In the Russian Roulette of facial deformities, cheek dimples are often something many of us wish we had landed on. Technically known as fovea buccalis, cheek dimples are caused by the irregular growth of a certain facial muscle during embryonic development. This muscle is shortened, causing our skin to stretch and pulling our lips behind into corners when we smile.
As cheek dimples can accentuate smiles, they can make someone look more youthful, approachable and societally attractive. In fact, in some cultures, dimples are associated with beauty and good luck.
While it is rather common to see individuals with cheek dimples, not everyone has them. Approximately 20-30% of the world’s population has dimples, making them less common than desired. For us undimpled lot — how are they formed and can we get them? Read on to find out more.
In some cases, dimples are caused by a change in a facial muscle called the zygomaticus major, which is often involved in facial expressions1. For example, it helps to raise the corners of the mouth when you smile.
In individuals with no dimples, the muscle usually begins at the bone in your cheek called the zygomatic bone. It runs downwards, connecting to the corner of your mouth.
On the other hand, the muscle may divide into two separate bundles of muscle on its way to the mouth for individuals with dimples. One bundle connects at the corner of the mouth, and the other connects below the corner of the mouth. This split in muscle can be referred to as a double major muscle. The movement of the skin over this major muscle causes the dimple to form when you smile. As it results from muscular variation that occurs during the development of the foetus, it can be thought of as a “birth defect”.
For some people, dimples may appear in their early years and fade away as they age. Additionally, cheek dimples can also become less noticeable when one ages and loses skin laxity, or loses weight drastically. That said, in most cases, this genetically inherited trait does not disappear completely.
Conversely, weight gain may make your cheek dimples appear more prominent because of the excess fat in your cheeks and face.
Although you may temporarily create indents in your cheeks, it is impossible to get permanent dimples with methods such as facial exercise.
Some people try to get dimples by piercing their cheeks instead, and often the results are unsatisfactory and not everyone is comfortable with having a dimple piercing.
Fortunately, those of us who did not inherit the trait can get them through surgical means — this is called dimple creation surgery or dimpleplasty. This is also a viable option for those who would want to make their one-sided dimple symmetrical.
A dimpleplasty is an outpatient procedure performed using a suture technique with an intra-oral incision. It is relatively simple, has few complications and can be performed under local anaesthesia or IV sedation. A study of 20 patients, only had 2 reported adverse outcomes. 
|30 - 45 minutes
|3 - 5 days
The procedure begins with a consultation with Dr Samuel Ho, where he understands both your needs and concerns. If all checks out, your new dimple location will be marked out on your face based on your requested position and Dr Ho’s recommendation.
An absorbable suture is then passed through the inside of the cheek, followed by a small incision made on the interior of the mouth. This suture then catches the undersurface of the dermis and is looped back to the first incision site, creating an indentation.
This suture is safely tied down to the buccinator muscle to create a dimple in the overlying skin. Dr Ho careful adjusts the tension of this suture to determine the depth of the dimple — a key step in ensuring a natural-looking cheek dimple.
This procedure takes about 30 to 45 minutes.
There is no need to worry, as the surgery will not leave a scar on the outside of the face and there is minimal downtime involved. You may return to work on the same day with a mask and you should avoid hard, chewy or spicy food for a week.
To minimise the risk of infection, a mouth gargle will be prescribed. As your cheek heals, avoid moving your mouth excessively and strenuous blowing actions to avoid complications.
You can also expect the dimple to look very deep within the first month, but this will gradually recede and appear shallower and natural-looking in the following months as the suture tension decreases. The sutures are then gradually absorbed by the body, resulting in a permanent dimple.
Hopefully, this article has helped answer any queries you may have about dimple creation surgery. Although it is a relatively simple surgery, it will still require a lot of thoughtful consideration before making a final decision. Always remember to communicate both your needs and concerns with your plastic surgeon so that they can work with you in getting a comfortable experience with results that best suit you.