By Dr Leow Aik Ming
In traditional Asian folklore, the presence of a dimple suggests good fortune and fertility, while in the West it is more simply viewed as a cute and unusual facial curiosity. For whatever reason, surgical creation of a dimple is an often mentioned as a form of Asian body modification, even though dimples seem to occur no more or less commonly in Asians than in others. Dimples have always been considered to be “cute”, however not all of us were blessed with that natural “cute” factor. All that can be changed, thanks to cosmetic procedures such as dimple creation surgery. Dimple creation surgery is safe and effective, but also potentially reversible.
Preoperative evaluation and planning
Communication is vital in order to achieve the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals, desirable position and shape of the dimple with the plastic surgeon. The plastic surgeon will work closely with the patient to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.
How is a dimple created?
The surgery can be performed on any kind of cheeks, be it chubby or not. It would be easier if the cheeks are not too chubby. The procedure involves simulating the natural way a dimple is formed, by forming a connection between the skin and the cheek muscle, such that when the muscle contracts, it pulls the skin inwards to form a dimple. The surgical procedure used to create a dimple is relatively easy and is commonly done on an outpatient basis.
Before the procedure, the inner (buccal mucosal surface) and outer (skin surface) of the cheek is infiltrated with local anaesthesia. It can be done by a blade or core biopsy instrument by placing an incision at the buccal mucosa. An adequate amount of the buccal mucosa, submucosal fat and cheek muscle are removed resulting in a shallow defect, leaving the skin intact. This will create a shallow cylindrical-shaped defect under the skin at the cheek. If a prominent dimple is desired, a larger soft tissue defect is created intraorally leaving the skin untouched. This defect is then closed by placing an absorbable suture through the cheek muscle on one side of the defect, then through the dermis layer of the skin and finally through the cheek muscle on the other side of the defect. A surgical knot is tied, which in turn will result in dimpling of the skin even without smiling for several weeks. The skin will, however, gradually flatten out in 2-3 weeks when the suture is absorbed. Once the internal scarring takes place, it will connect the muscle to the skin, creating a dimple when one smiles.
There is usually minimal swelling and bruises at the cheek after the surgery. The postoperative care is just as simple and uncomplicated as the procedure which involves regular mouth rinsing with oral antiseptic solution and antibiotic intake. Normal activities can be resumed straight after the procedure.