Dimple Creation | Additional design and healing decisions

Natural dimples come from zygomaticus major muscle fibers inserting into skin. Surgery creates a scar that adheres to the buccinator muscle. The patient marks the position in front of a mirror; the ideal location is where a faint dimple already appears with smiling, or the site of maximum depression when sucking cheeks in. Without a natural dimple, lines from the mouth corner and outer eye corner, or a higher Cupid's bow point, may guide placement; desired sites are often near the mouth corner or slightly lateral and above it. Placement too far laterally may risk facial nerve injury. Symmetry is confirmed visually and with ruler measurements.

The surgery aims to create a scar in the dermis that adheres to the underlying buccinator muscle, forming a dynamic dimple. At first there is a static indentation that deepens with movement; gradually only a hint remains at rest and it accentuates on smiling, resembling a natural dimple within 4–6 weeks. Small cutaneous dimples from suspension sutures are temporary and may be massaged out over time. An indentation that remains too deep at rest differs from this expected early phase and should be evaluated individually rather than assumed. This distinction helps avoid unnecessary concern while a normal dimple settles. Individual assessment by Dr. Vishal Purohit can clarify whether review is appropriate.

Natural dimples come from zygomaticus major fibers attaching to skin; dimpleplasty creates a dermal scar that adheres to the buccinator muscle. Placement is often chosen where a faint dimple already appears on smiling, or by facial landmarks if none exists. The supplied dimple-creation evidence does not state that a planned dimple alters or interferes with a pre-existing smile crease. The procedure uses an internal suture through a small intraoral incision with slight muscle electrocautery and no skin incision, so the external smile line is not directly cut. Individual anatomy varies, so placement should be discussed with your surgeon before surgery to assess overlap with any existing smile crease and expected dimple position.

Anatomically, a natural dimple comes from dermal tethering by zygomaticus major fibers. Dimple creation aims to make a scar in the dermis that adheres to the underlying buccinator muscle, so the dimple appears with smiling. Different approaches handle tissue differently, and the exact method changes how tissue is handled. Published evidence lists sudden disappearance of the dimple and asymmetry among complications, along with infection, bleeding, nerve or salivary duct injury. It does not provide a revision rate, so persistence should be judged very carefully and individually. The procedure is usually done under local anaesthesia after informed consent, following cleansing of the face and intraoral space.

A dimple forms when a scar in the skin adheres to the buccinator muscle; complications can include sudden disappearance or asymmetry. For depressed scars generally, larger ones may benefit from surgical revision with excision and advancement of wound edges, while tissue loss beneath the scar can be supported by deepithelializing the scar and advancing edges over it, or by advancing deeper tissue. Smaller depressed scars may benefit from surface smoothing or fillers such as fat, collagen or hyaluronic acid. Nonincisional modalities such as dermabrasion, laser treatments, or chemical peels may smooth contour; raised or erythematous scars may respond to silicone sheeting, intralesional triamcinolone, or pulsed dye laser. These are general scar principles, not a confirmed dimple-revision protocol.

Dimple creation uses an intraoral incision and a suture that passes through cheek mucosa, muscle and dermis; the described technique uses 3-0 Vicryl absorbable suture. Postoperative care includes antibiotics, analgesics, good oral hygiene, frequent mouthwash and oral rinsing, and avoiding a full smile for two weeks. Food trapping or an exposed stitch may relate to normal healing, suture material or irritation, but infection, bleeding, foreign-body reaction, or nerve or salivary duct injury are possible complications. Because the mouth is not sterile, rinsing as advised and reporting swelling, pain, fever or discharge matters. Do not attempt to remove or trim the stitch yourself. Your surgeon can decide whether observation, removal or further care is appropriate.

Open dimple techniques carry risks of bleeding, haematoma and infection, and infection may be bacterial or fungal. Complications are rare initially, but if infection is suspected, the treating clinician should consider both bacterial and fungal causes. Painful swelling can also follow normal healing or a blood collection, so prompt review matters when symptoms worsen. Because dimple creation is usually a minor procedure, most patients recover without complications, but worsening pain or swelling should not be ignored. Assessment is individualized; no single universal test applies, and further checks depend on examination and history. The clinician may also review oral hygiene and how symptoms have changed over time. Prompt review helps guide appropriate care and recovery.

Dimple creation aims to create a scar in the dermis that adheres to the underlying buccinator muscle, producing a dynamic dimple. An established attachment is therefore a three-dimensional tether, not just a surface mark. General scar-revision principles say deep tethering may need release and sometimes tissue interposition to prevent retethering, but individual anatomy varies. Replacing an old scar with a fresh one can leave raised or depressed scars, and results may be less predictable with poor wound healing or keloid tendency. Reversal is not guaranteed and may require careful assessment of scar depth and tissue quality before any revision plan for your cheek and realistic expectations with your surgeon after careful consultation.