Cheek Dimpleplasty: A New Classification of Described Procedures

Abstract

Cheek dimpleplasty has become a popular request amongst patients requesting cosmetic surgery. Since the first reported dimpleplasty in 1962, there have been many reported procedures in the literature for cheek dimple creation. Some of the procedures described by various authors as “novel” are actually similar if not identical to existing procedures. This study reviews the different procedures of cheek dimple creation and provides the first ever systematic classification for these techniques. EMBASE, Cochrane library, Ovid medicine, and PubMed databases were searched from its inception to June of 2019. We included all studies describing the surgical creation of cheek dimples. The studies were reviewed, and the different procedures were cataloged. We then proposed a new classification system for these procedures based on their common characteristics. The study included 12 articles published in the English language that provided a descriptive procedure for cheek dimple creation. We classified the procedures into 3 broad categories and subcategories. Type 1 procedures are nonexcisional myocutaneous dimpleplasties. In these procedures, the buccinator muscle is not excised. In type 1A, the suture used to create the adhesion traverses the epidermis. In type 1B, the suture does not traverse the epidermis, rather, the suture travels up into the dermis and returned back to the mucosa. Type 2 procedures are excisional dimpleplasties. In these procedures, the buccinator muscle is excised with (open) or without (closed) the excision of the mucosa. Type 3 procedures are incisional dimpleplasty. In these procedures, the muscle is incised and fixed to the dermis. Each of these groups of procedures has potential unique advantages and disadvantages. There are multiple procedures reported in the English language literature for the creation of cheek dimples. Most of the procedures are based on similar concept with minor variations. Our classification system, the Opoku-Simone Classification, will help facilitate communication when describing the different configurations of these procedures. Procedure within each group has similar potential advantages and disadvantages.