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Cheek dimples are well known aesthetic features of the midface. Some people who do not have them regard them as aesthetically desirable while others who have them would like to have them removed. When naturally present anatomic studies have shown that cheek dimples occur as a result of a defect in the zygomaticus muscle. This is why they deepen when one smiles as the soft tissue over the defect is pulled inward.

Surgical techniques for cheek dimple creation have been previously described and most use an intraoral approach. How to secure the skin inward in a reliable and sustained manner is the key to its success.

In the  November 2018 issue of the American Journal of Cosmetic Surgery, an article was published entitled ‘The Dimpleplasty: A New Streamlined Approach to Surgical Creation of Dynamic Facial Dimples, Our Experience, and Results’. In this paper the authors review published technique for facial dimple creation as well as describe their technique and experience in twenty (20) consecutive patients. Their cheek dimple technique consists of a trans oral approach using an 8mm dermal punch to remove a core of mucosa and subcutaneous tissue opposite the desired external cheek dimple location.  A PDS suture is the passed intraorally, catching the dermis at the skin dimple location, and then tied down.

At 6 months followup they experienced two complications (40 cheek dimple sites, 5% rate) with loss of one dimple and an infection in another. All other patients reported persistent bilateral dynamic dimple formation and excellent overall satisfaction with the appearance if their cheek dimples.

This described cheek dimple technique is very similar to the technique to which I have evolved over the years. Punch tissue excision and dermal suture fixation are the key elements.

Dr. Barry Eppley

Indianapolis, Indiana

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