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Do you do dimples?

Article-Do you do dimples?

Cheek dimple creation was one of the fastest growing cosmetic surgery treatments in 2016 in the U.K., according to data released by

It trailed only the mini facelift as the second fastest growing cosmetic surgery trend, with an 82% increase in inquiries, according to WhatClinic, a global healthcare comparison website where consumers compare and review clinics and prices. The data is based on patient inquiries for cosmetic surgery procedures made to 1,132 U.K. clinics listed on the site from January 2014 to January 2015, compared to inquiries from January 2015 to 2016.

Dr. SidebottomAndrew Sidebottom, BDS, FDSRCS, MBChB, FRCS (OMFS), a consultant oral and maxillofacial surgeon in Nottingham, UK, tells Cosmetic Surgery Times that requests for dimple creation are increasing as patients become aware the option is available.

“It is popular in the Indian subcontinent and hence patients with those origins are more aware of its availability,” Dr. Sidebottom says. “Different patients have different wants. Most would like an appearance only on animation. This is not possible in the short term, and it takes time to explain this. Also the appearance will change a lot in the first weeks and even up to one year.”

Dr. LahiriAnindya Lahiri, FRCS (Fellow of the Royal College of Surgeons) (Plast), a consultant plastic surgeon at hospitals in Birmingham, Sutton Coldfield and Solihull, UK, tells Cosmetic Surgery Times that while there is an increase in the inquiries for and the number of cheek dimple procedures, overall, the numbers are small.

“Many patients bring photographs of celebrities [or] models with dimples, to show what kind of look they wish to achieve. There is a wide variation in the requests. Some wish for only one; some for both cheeks; occasionally, [there is] a request for a particular shape,” Dr. Lahiri says.

NEXT: How to Create a Dimple


How to Create a Dimple

Dr. Sidebottom says he marks the ideal position the patient would like in the mirror, then injects local anesthetic. He removes an intraoral punch of mucosa and places a resorbable suture through and through to tie the skin to the buccinator. He closes the oral wound with Vicryl Rapide sutures (Ethicon).

“The depth of the dimple can be discussed with the patient in the mirror whilst tightening the through and through suture,” Mr. Sidebottom says. “The ideal approach would be to use a suture tied to the dermis; however, this is very difficult to achieve without a larger access wound. Multiple sutures can create a longer dimple. Don't tie the suture too tight, most patients prefer subtlety.”

Dr. Lahiri says he asks patients to draw where they’d like the dimples to be on their cheeks before surgery.

“The procedure is performed under local anesthesia,” he says. “A disc of muscle (buccinator) is removed at the site of election. The edges of the cut muscle are sutured to the dermis….”

Dr. Lahiri recommends doctors counsel patients realistic expectation and provide detailed post-surgery instructions to avoid loosening of sutures.

“Thorough dissection of the muscle fibres is necessary to allow good fixation,” he says.

The approaches for creating cheek dimples fall in two categories: “Suturing with or without blind coring technique and open approaches,” according to a paper in the April-June 2015 Journal of Cutaneous and Aesthetic Surgery, describing a simple technique for creating the facial dimples. The author, Ahmed Hassan El-Sabbagh, M.D., in the department of plastic surgery and member of the medical faculty at Mansoura University, Mansoura, Egypt, writes literature on dimple creation is sparse but demand for cheek dimple creation is on the rise.

Dr. El-Sabbagh describes a suturing technique he used on 23 female subjects. Bao and colleagues wrote about the technique in 2007, in which they would guide a monofilament nylon suture with a syringe needle, going through the dermis and active facial muscles — most notably the buccinator. As a result, they formed a sling between the skin and muscle, tying a knot to create the dimple. Dr. El-Sabbagh’s version had a few modifications. He uses one suture, rather than multiple sutures. To avoid hematoma formation, Dr. El-Sabbagh marks for dimples according to the location of facial artery pulsation. He creates dimples that are rounded or vertical, depending on facial shape. And vector of smile determines whether the dimple should be level with the mouth’s angle or above it.

He writes the suturing approach is simple and safe and results last about four months.

NEXT: Other Treatment Trends for 2017


Other Treatment Trends for 2017

Other procedures to top WhatClinic’s list of 2016’s fastest growing cosmetic surgery trends were liposuction; abdominal etching (contouring and shaping fat for flatter abdomens); alarplasty, or ear pinning; and cheekbone reduction.

While inquiries for breast implants dipped in 2016, breast augmentation with implants remains the most popular surgical treatment in the U.K., followed by eyelid surgery and liposuction, according to WhatClinic.

Trends to watch for in the U.K. in 2017, according to WhatClinic, are that the mini facelift’s popularity will continue to surge. Vaginoplasty’s popularity is also expected to soar.

WhatClinic offers detailed listings for more than 120,000 private healthcare clinics in 135 countries, according to its website.

Disclosures: Drs. Sidebottom and Lahiri report no relevant disclosures.

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