples are considered as a sign of good luck, apart from adding beauty to a smile. Dimples are formed when there is a defect in the cheek muscle (buccinator muscle). The skin overlying this defect is stuck down to the underlying connective tissue which creates a dimple in the skin with change in facial expression, like smiling. Dimples can be created on other parts of the face like the chin without any external incisions. The surgeon would advice you with the best position and size for your dimple.
A dimple creation procedure takes an approximate 30 minutes to complete. This is carried out under local anesthesia. The incisions are made in the inside of the cheek and there are no scars or incisions on the outside surface. A punch biopsy instrument is placed alongside the inner cheek (buccal mucosa) in lines with the location of the dimple and circular motions are made which cuts through the inner cheek, sub-mucosal and cheek muscle. The circular tissue is removed and the skin is left intact. The skin is positioned appropriately to create a dimple and the cylindrical gap is closed with absorbable sutures. The sutures are placed through the cheek muscle connecting the dermis layer of the skin. A surgical knot is then tied which dimples the skin without a smile.
The sutures dissolves and absorbs in 2 weeks and the skin flattens out creating a normal appearance as earlier. When the internal scar heals it connects the cheek muscle to the skin thus creating a dimple when smiling. This period could vary from a few days to several weeks depending on the healing and the extent of tissue removed. A dimple creation surgery can be performed both on cheeks that are chubby or not. The size of the dimple determines the amount of tissue to be removed.
Post surgical care as always has to be maintained. The oral cavity is a source of bacteria and hence great care has to be maintained. An anti-septic mouth wash has to be used a couple of times a day to keep the site as germ free as possible. Suitable antibiotics will also be prescribed to help with faster healing. Pain medications will be taken after consultation if needed to reduce pain. Mild to moderate inflammation will remain for a few days. Over animated facial expressions should be avoided for better results during the healing phase.
In certain rare cases there could be a temporary weakness of the cheek muscle after the surgery that could last for weeks. This is a totally reversible procedure.