I had a patient in the distant past that wanted a procedure to give him ‘Tom Brady’s chin dimple’. In considering such a procedural request the fundamental question is why do chin dimples occur? What is their anatomic makeup?
First chin dimples must be differentiated from chin clefts. A dimple is a circular indentation of various depths that occurs in the central portion of the soft tissue chin pad. This is different than clefts of the chin which are vertical lines of varying depths seen on the lower third of the soft tissue chin pad. Neither one has any associated underlying bone abnormalities. Developmentally it is much easier to understand how chin clefts occur than chin dimples. The paired mentalis muscle with its natural divergence as it comes over the end of the chin bone can be visualized to fail to merge completely (or merge and fail to adhere), leaving a vertical line of soft tissue deficiency.
Chin dimples, however, are much harder to imagine how they occur as a perfectly round indentation. It is a soft tissue deficiency for certain but why in a circular shape? While that question remains a mystery, how to create a chin dimple is not. Through an intraoral vestibular incision a circular excision of mentalis muscle and fat is done. Percutaneous sutures are then used to pull the overlying skin down into the soft tissue excision area in an in-out-back in fashion. Chin dimpleplasty can be attempted through an external skin incision but an obvious scar can be avoided with the intraoral approach.
Chin dimples occur in a variety of shapes some with a larger shallow indentation and others with a smaller diameter with a deeper central point. Surgically created dimples will be more like the latter. The former may be able to be created but requires a wide excision diameter and then the skin must be allowed to collapse inward after.
In conclusion can you get Tom Brady’s chin dimple? Exactly make not..but pretty close.
Dr. Barry Eppley