Dimple surgery (dimpleplasty) is designed to be permanent, and for most people it is. The procedure creates internal scar tissue that tethers the skin to the underlying muscle, mimicking the anatomy of a natural dimple. Once that scar tissue fully forms, the dimple typically remains a lasting facial feature. However, about 7.7% of patients in one large study of over 2,000 cases required a second procedure, with dimple disappearance being one of the top reasons.
How the Procedure Creates a Lasting Dimple
Natural dimples exist because of a split in one of the cheek muscles. Strands of connective tissue from that split attach directly to the inner surface of the skin, pulling it inward when you smile. Dimpleplasty recreates this effect surgically.
Working from inside the mouth, the surgeon scrapes away the tissue connecting the inner cheek skin to the muscle beneath it. This creates two raw surfaces that, as they heal, fuse together with scar tissue. A suture is placed through the skin and cheek muscle to hold everything in position while that scar forms. The width and depth of the scraping determine the size and shape of the final dimple. Once the absorbable suture dissolves over several weeks, the scar tissue left behind acts as the permanent anchor point, pulling the skin inward during facial expressions just like a natural dimple would.
What the Healing Timeline Looks Like
Right after surgery, the dimple will be visible all the time, whether you’re smiling or not. This “always on” look is normal and expected. It happens because the suture is still holding the skin taut before the tissues have had a chance to soften and settle.
Over the first few weeks, as the absorbable suture dissolves and scar tissue replaces it, the dimple starts to look less exaggerated. By three to six months, most people find the dimple appears primarily when smiling, closely resembling a natural dimple. After that point, results stabilize and the dimple becomes a permanent feature for the majority of patients. Some subtle changes can still occur over time depending on individual healing and how the facial tissues shift with age or weight changes.
When Dimples Fade or Disappear
While the goal is permanence, it doesn’t work out that way for everyone. A study published in Archives of Plastic Surgery analyzed 2,048 dimpleplasty patients and found that 159 (7.7%) needed a reoperation. The most common reason was undercorrection, meaning the dimple wasn’t deep or prominent enough, accounting for 49% of revisions. Complete disappearance of the dimple was the second most common reason, responsible for about 39% of reoperations (62 patients out of the 159). Overcorrection, where the dimple was too deep or visible at rest, made up roughly 5.6% of revision cases.
Dimple disappearance typically happens when the scar tissue doesn’t form a strong enough bond between the skin and muscle. This can result from the body reabsorbing scar tissue more aggressively than expected, or from the suture losing tension before adequate healing occurs. Individual factors like skin thickness, tissue elasticity, and how your body heals all play a role. When it does happen, the procedure can generally be repeated.
Risks and Complications
Dimpleplasty is a relatively low-risk procedure. Infection is rare, partly because the mouth heals quickly and oral antibiotics are used as a precaution. In the large study mentioned above, only 5 out of 2,048 patients (about 0.2%) had sutures removed due to infection. The risk of nerve damage in the cheek area is considered extremely uncommon.
The more realistic concern for most people isn’t a medical complication but an aesthetic one: getting a result that looks too deep, too shallow, or not quite in the right spot. Five patients in that same study (about 0.2%) simply changed their minds and had their sutures removed. Removing the suture early, before significant scar tissue has formed, can allow the dimple to fade. Once the scar tissue has fully matured, though, reversal becomes much more difficult because the structural change has already taken place inside the cheek.
Factors That Affect Long-Term Results
Several things influence whether your dimple stays put over the years. Thicker cheek tissue tends to produce more reliable scarring, while very thin skin may not hold the tethering effect as well. Significant weight fluctuations can also alter how the dimple looks, since changes in facial fat shift the relationship between the skin and the underlying muscle. Aging has a similar effect: as skin loses elasticity and facial volume changes over the decades, the dimple’s appearance may subtly shift.
The surgeon’s technique matters too. How much tissue is removed, how the suture is placed, and how much tension is applied all affect the quality of the scar that forms. Too little tissue removal may mean the raw surfaces don’t bond strongly enough, leading to fading. Too much tension on the suture can cut off blood flow to the tissue and compromise healing. These technical details are a major reason why outcomes vary between providers and why choosing someone experienced with the procedure specifically makes a meaningful difference in permanence.