Dimples are depressions in the skin of the cheeks that appear when one is smiling. They are usually not obvious when one is not smiling in those who have them naturally. Cheek dimples are an inherited trait and are reported to be genetically dominant. Cheek dimples are almost always on both sides and rarely on just one side of the cheek.
The cause of cheek dimples has been studied anatomically. It has been found to be the result of an abnormality of the zygomaticus main muscle of the upper lip and the corner of the mouth. This muscle extends from the cheekbone to the corner of the mouth. When a cheek dimple occurs, it is due to a split or hole in this muscle. When you smile, the muscle contracts and this hole gets bigger, absorbing the skin that covers it, so to speak. This explains why a cheek dimple may not be visible when one is not smiling, but can be seen when one is.
Some people want to have cheek dimples because they see it as an attractive facial feature. At my plastic surgery practice in Indianapolis, dimpling (cheek dimpling surgery) is possible through a small operation. This is done by making a small incision on the inside of the cheek opposite the desired location of the dimple. The dissection is made through the zygomatic muscle and a small permanent suture is placed between the underside of the skin and the muscle. It is important not to over-tighten this suture as it is not particularly natural to have dimples when you are not smiling. The procedure definitely creates some bruising and its biggest complication is that the dimple may not be permanent if the suture comes out in the first few weeks after surgery. Small to moderate sized dimples can usually be created, but large or deep indentations require tissue removal, which I do not advise. It is best to do this procedure with the patient awake so you can see what the dimple looks like when you smile.
This procedure is reversible if one does not like the results. It is relatively easy to cut the sutures within the first month after surgery, which is the period of time in which it is necessary to know if the result is acceptable.
