Can My Surgically Created Dimples Be Reversed?

Q: Can you undo cheek dimple surgery I had done about 10 years ago? If so, how is it done?

A: The surgical making of cheek dimples is different from what causes natural cheek dimples. Anatomically, natural cheek dimples have been shown to be present from a split in the zygomaticus nuscle which runs from the upper lip to the cheek above. Because of this natural split in the muscle, the overlying soft tissues are pulled down or tethered into the split muscle, creating an overlying indentation in the cheek. Depending upon the size of the muscle split and the amount of tethering, this is why some dimples don’t appear until one is smiling or those that have them at facial rest get much deeper with smiling. The surgical creation of cheek dimples is done by going from inside the mouth, splitting between the zygomaticus muscle, and sewing the underside of the desired spot on the cheek down to the muscle.

Reversing cheek dimples is a matter of releasing the tethered skin and placing something between the skin and the muscle as a soft tissue filler or spacer. The best filler for that, in my opinion, is fat. The easiest and most convenient place to harvest fat is the buccal fat pad which is anatomically close to where one would be working for the cheek dimple release.

In natural cheek dimples, or in surgically created ones of long-standing, the result will be a softening or less prominent depth of the dimple. This is because some of the dimple presence is due to inverted or indented  skin, which an intraoral approach alone will not solve. The skin also could be completely leveled but this would require a skin incision to do so. This creates a small scar in the skin as a replacement for the dimple which may or may not be a good trade-off.

Dr. Barry Eppley

Indianapolis, Indiana