In this PSP exclusive, Kimberly Lee, MD, a board-certified facial plastic surgeon and leading expert in dimple-creation surgery, shares what plastic surgeons need to know about this trending procedure as well as the TikTok-driven “dimple makers” phenomenon. Throughout the conversation, Lee emphasizes safety protocols, debunks common misconceptions, and shares inspiring patient stories.
Plastic Surgery Practice: As a dimple-creation surgery expert, can you share insights on your techniques for natural-looking dimples?
Kimberly Lee, MD: Every face is unique, so when it comes to creating natural-appearing dimples, it’s critical to really scrutinize the face and every line and wrinkle that is created with dynamic movement on that face. Only by doing that can you design dimples placed in the most natural-appearing location that will give the best result for that face.
PSP: What advice do you have for plastic surgeons who are interested in offering dimple-creation surgery to their patients?
Lee: Plastic surgeons who are interested in offering dimple-creation surgery should know that it is one of the least predictable procedures, so patient selection is critical. After all, dimple depth can vary among patients due to cheek anatomy.
PSP: The TikTok trend of “dimple makers” has gained popularity. What are the advantages and drawbacks of non-invasive methods for dimples, and how can surgeons guide patients in making informed decisions?
Lee: When it comes to noninvasive methods for achieving dimples, TikTok has shown some alternative ways to achieve dimples that may not be invasive or are minimally invasive (and are not surgical). Some of these dimple-makers yield results that are temporary. When it comes to doing something that’s noninvasive, it’s unreasonable to expect that the results will be natural looking and or have longevity. I’ve also seen dimple piercings that don’t appear to be as natural looking like ones that are surgically created.
When it comes to having a dimple created, the best piece of advice I can give to patients is to really do their research. Make sure it’s somebody who’s been credentialed and is properly trained to do this procedure. This procedure is done on your face, which is different from other body parts you can hide with clothing. So, it’s critical that you go to the best person who could achieve these results for you.
PSP: How do you emphasize safety in dimple-creation surgery?
Lee: Even though dimple creation surgery is done in the office under local anesthesia, meaning the patients are awake, it’s still a minor procedure and protocols must be considered. After all, I prioritize safety and care in all procedures, whether minor or major.
Secondly, it’s important to consider that the oral cavity and upper digestive tract is an area that has a lot of bacteria, so you don’t want to have an infection after the procedure. I typically prescribe antibiotics after the procedure, as well as some additional special treatments that will help minimize the risk of having a complication.
Thirdly, it’s important to have a strong knowledge of the anatomy of the cheek, because without properly understanding the anatomic locations of blood vessels, muscles, and nerves, one could inadvertently get damaged and lead to complications. Treating it as a major surgical procedure, we ensure sterile instruments. We try to keep everything as sterile as possible, even though the oral cavity is not a sterile area.
PSP: What are the most common misconceptions or myths that patients have about dimple-creation surgery, and how do you address them during consultations?
Lee: Some common misconceptions or myths about dimple creation surgery is that there’s no incision. There is an incision on the inside of the cheek. Typically, when we’re creating dimples, we are recreating what would happen if you were born with dimples.
When people are born with dimples, it’s due to a muscle defect that attaches to the skin’s underside. Every time that muscle contracts, which is usually when you smile, that skin gets pulled in a little bit, creating a really cute and dynamic dimple.
So, when we’re recreating a dimple surgically, we want to recreate the natural process.
Some patients have fuller cheeks with more buccal fat in the area, and there’s a common misconception that this leads to deeper dimples, but in reality, the opposite is true. When there’s too much fat in the cheek, it can impede the scar or the adhesion of the muscle to the skin, causing a less deep dimple. Another common misconception or an unknown fact about dimples is that they can be reversed.
If you’re not happy with the dimple, we can go in and try to reverse it. Sometimes, patients have dimples that are either too deep or too shallow. If they’re too deep after healing, we can sometimes adjust them, and if they don’t appear as deep as the patient desires, we may need to make them deeper during a follow-up procedure. Unfortunately, because I can’t biopsy patients’ DNA and know exactly how they’re going to heal, that leads to unpredictability. I can accurately predict the location and the orientation of the dimples, but not their depth.
PSP: Could you please share some patient testimonials or stories that highlight the emotional and physical transformations that individuals have experienced after undergoing dimple creation surgery?
Lee: I’ve probably performed more dimple procedures than anyone I know, as we do them every week in our office, often multiple times in a single day. Patients feel like it’s life-changing for them for several reasons; usually they’re very happy because they have a bright smile, they feel like they look cute, and some cultures believe dimples are a sign of good luck.
Some patients come in because they’ve seen how having dimples brings them closer to family members who already have them, even though they were not born with dimples themselves. Other patients have mentioned that dimples draw attention away from areas of their face they’re insecure about, helping to boost their confidence. For example, I had a patient with a receding hairline who wanted dimples to divert attention from it. I have other patients who have a little bit of asymmetry between the two cheeks and want to put in a dimple to camouflages the asymmetry.