The Procedure

What is the procedure ?

For all peoples, the smile is the impress appearance of the face. Besides the beautiful lip, the thing can increase the charming of your smile is “dimple”. But actually, Dimple is one feature on the face which happened from the skin is dimpled by naturally; the cause of dimple is a defect of the muscle. It’s because there are the connected area between the cheek and the cheek muscle (lower part) which can make the mouth working. So, when the muscle is moving such as smiling or speaking, the muscle will pull the cheek skin down, that’s dimple occurred on your face.

But dimple may occur in some peoples since their birth, not everybody. The people with the dimple, obviously visible when they smiling. Dimple on the cheek enhance facial beauty and expression, attractive face, looks more sweet which most of the woman desire to have it on the face also. Moreover in some cultures dimples are considered a sign of good luck and prosperity. But however, even the people who born with the natural facial dimples can lose them or the depth of the dimple is reduced when they get older or the skin, muscle and physical weight changes.

But nowadays, in this century when the facial appearance from your birth is doesn’t matter anymore. When any flaws on the face can be corrected by the plastic surgery and including making the dimple on the face which can make only 1 side or both sides of the cheek or we call “ Dimple Creation surgery”( dimpleplasty), the procedure that involves recreating this naturally occurring process.

The Method

How the procedure is performed ?

The appearance of dimple can done in 2 types, type and the small length type. The procedure will be started with marking the position of dimple on the face where it created by letting the patient look at their face in the mirror and try to smile. And the position where suitable for creating the dimple will be marked. And then, the surgeon will apply the local Anastasia on the patients to avoid the pain during the surgery. Then, the incision will be made inside of the cheek (inside the mouth) to cut out some pieces of the cheek muscle or we call “Zygomaticus Major”. The muscle that control the lip’s working (which can make you smile) until you can access the fat layer of your cheek and tied the remaining muscle with the cheek skin to create the artificial muscle between the cheek skin and the muscle and they will attach to the each other. And the surgeon will be close the incision with the suture as the final process. But in the beginning after the surgery, you cheek is dimpled all the time, but it will be normal in 3 months, you will have the dimple on the face when you smile only. Because the fascia between the muscle and cheek skin is extend over the time.

What type of Anastasia is necessary for the procedure ?

Local Anastasia

How will the incision look like ?

The incision after dimple creation surgery will be made inside of the cheek in the mouth, about 1 cm of the length which is invisible. The dimple can be created on 1 or both sides of the cheek.

Ideal Candidates

Is this procedure suitable for the candidate?

  • The candidate can be both of man and woman but must be in good health, don’t have the serious medical or condition which can be risky for undergo the surgery
  • must over than r 18 years old of the age, when the body is already stop develoing
  • The people who want to create the dimple on the cheek which can be on 1 side of both sides
  • The peoples who want to improve the appearance, looks more beautiful , sexy and attractive 
  • The people who want to have the brighten smile and add character
  • The peoples who want to restore symmetry with the face
  • Emotional stability is one of the most important factor
  • The people who believe in the prosperity, because in some culture dimples are considered a sign of good luck and prosperity
  • The peoples who want to revision the dimple creation, because they don’t happy with the result of the surgery in the earlier time
  • The people who understand about the procedure clearly and including the complication and the side-effect after the surgery

What are the results the candidate can expect ?

  • The result of the surgery is immediately visible and permanent 
  • The face look sweeter and softer 
  • The face look natural beautiful 
  • Have the smile and facial expression 
  • In some people who believe in the fortune , the dimple can be the sign of good luck
  • The result of the surgery is safe, the generally complications are not expected except for minor bruising and swelling.
  • Increasing the self-esteem and be more self- confident with the smile 

Recover/Post-Operative

Length of stay at the hospital and in Thailand

Out-patients, recommends 9 days in Thailand

Pre-operative care

  • Have a consultation with the surgeon, inform the surgeon about the medical problem and condition 
  • Discuss with the surgeon about the surgeon about the expected result, what type of the dimple you would like to create, the position of dimple creation and etc.
  • If you are having a combination of plastic surgery procedures, the surgeon will explain you about this and the surgery will take longer recovery time. You can make a decision to do it or not. 
  • You will be asked to stop taking Aspirin, ibuprofen, and products containing aspirin and ibuprofen including anti-inflammatory medication and including high dosing any multivitamins/herbal remedies/teas etc before and surgery for 2 weeks , this may inhibit blood clotting and cause bleeding problems during and after surgery
  • Stop drinking alcohol or smoking before and after the surgery 2 weeks, that’s effect to delay wound healing

