Q: Dr. Eppley, My problem is quite complex. I had a dimpleplasty last December and I was told it would take about 2 months for the dimple to flatten. I have waited 4 months so I had the Dr remove the retention stitch which he said would flatten my cheek. After 2 months it didn’t happen so I had a a buccal muscle closure…. It’s been 5 weeksnd no improvement. My surgeon says he’s out of ideas and there nothing more he can do..I am devastated with these two horrible indentations and would do anything to have my face back. I hope I can hear from you with great news.
A: I am assuming by your description that you have a cheek dimpleplasty to try and reduce/eliminate your cheek dimples as opposed to a dimpleplasty to create them. Both surgical efforts appears by your description to be done close the soft tissue defect/herniation below the dimple and nothing else was added. If this is an accurate interpretation on my part, my suggestion at this point is to add volume either through fat injections or a dermal-fat graft. Given the scar that is there now and the refractory nature of your cheek indentations, I would have more confidence in dermal-fat grafts at this point.
Dr. Barry Eppley
Q: Dr. Eppley, what can you tell me about this new procedure of making cheek dimples?
A: There have been media reports recently that talk about a ‘new’ plastic surgery procedure known as dimpleplasty. While this has been touted as being new, it really is not. The actual procedure of making dimples dates back several decades.
Cheek dimples are actually anatomic defects in the zygomatic muscles which run between the lips and the cheeks. This is an important muscle for smiling as it helps lift up and out the upper lip. In someone with cheek dimples, this muscle has a split in it. When someone smiles and the zygomatic muscle contracts, the split in the muscle separates which allows the skin overlying the split to be pulled inward. Thus a cheek dimple is really a hernia in the muscle. How big and where it is located determines the location and the size of the dimple.
In cheek dimpleplasty, a small incision is made inside the cheek where a split in the muscle is created. This allows the underside of the cheek skin at the desired dimple location to be sewn or attached to the inside of the cheek lining. This creates a scar or attachment that will lead to dimples when one smiles. This is a simple outpatient procedure done under local anesthesia so the dynamics of smiling and the dimple effect can be seen. There really is not recovery other than some mild cheek swelling. The biggest risk of the surgery is that the cheek dimples may be less or even more noticeable than desired. (depth of the dimple)
Dr. Barry Eppley