Dimple Creation Surgery — Cost, Top Hospitals & Success Rates | MyMedicPlus

Dimple creation surgery is a minimally invasive cosmetic procedure that creates an artificial dimple — a small indentation — in the cheek by surgically establishing a fibrous scar connection between the inner cheek mucosa and the underlying facial muscle (buccinator muscle) or skin, simulating the natural dimple that forms in some individuals due to a congenital bifurcation of the facial muscle.

Natural facial dimples form when smiling because the zygomaticus major muscle has a bifurcation (split) that creates a tethered point in the overlying skin, producing the characteristic indentation during facial animation. Surgically created dimples replicate this anatomy: an absorbable suture is passed from the inner cheek mucosa through the buccinator muscle to the undersurface of the facial skin, creating a fibrous adhesion that forms a visible dimple — initially visible at rest and becoming more pronounced with smiling, though the resting dimple may fade as the suture absorbs and only the fibrous scar maintains the effect.

The procedure is performed under local anaesthesia in an outpatient setting by a plastic surgeon or oromaxillofacial surgeon. It requires no external incisions — a small punch incision is made on the inner surface of the cheek, with no external scarring. Most patients resume normal activities within a day or two, with initial swelling subsiding over 5–7 days.

Dimple creation surgery is a purely elective cosmetic procedure with no medical indication. It is performed solely at the patient's request to enhance facial aesthetics by creating one or two cheek dimples, which are widely considered an attractive facial feature across many cultures — associated with a youthful, playful, and appealing smile.

Occasionally, dimple creation is performed as part of a broader facial harmony enhancement, combined with other facial procedures such as bichectomy (buccal fat removal), rhinoplasty, or otoplasty. It may also be requested as part of gender-affirmation facial feminisation surgery (FFS), as facial dimples are associated with feminine facial aesthetics in many cultures. Early specialist referral for accurate diagnosis and treatment planning is recommended for all patients experiencing significant symptoms, as timely intervention typically yields better outcomes than delayed treatment in most clinical scenarios.

Ideal candidates for dimple creation surgery are adults over 18 years with realistic expectations who desire enhancement of their facial aesthetics through the creation of natural-appearing dimples. The procedure is suitable for all face shapes and skin tones. Patients with adequate cheek soft tissue volume (sufficient subcutaneous fat and muscle) produce the most natural-appearing dimples. Very lean patients with minimal cheek fat may have less pronounced results.

Contraindications include active skin or oral infection in the cheek area, bleeding disorders or use of anticoagulants that cannot be safely paused, known keloid scarring tendency (risk of irregular scar formation), and a history of facial nerve damage to the cheek area. Patients with unrealistic expectations — expecting the dimple to look identical to a naturally occurring dimple in all circumstances — should be counselled thoroughly before proceeding. Smoking impairs wound healing and scar maturation; patients are advised to stop smoking 4 weeks before and after the procedure.

The standard dimple creation technique uses a cylindrical punch biopsy tool (3–5 mm diameter) to create a small circular incision on the inner mucosal surface of the cheek at the precise location where the dimple is desired. The location is marked with the patient smiling in front of a mirror — the preferred position is typically at the intersection of a vertical line from the lateral canthus of the eye and a horizontal line through the corner of the mouth, though patient preference guides exact placement. A small core of buccal mucosa, submucous fat, and muscle is removed or a dissection created, and a permanent or absorbable suture (typically 3-0 or 4-0 absorbable monofilament) is passed from the inner mucosa through the buccinator muscle and dermal layer of the skin, creating the tethering adhesion.

Variations include using a single absorbable suture (which relies on fibrous scar formation after suture absorption to maintain the effect, with some risk of gradual fading) versus permanent non-absorbable suture (which maintains the dimple more reliably but carries theoretical risks of palpable suture material and infection over time). Bilateral dimple creation (both cheeks) is common and symmetry is carefully assessed. The procedure can be reversed by cutting the internal scar band through a second small intraoral incision, though reversal reliability decreases as fibrosis matures.

