Thank you for your question.
You submitted a question without a photo but you are asking about the permanence of undergoing
dimpleplasty and you are asking about a very specific issue related to the suture which
you describe as a blue suture and that’s placed permanently and that can cause a problem
later on.
Well, certainly I can give you some guidance about this question.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years and dimpleplasty
is a procedure that I’ve become well known for and we’ve actually been recognized in
the media and patients come from around the world for dimples and I’ll certainly give
you some guidance as to this question about permanence.
Something to understand is first of all, there is the short-term consistent result and then
what happens as time goes on.
So, first of all, the concept of doing, creating a dimple is to try to mimic what nature creates
for a person who has a natural dimple and what that has to do is an anatomic aspect
of the muscle inside the mouth called the buccinator muscle and this muscle has a little
opening and there is a connection.
So that when someone smiles, they get a dimple, they get a little indentation.
And several well known celebrities have these dimples and people come in and show pictures
to me about what the types of dimples they like and the types they don’t like and what
kind they want.
Now the technical aspect of creating a dimple for a surgeon is to essentially create a little
opening in the mouth and connect the muscle that’s inside the mouth with the skin and
then having that connection hold and that’s critically important.
And so what I tell my patients is when you have a dimpleplasty procedure, expect that
the dimple will be there even if when you’re not smiling and to different degrees of depth
for the first several months.
That is very important to understand because we want that connection to be tight.
I tell my patients that if you are not prepared for that and you want something that’s super
subtle, you’ll end up not having something that’s going to last for the long-term.
And so I end up always doing something when I’m being aggressive to connect the skin
with the muscle.
Now to answer the question about the blue suture, what you are describing is basically
a non-dissolvable suture specifically most likely a suture called Prolene.
Well, in the deeper tissues of the body where there is no connection between the outside
and the inside, permanent sutures are routinely placed.
And so specifically in that space, that suture is not likely to cause any issue.
The reason to use a permanent suture for a surgeon is to have the strength of that suture
and maintaining that kind of connection for the critical amount of time in order for the
body to prevent healing tissue that allows that permanence to occur.
When you use a dissolving suture, sometimes because the body breaks down that suture and
when that breakdown involves some degree of inflammation, that can be somewhat challenging
in getting the desired outcome especially when the body forms a capsule or some type
of inflammatory response whether it’s the different type of sutures that are generally
dissolvable.
So I think that you don’t have to worry that that suture would be a problem in the
long-term.
It’s just a matter of getting past the initial period where the possibility of infection
is a risk because you are working from the inside of the mouth and the inside of the
mouth has lots of bacteria.
So in our practice, we have our patients placed on antibiotics and we have them use antibacterial
mouthwashes and we give them specific restrictions about different types of food and temperature
of food to allow the opening of the mouth to heal adequately so that the risk of infection
is minimized.
So with that being said, meet with a doctor who is highly experienced with dimple procedures.
I always say that interestingly, as a side note, that this procedure is deceptively complicated.
It is working in a very small area to create a very specific result and a lot of doctors
simply just don’t do enough to become good at this procedure.
So I actually have very well known surgeons refer their patients to me for dimples because
we do a good number of them and it’s just something that is niche procedure and this
has nothing to do with being a better surgeon or not.
It‘s just a matter of experience and consistency of doing a particular operation.
So that being said, again meet with a doctor who is experienced with doing dimples and
learn from their experience what they feel the longevity of the procedure would be.
It’s very important to understand that when you talk about permanence with any operations
in the face, you are also dealing with nature’s process, facial aging, environmental factors,
weight gain, weight loss, stressors.
So in the context of all that, you have to understand what’s the likelihood of the
dimple being something that will last for you and whether or not enhancement or revision
procedure or repeat procedure will be necessary.
I think that when people look for permanence, I always remind everyone that we are not permanent.
We are continuously changing and aging processes affect everyone differently considering the
factors of genetics and environment.
So I hope that was helpful, I wish you the best of luck and thank you for your question.