Dimple Surgery: Everything You Need to Know

Dimple surgery (also known as dimple creation surgery or dimpleplasty) is an elective plastic surgery procedure that's done to create dimples on the face. Dimples are the small depressions in the cheeks that appear when some people smile. An inherited trait, dimples arise due to indentations in the layer just beneath the skin (called the dermis).

The procedure is typically done on an outpatient basis. The surgery involves the formation of a dimple with the creation of scar tissue in the dermis between the muscles of the face using small instruments and incisions, and a small amount of tissue is removed.

Dimples are considered attractive by many, and the global popularity of dimple surgery has been on the rise. If you are considering having this surgery, it's important that you understand how it works, how to prepare, and what recovery looks like.    

What Is Dimple Surgery?

Dimple surgery is not a medical necessity; rather, it’s an elective procedure that people undergo to improve self-image and feelings of self-worth. Since it’s an outpatient surgery, you won’t need an overnight stay in the hospital to recover. Local anesthesia is used, so you’re not put to sleep during surgery.

Typically, one incision, measuring approximately 2 centimeters (cm), is made for each dimple. Recovery is usually quick and simple. Ultimately, the permanent, new dimples are created by the scar tissue that develops as these small incisions heal.

Contraindications

There are no outright contraindications to dimple surgery. However, some conditions increase the chance of complications, such as an infection.

These include:

• Smoking
• Prior facial surgery
• Prior dental surgery
• Problems with dental hygiene or health
• A mouth infection, such as herpes

Prior to undergoing dimple surgery, you and your plastic surgeon will go over your medical and dental history.

Potential Risks

Overall, dimple surgery is safe, and complications are rare.

That said, complications can include:

• Excessive bleeding of the incision site
• Hematoma (bruising)
• Swelling in the facial region
• Nerve damage due to the procedure
• Infection of the surgical site
• Chronic infection, a rare complication producing nodules or abscesses due to infection (actinomycosis) by bacteria that's normally present in the mouth and nose
• Failure of surgery, such as asymmetry of dimples or inadequate dimple formation

Purpose of Dimple Surgery

Dimple surgery is completely elective and doesn’t treat any underlying medical condition. The benefits of this procedure primarily have to do with boosted confidence and self-satisfaction due to the changed post-operative physical appearance.

Notably, there’s clinical consensus that this surgery yields very high patient satisfaction; most feel their lives are improved afterward.  

Unlike other, more invasive surgeries, there are no specific tests necessary before dimple surgery. Typically, initial consultation involves ensuring adequate overall health, and discussion with the healthcare provider about potential contraindications.

In most cases, a physical assessment of health measures, such as weight, heart rate, and blood pressure is done before surgery is scheduled.   

How to Prepare

Though dimple surgery is relatively minor, some preparation is necessary. This means potentially making some changes to your lifestyle and the medications you’re taking, as directed by your healthcare provider.

Location

Dimple surgery occurs in an outpatient surgical center of a hospital, procedural clinic, or plastic surgery office. You will be awake during the procedure, and a local anesthetic is used.

Here’s a quick breakdown of what you can expect:

• Lights: The operating room needs to be well-lit, so there will be bright adjustable lights.
• Operating chair: You’ll be placed on an adjustable operating table or chair, to give your surgeon access to your face and mouth.
• Scalpel: Small incisions will need to be made in your mouth and cheek, using specialized, small scalpels.
• Surgical scissors: Your surgeon may specialized scissors to remove tissue to create the dimple.
• Other surgical tools: Surgical needles and sutures may also be necessary.

What to Wear

Since dimple surgery is an outpatient procedure, you don’t need to bring along a change of clothes.

Your healthcare provider will tell you to wear:

• Loose shirt and/or sweater
• Comfortable pants
• Slip-on shoes
• Normal undergarments are fine, though it’s a good idea to emphasize comfort with these

Food and Drink

Your healthcare provider will advise you of any special adjustments, but generally, it's recommended that you don't consume alcohol the night before surgery

Medications

Tell your surgeon about all prescription and over-the-counter medications, as well as herbs or supplements you’re taking.

Your healthcare provider may tell you to stop or reduce the following in the days or weeks before your surgery:

• Motrin IB, Advil, and Ibuprofen IB (ibuprofen)
• Aleve, Midol, among others (naproxen)
• Enteric Coated Aspirin, Children’s Aspirin (aspirin)
• Blood-thinning drugs, such as Coumadin (warfarin) Plavix (clopidogrel)
• Estrogen and tamoxifen
• Herbs and supplements such as vitamin E, fish oil, echinacea, ephedra, ginseng, and St. John’s wort, among others.

Your healthcare provider will tell you if you can take Tylenol (acetaminophen) instead of other pain medications before your surgery.

What to Bring

Even though dimple surgery doesn’t require an overnight stay for recovery, you’ll still need to think about what to bring along. Here’s a quick list:

• Insurance information
• Identification
• Glasses or contact lens case
• A ride home
• A list of medications, supplements, and herbs you’re taking

Pre-Op Lifestyle Changes

Smoking tobacco can impact healing and recovery and should be stopped completely or temporarily in preparation for your surgery. Your surgeon may advise you to quit for three to six weeks before surgery. Talk to your healthcare provider if you’re looking for support with this.

What to Expect on the Day of Surgery

The dimple surgery procedure, itself, doesn’t take very long—usually only about 20 to 30 minutes—but preparation and recovery will require additional time.

