A dimple creation surgery needs an approximate thirty minutes to complete and is carried out under local anesthesia. A punch biopsy instrument is placed alongside the buccal mucosa (inner cheek) and circular motions are made in order to cut through the inner cheek, sub-mucosal and cheek muscle. The circular core that's created is removed; the skin is left unaffected and intact. A shallow cylindrical shaped "defect" is created under the skin; this defect will then be closed with absorbable sutures. The sutures are placed through the cheek muscle, dermis layer of the skin and chick muscle on the side of the "defect". A surgical knot is then tied which dimples the skin without a smile.
Over the first two weeks the sutures will dissolve and the skin flatten out. As the internal scar heals it connects the cheek muscle to the skin to create a dimple when smiling. A dimple creation surgery can be performed on cheeks that are chubby. The dimple can also be customized in its shape and size depending on the desire.