Dimple Surgery (Dimpleplasty)

Some people are born with the small hollow that appears in the cheek when they smile; others spend years looking at it in the mirror with a touch of envy. A dimple is really a hidden “flaw” beneath the surface of the face: one of the cheek muscles is short or split in two, so that smiling pulls the skin inward and forms that endearing dent. It is nothing more than a genetic variation — yet in the way we read faces it has come to stand for youth, warmth and approachability.

In recent years, “why don't I have one?” has become a request we hear more and more often in clinic. The surgical procedure known as dimpleplasty aims to create this hollow in the cheek or chin of people who were not born with a dimple. The operation looks small in scale — but giving realistic information about how lasting the result is, when it will start to look natural and how it affects the smile matters just as much as the technique itself.

This page treats dimple surgery the way we would talk it through in the examination room: who it suits, how it is planned, whether it is done from inside the mouth, whether it leaves a scar, how long it takes and the question people ask most — is it permanent? The desire for “back dimples” on the lower back is covered honestly in its own section too.

What Is a Dimple and How Does It Form?

A dimple (in medical terms fovea buccalis) is a small depression in the skin of the cheek or chin, usually appearing when a person smiles. In people born with one, the cause is a structural difference in one of the facial muscles — the zygomaticus major or the cheek muscle (buccinator): part of the muscle is split in two, or attaches to the skin by a short band. When you smile and the muscle contracts, the skin is drawn inward at that point and the dimple appears.

Here is the key detail: a dimple is essentially a spot where the skin is bound to the muscle beneath it. Dimpleplasty imitates exactly that — it creates a small, artificial adhesion between the skin and the underlying cheek muscle, forming a tether that pulls the skin inward when you smile.

Natural dimples do not always stay the same for life. The fat pads of the face thin with age and weight changes alter cheek volume, so a dimple that was obvious in youth can fade in later years. It is a reminder that a dimple is not a fixed anatomical “organ” but a dynamic relationship between tissues.

Dimples are most often requested in three areas:

• Cheek dimple: the most common request. It is usually placed along a line running up and out from the corner of the mouth.
• Chin dimple (chin cleft): the vertical hollow in the middle of the chin. It is requested less often in women and is planned differently in technical terms.
• Back dimples (“dimples of Venus”): not on the face but on the lower back, the two symmetrical hollows where the back meets the buttocks. These are covered in a separate section below.

Who Is a Candidate for Dimple Surgery?

Dimple surgery is a small procedure that can be carried out in healthy adults whose expectations are clear. In general, a suitable candidate looks like this:

• Over 18, with facial growth complete
• Cheek tissue that is neither very thin nor too thick, so the surgeon can work comfortably in the space between skin and muscle
• Willing to accept that this may be a permanent change and that its location will stay roughly fixed
• Realistic in their expectations: the goal is a natural hollow that appears on smiling, much like a person born with a dimple — not a deep notch that shows all the time

Position and depth are decided together during the examination. The patient is asked to smile, and the point where the cheek naturally moves most is marked; a poorly placed dimple sits out of step with the smile and can make the face look artificial.

Who Is Not a Candidate?

Operating on everyone who asks, on the same day, is not the right approach. In the following situations dimple surgery is postponed or advised against:

• Under 18, still growing: a procedure done before facial proportions settle can end up looking out of place later.
• Active infection in the mouth or serious gum disease: because the procedure is done from inside the mouth, these problems need to be treated first.
• Conditions that impair wound healing: uncontrolled diabetes, immunosuppressive treatment and a tendency to keloid or hypertrophic scarring are all weighed carefully.
• Heavy smokers: smoking hampers healing of the tissues inside the mouth; stopping around the time of the procedure is advised.
• People with unrealistic expectations: requests such as “visible at all times, even without smiling, and very deep” usually do not produce a natural result; this needs to be discussed openly beforehand.
• People with prior filler, fat injection or surgery in that part of the face: the tissue planes may have changed, so a separate assessment is needed.

In patients who bleed easily or take blood thinners, the medication regimen must always be reviewed beforehand with the physician's knowledge. The decision is individual to each patient; the list here is a guide, not a fixed prescription.

Examination and Planning

In dimple surgery the most decisive stage is not the scalpel but the planning. A few things are settled at the examination:

Position. The classic reference is the area where an imaginary line drawn up and out from the corner of the mouth crosses a line dropping down from the outer corner of the eye. But that is only a starting point; what really matters is finding where the cheek naturally hollows when the patient smiles. Two or three candidate points are marked with the patient in front of a mirror.