When performed by an experienced surgeon, dimple creation produces a natural-appearing indentation that becomes visible on smiling and initially appears at rest. Patient satisfaction rates are high — reported at 85–95% in published series. The procedure is fast (30–45 minutes), uses only local anaesthesia, requires no hospitalisation, produces no external scars (the incision is intraoral), and allows rapid return to social activities.

Long-term, the dimple appearance may evolve over months to years. The initial dimple visible at rest typically fades gradually as the absorbable suture is absorbed — this is actually preferred by many patients who want a natural-looking dimple that is visible during smiling but not constantly at rest. Surgeons who use permanent suture or create stronger fibrous adhesions can achieve a more persistent dimple. The final appearance is usually apparent at 6–8 weeks after post-operative swelling has fully resolved.

Dimple creation surgery is generally safe but carries specific risks that should be clearly communicated. Asymmetry — unequal depth, size, or position of bilateral dimples — is the most common patient complaint and may require revision. Initial deep dimples at rest can be an unwanted aesthetic outcome for patients who expected a subtler result visible only on smiling.

Infection within the oral environment — where bacterial colonisation is constant — is a recognised risk (approximately 3–5%), presenting as increasing pain, swelling, discharge from the intraoral incision, or fever. Treatment with antibiotics is usually sufficient, though in rare cases suture removal may be required if infection is severe or persistent. Facial nerve injury — to branches of the buccinator nerve supplying the cheek — is a theoretical risk but extremely rare given the superficial nature of the procedure. Haematoma (blood collection within the cheek), scarring, and suture granuloma are uncommon complications. Fading of the dimple over time — particularly with absorbable sutures — results in up to 30% of patients requiring touch-up procedures.

Recovery is straightforward. Mild swelling and bruising of the cheek is expected for 3–7 days. The intraoral incision heals within 1–2 weeks. Patients should rinse the mouth with chlorhexidine antiseptic mouthwash three times daily for 1–2 weeks to maintain oral hygiene and reduce infection risk. A soft food diet is recommended for 48–72 hours. Normal activities and work (desk-based) can be resumed the next day; strenuous activity should be avoided for 1–2 weeks.

The dimple appearance changes significantly over the first 6–8 weeks as post-operative swelling resolves and fibrous scar matures. Initial assessment of the final result is performed at 8–12 weeks. Revision procedures (to deepen an inadequate dimple, correct asymmetry, or repair a faded dimple) can be performed after 6 months once the primary result has fully matured.

Dimple creation surgery costs $1,500–$3,000 in the United States (bilateral, including surgeon fee, local anaesthesia, and follow-up). In the UK, the procedure costs £600–£1,500. Since this is a purely cosmetic procedure, it is not covered by health insurance or NHS in any country.

For medical tourists, dimple creation surgery at reputable plastic surgery clinics in India, Thailand, Turkey, and South Korea costs $200–$600 for bilateral dimples — representing 70–85% savings versus US prices. These destinations have thriving medical tourism industries for cosmetic procedures, with internationally trained surgeons performing high volumes of facial aesthetic surgeries in NABH or JCI-accredited facilities. Patients are advised to obtain itemised cost estimates from multiple providers and verify insurance coverage or national health system entitlements before proceeding. Medical tourism at accredited hospitals in India, Thailand, Turkey, or Mexico can reduce total procedure costs by 50–80% compared to US or UK pricing, with internationally trained specialists and comparable clinical outcomes for elective procedures.

Hyaluronic acid filler injection — injecting a small volume of dermal filler into the cheek tissue to create an artificial dimple — is a non-surgical alternative that avoids incisions and general anaesthesia but provides temporary results (lasting 6–18 months before the filler is absorbed) and does not create the dynamic dimple visible on smiling that surgery achieves. It is useful for patients wanting to trial the look before committing to surgery.

Natural-appearing dimples cannot be created by topical treatments, suction devices, or piercings — these methods produce scarring or deformity rather than anatomically correct dimples. The surgical dimple creation procedure with fibrous scar formation remains the only reliable method for creating a persistent, natural-appearing cheek dimple.