Dimple Creation

A dimple on your cheek is aesthetically very pleasing and a mark of your identity. Dimples are considered by the majority as a very attractive facial feature. Natural dimples usually occur on both sides of the face, and are generally present only when the face is animated (while smiling). A natural dimple is usually formed when there is a small defect in the cheek musculature. The skin overlying this small defect is stuck down to the underlying connective tissue when the muscle contracts with smiling; it splits apart and allows the overlying skin to indent. In case of chin dimple which is a static depression on chin commonly demanded by male patients.

There is a huge demand now for surgically created dimples both from women and men. It is possible to create a dimple by a minor plastic surgical procedure under local anaesthetic as a day case. The results of this cosmetic procedure are usually permanent. The location and size of the dimple is a personal choice and it is decided in your consultation with the doctor.

The Operation

Dimple creation surgery is, in itself, a fairly simple one and is commonly done under local anaesthesia on an outpatient basis. You will be awake and comfortable during the entire procedure. Special arrangements can be made if you would rather be asleep for the dimple creation surgery. The dimple surgery takes about 45 minutes to perform and you can go home right away after the procedure. Usually normal activities can be resumed immediately after the procedure.

In case of chin dimple an intraoral incision taken in lower gingivo-buccal fold to identify the lower midline part of the mandible grove is created in the midline to create adequeate depression and two holes on the anterior wall of the bone

An anchoring sutures passed from the dermis of desired dimple area which fixes the dermis in the midline grove . Rest all layers sutured with absorbable material.

Risks And Limitations

As in any operation, there are risks involved in the form of infection, bleeding, scarring, under/over correction, revisional surgery and weakness of the involved muscles although extremely rare. There are minimal complications with dimple formation aside from a little bit of swelling and bruising.

After The Operation

There is usually minimal swelling following the procedure, and the after care is just as simple and uncomplicated as the procedure. Patient need to be on liquid dieat for 5 to 6 days. The after care usually involves regular mouth rinsing with antiseptic solution and a course of antibiotics.

You can go back to work the next day, but avoid strenuous activities like contact sports and exercise that can injure your face. The healing period is between 7 to 10 days. After a few weeks, you will notice that the operated area is already taking shape; the dimple is becoming more apparent while you smile (during active animation of facial muscles) and feels natural like you are born with it. Final results can be seen after a month.

Like any operation that is carried out under a general anaesthetic, there is a small risk ofchest infection, particularly among people who smoke. There is a small risk that infectioncould adversely affect the success of the operation. Were it to happen, it may be necessary to remove, temporarily, a manufactured implant if that has been used, or it may cause a graft of bone or cartilage to dissolve. In either event, it should be possible for you to have afurther reconstructive operation once the infection has cleared. Sometimes a manufactured implant will extrude through the skin of the nose or its lining and need to be removed. This can happen months or years later, and is more likely if a large implant has been used or if the nose is accidentally injured.

After The Operation

You can expect to have some minor bleeding from your nose for the first day or two and you can gently dab this away with a gauze swab or clean handkerchief. Unless you are advised otherwise, it is best for you to leave any crusts in your nostrils for the first week and then gently cleanse them away with cotton buds. You should keep your head up as much as possible and avoid having hot baths. Do not blow your nose and try your best not to sneeze through your nose.

Stitches inside your nose will probably be of the dissolving type and do not need to be removed. If your stitches are outside your nose, your surgeon will advise you on their care and the time for their removal. You will also have a firm splint over your nose in order to protect the new frame and keep it stable whilst it is settling in. Once the splint has been removed, this protection is gone and you will have to be very careful in the way that you handle your nose for the first six weeks. You should avoid any activities where you might knock your nose and you should not move it from side to side between your finger and thumb. Try your best to sleep on your back. The initial swelling and bruising will probably have disappeared within the first two weeks sufficiently for you to feel confident to show your face in public again.

However, it will take at least three months for the reconstructed shape of your nose to mature and maybe a lot longer if you have had a lot done. Do not be too critical of your nose too early. Minor unevenness of contour is common during the first few months and usually settles with time.

Sometimes (in about 10% of patients) the nose does not look right for the patient after all the swelling has settled. In these cases, it is usually possible for the surgeon to carry out a second operation to the residual problem of appearance but, not until all swelling has settled from the first operation. Most surgeons wait for a year for this to happen. Secondary surgery like this may involve additional expense.

After The Surgery

After your surgery there is usually some bruising of the cheeks and with gravity this tends to descend into the neck. Discomfort is usually mild and can be controlled with analgesics. It is normal for there to be some numbness of the skin of the cheeks and ears. This will usually disappear in a few weeks or months. It is better to keep the head elevated for a couple of days to reduce swelling. Drainage tubes will be removed a day or two after surgery. Avoid strenuous activity, saunas and massage for at least two weeks.

At the beginning your face will look a little puffy and may feel rather strange and stiff. The scars can be very well hidden by women with their hair and disc shaped earrings so that they should be able to resume work and social activities within a couple of weeks. Camouflage make-up can be helpful in masking bruising.

Men find it more difficult to disguise the scars and will need to shave their beard closer to the ear in front and also behind the ear where the skin has been lifted. The scars in the hair do not usually show except that the hair is cut shorter immediately around the wound. There may be some slight reduction in hair growth in the temples, but this is not usually a problem unless the hair is very thin and repeated facelifts are being carried out.