Symmetry. If two dimples are wanted, their distance from the corner of the mouth and their height are compared. Every face is naturally somewhat asymmetric, and this is explained to the patient in advance.

Depth and type. Whether it should appear only on smiling, or be faintly sensed at rest too, is a preference that affects the technique and how tightly the suture is placed.

Tissue thickness. If the cheek fat layer is thick, it can be harder for the tether to draw the skin inward; the surgeon adapts the plan accordingly.

At this consultation your medications, supplements (particularly blood-thinning ones such as aspirin, omega-3 and high-dose vitamin E), smoking habit and any dental problems are asked about one by one. Photographs are taken; these are valuable both for planning and for comparison afterwards.

How Is a Dimple Created? The Technique Explained

Cheek dimple creation is today done almost entirely from inside the mouth (intraorally). This means there is no incision scar visible on the outside of the face — one of the reasons the approach is preferred.

The general sequence is as follows:

1. Local anaesthesia. Local anaesthetic is applied to the marked area and inside the mouth. Pain during the procedure is kept to a minimum; the patient stays awake and can smile to give feedback when needed.
2. Entry from inside the mouth. A small opening is made on the inner surface of the cheek, at the point corresponding to the mark made on the outside. A little fat and soft tissue is removed to create a small space between skin and muscle.
3. Forming the tether. Using a dissolvable suture, the muscle or deeper tissue on the inner cheek is fastened to the underside of the overlying skin. This suture creates the artificial adhesion that will draw the skin inward on smiling.
4. Checking and closing. The patient is asked to smile so the dimple's position and depth can be checked and, if needed, adjusted. Because the opening inside the mouth is small, it is usually closed with a dissolvable suture; there are no stitches on the outside.

The whole procedure usually takes 15–30 minutes. Because the work is done inside the mouth, there is no visible wound or dressing on the face, and the patient goes home the same day.

What will you see at first? In the first weeks the dimple may be noticeable even when you are not smiling — that is, with the face at rest — as a slightly sunken, sometimes reddened spot. This does not mean the natural look has been lost; on the contrary, it is a normal part of the process. As the tether formed by the suture softens over time, the dimple gradually turns into a natural hollow that appears only when you smile.

Chin Dimple

A dimple in the middle of the chin (a chin cleft) is planned differently from a cheek dimple. Here the issue is sometimes not just soft tissue but the structure of the chin bone and the chin muscle (mentalis). Mild cases may be handled with a similar suture technique, while for some requests the result is limited; that is why expectations for a chin dimple need to be discussed very clearly beforehand. For readers interested in the overall balance of the chin line, we have a separate page.

Technical Options and Comparison

There is no single standard approach to creating a dimple; the technique changes with the site and the tissue. The table below compares the most commonly used approaches.

The table offers a general framework. Which technique is appropriate is decided at the examination, according to tissue thickness, the depth wanted and the anatomy of the area. Two people with the same request can end up with different plans.

Back Dimples (“Dimples of Venus”)

The symmetrical hollows on the lower back, either side of the spine, are popularly called dimples of Venus. Whether a person is born with them depends largely on their bone structure and pelvis; the hollow forms because the skin is firmly bound to the connective tissue beneath in that area.

Here it is important to be honest: back dimples are not as predictable a procedure as cheek dimples. The main factor that determines the result is the bone-and-ligament structure, and that cannot be created surgically like for like. In practice, two routes can be taken:

• Thinning the surrounding fat (with liposuction support): the subcutaneous fat around the area is thinned under local anaesthesia, so that an existing or faintly visible hollow shows more clearly. This is less about “creating” a dimple and more about “revealing” one, and the result is limited by the person's own anatomy. For general information about removing body fat from a specific area, see our separate page.
• Dermal fixation: attempts to form a hollow by fastening the skin to the tissue beneath have been described; however, the long-term durability of the tether in this area is more variable than for a cheek dimple.

For readers interested in the overall shaping of the hip and waistline, we have a separate page.

When back dimples are requested, what can be achieved and what will remain limited must be discussed clearly at the examination beforehand. Saying that “a clear dimple can be formed on any body” is not realistic here.

The Day of the Procedure: Step by Step

A cheek dimple procedure does not require hospital admission; it is carried out in an outpatient setting under local anaesthesia.

A strict fasting rule is usually not needed beforehand, but your surgeon's instructions take priority. When you arrive, position and symmetry are checked one last time in front of a mirror, and you are asked to smile so the marks can be confirmed. The mouth is cleaned with an antiseptic.

