Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
Send us all your questions or requests, and our expert team will assist you.
The procedure typically begins with the administration of local anesthesia. The surgeon injects lidocaine with epinephrine into the cheek tissue. The needle is inserted from the inside of the mouth, similar to a dental injection.
The anesthesia numbs the entire cheek area within minutes. Epinephrine helps constrict blood vessels, minimizing bleeding during surgery. Patients remain awake and alert but feel no pain, only pressure or tugging sensations.
Once the area is numb, the surgeon makes a small incision in the buccal mucosa (the inside of the cheek). This incision is typically only 2 to 3 millimeters long. It is placed precisely opposite the marked location on the external skin.
Because the incision is inside the mouth, there is absolutely no scarring on the face. The surgeon uses a scalpel or sometimes a laser to make this cut, gaining access to the underlying muscle and fat.
Through the small opening, the surgeon dissects the submucosal fat to locate the buccinator and zygomaticus major muscles. This dissection creates a small tunnel or pocket.
In the biopsy punch method, a small core of the muscle and fat is removed to create a defect. In the suture method, the muscle is exposed to allow the suture to grab it. The surgeon carefully avoids the parotid duct (Stensen’s duct), which transports saliva.
This is the core of the procedure. The surgeon passes a needle carrying an absorbable or non-absorbable suture from the inside of the cheek, through the muscle, and up to the deep layer of the skin (dermis).
The needle catches the underside of the skin but does not penetrate through to the outside. It is then passed back through the muscle and out through the incision. This creates a loop that encompasses the muscle and the skin.
Once the suture loop is in place, the surgeon ties the knot. As the knot tightens, it pulls the skin inward toward the muscle, creating the dimple. The amount of tension applied determines the depth of the dimple.
The surgeon checks the depth and symmetry before finalizing the knot. The dimple will appear very deep at this stage, which is necessary to account for the slight relaxation that occurs during healing.
After the dimple is secured, the small incision inside the mouth is closed. Usually, one or two dissolvable stitches are used. These stitches are made of gut or similar material that breaks down and falls out on its own within a week or two.
Some surgeons leave the tiny incision open to heal naturally if a biopsy punch was used, as the mouth heals very quickly. If sutured, care is taken not to make it too tight, which could cause discomfort.
Immediately after surgery, the patient is given an ice pack to hold against the cheeks. There is usually no pain while the anesthesia is still adequate. The cheeks will feel swollen and numb.
The patient is monitored for a short period to ensure there is no excessive bleeding or adverse reaction. They are then discharged with postoperative instructions. The dimples will be visible as deep indentations even without smiling.
Because the wound is in the mouth, infection control is vital. Patients are prescribed a medical-grade antiseptic mouthwash (often chlorhexidine). They must rinse their mouth several times a day, especially after eating.
Keeping the mouth clean prevents food particles and bacteria from entering the healing incision. This regimen usually lasts about 1 to 2 weeks until the incision is fully closed.
Swelling is normal. It varies from mild puffiness to a “chipmunk” appearance. Bruising is less common but can occur on the cheek. The swelling typically peaks within 24 to 48 hours and then subsides.
Patients are instructed to sleep with their head elevated on extra pillows to help drain the fluid and reduce swelling. Continued icing for the first 48 hours is highly recommended.
For the first few days, a soft diet is recommended to avoid trauma to the incisions. Foods like yogurt, soup, mashed potatoes, and smoothies are ideal.
Patients should avoid hard, crunchy, or spicy foods that could scratch the incision or cause stinging. Drinking through a straw should be done cautiously or avoided if it creates excessive suction in the mouth.
Pain is generally mild. Once the anesthesia wears off, patients may feel soreness or a dull ache in the cheeks. This is usually manageable with over-the-counter pain relievers like acetaminophen.
More potent narcotics are rarely needed. Antibiotics prescribed for infection prevention should be taken as directed. Patients should avoid aspirin or ibuprofen, if possible, for the first few days to minimize the risk of bruising.
Patients can usually return to work or school the next day, although they will have visible dimples and some swelling. Strenuous exercise should be avoided for a few days to prevent increased blood pressure from causing bleeding or increased swelling.
Smiling and talking are encouraged within comfort limits. Still, excessive stretching of the mouth (like yawning widely) should be done carefully to avoid putting too much tension on the fresh sutures.
Send us all your questions or requests, and our expert team will assist you.
You might feel a small knot or a tightness inside your cheek with your tongue for the first few weeks. This is normal. As the tissues heal and the suture dissolves (or gets buried), this sensation will disappear.
It is very unlikely to disappear immediately. In fact, it is usually too deep at first. If it seems to fade, it might be due to swelling masking the depth. Wait for the swelling to go down to see the actual result.
Brush gently. Be careful not to slip and poke the inside of your cheek with the toothbrush. Use a soft-bristle brush and avoid the area of the incision for the first few days. Rely on the mouthwash for cleaning that specific spot.
Absolutely not. Smoking introduces heat and toxins directly to the incision site inside the mouth. It dramatically increases the risk of infection and surgical failure. You must wait until it is fully healed
Yes, swelling often affects one side more than the other. One cheek might look puffier, or the dimple might look deeper on one side initially. This asymmetry usually resolves as the healing progresses.
Your Comparison List (you must select at least 2 packages)