On the surgery date

  • Take a bath and wash your hair wash your hair (because after a surgery, you maybe not confortable to do it for a few days) but without applying the lotion and cream on the body including no makeup
  • Take out all accessories, such as earring and also remove the nail polish before getting the operation room
  • Wear the loose cloths or comfortable, If possible take the shirt with the button in front. 
  • Sleep well before the surgery
  • Make a physical checking up to be sure that you have the normal level of your blood pressure or any disease come up which can’t undergo the surgery or not

Post-operative care

  • After the surgery, you maybe feel uncomfortable to open the mouth and feel stretched 
  • The painkiller pill and antibiotics medication is recommended if the pain is extremely and for preventing to get infection during the healing process and continue taking them until they are all gone
  • The surgeon will recommend you lay down in the position with your head higher than body. This will help relieve pressure from your treatment area reducing swelling and pain 
  • Try to avoid seeing your face from the mirror in the first few days, because it will be complete swelling especially your mouth and this will scared you even it’s very common symptom after the surgery 
  • The surgeon will recommend applying the cool pack or frozen peas, this can reduce the swelling and stop bleeding (especially, the first few days is recommended to keep cool pack on your surgery area all the time) and including vitamin A and C is also can help. 
  • After 48 hours, when you stop applying the cool pack on the cheek, just let it heal by itself and the swelling will fade away in 4-5 days
  • 2 days after the surgery, you can brush your teeth but very gentle, this can separate the incision from each side. And keep the mouth clean, gargling with the antiseptic mouthwash the saline as often as you can per day 
  • It’s common after the surgery for bleeding or oozing ,the depression might be permanent for two to three months after the surgery
  • 3 weeks because of the rising high blood. This can cause of bleeding inside your cheek
  • During the recovery time, try to drink water as much as you can and should stop eating after the surgery date at least 24 hours to avoid getting infection from the bacteria in the mouth
  • Keep eating the soft food until 2 weeks after the surgery and continue avoiding strong food or sticky food or the uncooked foods, fresh fruits or vegetable which maybe have the bacteria contained until 4 weeks. Because this is risky to make your incision get infection
  • Keep all incision and suture lines free of moisture to ensure proper healing. Do not allow creams, lotions, or topical arnica into the incision because they can cause inflammation
  • If you have bleeding or oozing come out from the wound, it’s normal from the surgery. Just disregard and it will fade away in a few days. 
  • You may notice a change in your smile, tingling, the sporadic sharp pain, pulling, burning, cold or other unusual sensations. These usually subside within the first few weeks. Your end result is usually seen within 4 months
  • Don’t try to use the tongue to touch the incision inside the mouth, and if the suture falls-off from incision. That’s normal because it’s the absorb suture and no danger to the body
  • Do not open your mouth widely, or over animated facial expressions during the healing phase, this can disturbs incision 
  • About 7 days after the surgery, you have to come back to see the surgeon again for follow up checking to be sure that the incision go well, no side-effect or complication
  • For the dimpled hole, the surgeon will recommend you to put the oily cream or moisturizer in the hold to help the healing process
  • You can resume light activity the day of surgery. Do not lifting heavy objects and, especially, no bending over to lift objects. Its can caused of raising your blood pressure and heart rate through strenuous which this can slow-down the healing process
  • Avoid extreme activities or strenuous sport at least If you feel ashamed with the dimpled cheek (even when you don’t smile), you can put the anti-dust mask or put the plaster with the same color with your skin , this can help 

What are the possible risks and complications involved?

Common symptoms

After the surgery, you maybe feel stretched, pain, uncomfortable, mild swelling and bruising including the temporary weakness of your cheek muscle, but just for temporary and it will go away over the time

The muscle sutured to create the dimple is unbound

This will make the surgery unsuccessful, due to when the suture which holding the dimple breaks prematurely. The cheek skin can’t be dimpled anymore or including too shallow a dimple or the dimple might disappear completely. Only one way to solve these problems is revision the surgery

The asymmetry of the both sides of dimple

This can happen when one dimple is larger than the other due to the surgeon cut the different amount of the cheek muscle from each side. This you have to go back to correct one of both dimples for the improving.

Infection

This is rare and the risk is minimized with antibiotics prescribed before and after the surgery. But if can happen if you the oral care is not good enough and eat some food that can have bacteria during the recovery time

Bleeding

Normally, after the surgery you will have bleeding, oozing, but in case you have extensive bleeding or so much. You should go back to see the surgeon as soon as possible. Maybe it’s cause of the blood clots from the surgery or the other reasons. But this can be prevented by avoiding medications such as anticoagulants before your surgery.

The nerves are inquired

This may happen during the surgery when the surgeon but some piece of the cheek muscle and some nerves are disturbed in the process of cutting.