After the local anaesthetic the area goes numb; you may feel pressure and touch during the procedure, but pain is kept to a minimum. The surgeon asks you to smile as needed and adjusts the dimple's position in real time. When it is finished there is no dressing or visible stitch on your face; there is only a small entry point inside the mouth.

On discharge you are given written instructions on oral hygiene, eating and medication. You can go home the same day and, in most cases, return largely to your usual routine the next day. On the first day, you should feel comfortable before driving.

Week-by-Week Recovery Timeline

The timeline below is for a typical cheek dimple procedure. Every patient's course is different, and the programme your own surgeon gives you always takes priority.

First 24–48 hours. There may be mild swelling, tightness and sometimes light bruising in the cheek. Pain is usually mild and eases with simple painkillers. Tenderness at the entry point inside the mouth is normal. During this period soft, warm foods are preferred; very hot, hard and spicy foods are avoided.

Days 3–7. Swelling and bruising subside noticeably. Most people return to work and social life in this window. For oral hygiene, use the antiseptic mouthwash your surgeon recommends and brush your teeth gently. During this time the dimple may still look obvious at rest, even when you are not smiling — this is to be expected.

Weeks 2–4. The dissolvable sutures inside the mouth break down and the entry site heals. The visibility at rest slowly begins to lessen. Vigorous facial massage and firm pressure on the area are avoided during this period.

Months 1–3. This is the most decisive stretch of the process. As the tether softens, the dimple increasingly becomes a natural hollow that appears only when you smile. In most people the dimple takes on its natural look within 2–3 months. The right time to judge the final result is not the first few weeks but this period.

Risks and Possible Complications

Small as it is, dimple surgery — like any surgical procedure — carries its own risks. Knowing them is the first step to not being caught off guard:

• Swelling, bruising and temporary tenderness: the most common effects, and usually self-limiting.
• Infection: because this is an intraoral procedure, oral hygiene matters. Increasing pain, redness, swelling or fever should prompt a call to the physician; most infections are brought under control with appropriate treatment.
• A dimple that is too obvious or too faint: if the tether ends up tighter than intended, the dimple can look too deep and constant; if it stays loose, it may not appear enough on smiling. Either situation may call for a further procedure.
• A persistent hollow: if the tether does not soften over time, the dimple can stay visible at rest and give an artificial look.
• Asymmetry: a difference in position or depth between two dimples can remain; if marked, correction may be considered.
• Altered sensation: temporary numbness or a change in feeling at the site can occur; it usually settles over time.
• Rare risks involving the facial nerve: because branches of the facial nerve run close by in the cheek, a temporary change in facial expression is a theoretical risk if the technique is not applied correctly; this is why it matters that the procedure is done by a physician who knows the anatomy.
• An aesthetic result different from expected: the position or look of the dimple may differ from what the patient anticipated.

How often these occur depends on the person's general health, tissue structure and oral hygiene. All of these possibilities are discussed with you individually before the procedure and are set out in the written consent form.

Reversing Dimple Surgery

One of the questions people ask most is what happens if they are not happy with the result. Reversing the procedure is theoretically possible; but saying it “easily returns to how it was” would not be accurate.

Corrective procedures — loosening the tether that was formed, or placing tissue in between — have been described. But every surgical correction carries its own healing process and risks, and there is no guarantee that the result will return exactly to its pre-procedure appearance. For that reason it is better to consider dimple surgery not as something you can “undo whenever you like” but as a change that may be permanent. These possibilities should be discussed openly with the physician before you decide.

Is the Result Permanent? What to Expect Long Term

This is the question people wonder about most, and the honest answer has two sides.

On one hand, dimples created with dimpleplasty tend to be permanent in most people; the skin-to-muscle tether settles over time and the hollow that appears on smiling is preserved for a long while. On the other hand, saying it “stays on the face unchanged for a lifetime” is not realistic. A few variables can affect the result:

• The tether loosening over time: in some people the adhesion softens over months to years, causing the dimple to fade; a repeat procedure may then be needed.
• Weight changes: marked weight gain can increase cheek volume and make the dimple shallower; weight loss can make it more pronounced.
• Ageing: over the years, changes in the facial fat and skin can alter how the dimple looks.

Because of these variables the result differs from person to person. In most patients the dimple is preserved for many years; but a firm, unchanging promise of a “lifetime guarantee” would not be medically accurate.