Before the Surgery

Your surgeon may advise you to wash your face with anti-bacterial soap on the morning of your surgery. It’s a good idea to arrive at your appointment early; this gives you enough time to get settled and fill out intake forms.

You’ll undergo an initial examination and consultation, which includes:

• Assessment of vital health measures, such as body temperature, heart rate, blood pressure, and others, helps ensure a safe procedure.
• Pre-operative consultation with the surgeon or member of the medical team to ensure that you don't have any acute health issues.
• Ink-marking of the precise location of the desired dimples occurs before surgery. In some cases, you may be asked to mark where, exactly, you’d like dimples.

During the Surgery

Here’s a breakdown of the most common steps of dimple surgery:

• Topical anesthetic: To help ease discomfort, a topical anesthetic may be applied to the inside of your mouth, as well as on your face near the desired location for the dimples. This can cause tingling and numbness.
• Sterilization: You’ll need to gargle an antibiotic solution to lower your risk of infection.
• Placement: Based on the markings of the desired dimples on the face, your surgeon will use forceps to section off the associated area inside your mouth.
• Injected anesthetic: Once the specific areas for the operation are targeted, your surgeon will apply additional anesthetic via injection.  
• Incision: Your surgeon will use a small scalpel to make an incision in the mucous membrane inside your mouth. Using surgical scissors, excess tissue is carefully removed to create the dimple.
• Suturing: A surgical needle is run through one of the ends of the planned dimple and threaded to the other end, essentially creating a suture on the inside of the mouth. The depth of the intended dimple is adjusted by tightening or loosening this suture.

Once the sutures are in place, you’ll be allowed to rest and recover in a post-operative recovery area.

After the Surgery

Unlike many other surgeries, recovery from dimple surgery is relatively quick. Barring any immediate complications, you should be able to go home shortly after the procedure. Before you go home, though, there is a final consultation.

Here’s a rundown:

• You’ll receive instructions about proper care for the healing surgery site (or sites), what medications you need to take, as well as other post-operative instructions.
• The team will ensure you’ve made arrangements, such as having someone drive you home.
• You’ll be able to ask questions about what you can do to promote positive outcomes. Come away from surgery knowing exactly what’s expected of you.

Recovery

Your dimples will be visible immediately—though final results aren’t typically seen until two months afterward. The sutures used in this procedure don’t need to be removed and will dissolve on their own.

What can you expect during recovery? Here’s a quick breakdown:

• Follow up: At one to two weeks, you will have a follow-up appointment so your surgeon can ensure that you are healing appropriately.
• Liquid diet: Since you will have healing incisions and sutures in your mouth, your healthcare provider will direct you to stick to a liquid diet for five days following surgery. This will mean avoiding solid foods. You can drink protein shakes or eat soup. Your surgeon might also tell you not to use a straw.
• Working: Most people are able to return to work the following day after surgery; however, you may want to take a couple of extra days off afterward, as you’ll likely experience some swelling and redness.
• Physical activity: While you shouldn't have limitations in terms of light daily tasks, you’ll be advised to hold off on very strenuous activity for one to two weeks following surgery. If you’re unsure whether you should be doing something, ask your healthcare provider.

If you're planning social events, keep in mind that your dimples will usually be visible whether or not you smile as you are recovering.

Healing

Proper healing of the surgical sites is essential for the success of your surgery.

Here’s a breakdown of what to keep in mind as you heal:

• Pain relief: Pain and soreness are common around the newly created dimples, especially for the first five to seven days. Your healthcare provider may recommend or prescribe medications to help you manage your pain.
• Icing: Throughout the period of recovery, it’s not unusual for people to experience some swelling and redness in the face, and you can use ice to help reduce swelling.
• Hygiene: When washing your face, make sure to pat the dimples and surrounding areas lightly and don’t scrub. You may also need to take precautions when brushing your teeth, as directed by your healthcare provider.

Coping With Recovery

While dimple surgery is well-tolerated and successful, some people may experience a psychological and emotional fallout afterward. Depression and anxiety can occur after plastic surgery procedures.

If you’re struggling with difficult emotions in the aftermath of dimple surgery, here’s what you can do:

• Let your healthcare provider know: They can direct you to resources or refer you to a mental health counselor.
• Get help from loved ones: Talking to family members or friends about what you’re going through can also be helpful.
• Support groups: Networks of others who are going through what you are can also be a good source of support and information. Ask your healthcare provider to recommend a helpful group. 

Possible Future Surgeries

Dimple surgery typically leads to permanent results; however, sometimes the effects may fade or even entirely disappear over time. There is a risk of uneven or insufficient results.

While it's not common, you might need additional surgery, including:

• Revision surgery: In cases where the dimples fade away, or if they are uneven, a second dimple surgery can be performed to correct it.
• Dimple reduction: If your dimples are too deep or too large, you can also have a procedure to correct the issue. With a second procedure, your sutures may be tightened to reduce the size of your dimples.  

A Word From Verywell

As much as the prospect of having a cosmetic procedure like dimple surgery may be intimidating, it’s important to keep in mind that this procedure is usually successful and well-tolerated.

Dimple surgery has been performed since the 1960s, and in the intervening years it’s come a long way; the techniques employed today make it safer than ever before.

In the medical literature, most patients are satisfied with their results. For those that find dimples attractive, this procedure may be the key to a more positive self-image, as well as the confidence that comes with it. That’s something worth smiling about.