Dimple over the cheek makes a face cute and appealing and hence it contributes towards facial feminization in MTF transgender
Procedure: An incision is made inside the mouth at the desired level of dimple. Small part of muscle is removed and muscle edges are anchored to inner layer of skin. Initially the dimple is visible even without smile but over the time dimple is present only during smile / facial animation. There will be no scar visible on the skin. The dimple can be reverted back if desired.
Duration of Procedure: 30 minutes to 1 hour
Recovery Time: Immediate. Mild swelling may persist for few days. You may be asked to have only soft diet for a couple of days.
Longevity of Results: Usually permanent. Dimple creation surgery is safe and effective, and can also be reverted back if needed.
Females have projected, fuller and rounder cheeks and the male cheeks are hollower in this area (actually the projection in males is more over the upper and lateral part much above the part in females). Female hormonal therapy leads to fuller cheeks to a variable nature.
Malar / Cheek bone areas enhanced with cheek implants also called as malar implants. Solid Implants (silicon /HDPE implants) are preferred. We are using HDPE implants for over many years. These implants allow tissue in growth and have least chances of infection and extrusion.
Approach / Procedure:
Most common approach is intraoral though other approach is coronal or eyelid incision.
An upper buccal incision is made safeguarding the parotid duct opening. A pocket is created in the malar region safeguarding infraorbital nerve. The implant is inserted (the shape and size of the implant can be customised intraoperatively).The HDPE implant is fixed in position with ultrafine titanium screw.
Before operation marking is done as shown in figure. A line is drawn from ala (outer edge of nostril. Another line is drawn from oral commissure (angle of mouth) to lateral canthus (angle of eye). The implant should lie just below the transection of the two lines to avoid unnatural appearance.
If minor enhancement is required, this can be achieved by fat grafting. Fat is harvested from your own body (like from tummy, buttock or thigh) and is injected into the cheek area to make them fuller and rounder. It is safe as the fat belongs to your own body. It may need touch up (top ups) as fat disappears over a period of time.
Duration of Procedure: 1 -2 hrs.
Anaesthesia: General / Local with sedation.
Recovery Time: Back to work in 5 to 7 days. Mild swelling / bruising may persist for a couple of days.
Longevity of Results: Permanent.