Females often have more forward projection in their cheekbones as well as fuller cheeks overall, with a triangle formed by the cheekbones and the point of the chin. Planning of cheek contouring is done while planning reshaping of the chin. The cheeks are reshaped by cutting away bone and repositioning the facial bones. Augmenting the cheeks with implants or with fat harvested from other parts of the body is common. Risks of implants include infection, and the implant moving and becoming asymmetrical; fat can eventually be absorbed.
Cheek dimples are usually considered as an attractive feature of facial beauty. Unfortunately, not all beautiful girls have dimples. We used a new and simple technique for natural dynamic dimple creation, passing a transcutaneous bolster stitch after scraping off the dermis of all mucomuscular attachments, and without bolster stitch if does not want. This procedure done under local anaesthesia as a daycare. This procedure is safe, reliable and easily reproducible. As no tissue is excised, chances of bleeding and haematoma formation are negligible. With this procedure, the patient satisfaction rate is very high, and patients seen long time after surgery continue to be pleased with their surgically created dimples. Dimples on cheeks enhance facial beauty and expression. They occur in both sexes.
The position of the dimple is marked by the patient in front of the mirror. The point of intersection of the perpendicular line dropped from the external canthus and horizontal line drawn from the highest point of the cupid's bow laterally. Similarly, the patient is asked to create a negative suction and suck the cheeks inside. The site of the maximum depression is the marked site of the dimple.
The patient is discharged immediately with antibiotics and analgesics. Meticulous oral hygiene with mouthwash and oral rinse is of utmost importance. The bolster stitch is removed on postoperative day 7. Initially, there is a static dimple which deepens on animation, but gradually with time there is only a hint of dimple when static and accentuates on animation.
Drawback of this procedure is that the bolster suture is visible on the cheek for the first 7 days after the surgery, other rare complications are hematoma, bleeding, edema & extremely uncommon, there is a potential for injury to the buccal branch of the facial nerve.