Journal of Clinical and Aesthetic Dermatology

MAY 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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25 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY May 2018 • Volume 11 • Number 5 O R I G I N A L R E S E A R C H dimples among the mesoprosopic group, compared to the other two groups, with no unilateral or bilateral predominence (Figure 4). Conversely, we observed a predominance of unilateral dimples in the leptoprosopic group and a predominence of bilateral dimples in the euryprosopic group. The shape of the dimple also varied according to the facial shape—leptoprosopic individuals tended to have long, narrow dimples (Figure 5), while the euryprosopic group tended to have short and circular dimples (Figure 6). The depth of the dimples did not vary significantly between the three groups. GUIDELINES FOR SURGICAL CREATION OF DIMPLES We offer the following guidelines, based on our observations, for surgeons who perform dimpleplasty (see Figure 7 for an overview of guidelines): • The sex of the patient does not impact the number or position of dimples. • The unilateral dimple is predominant among individuals with the leptoprosopic facial shape; thus, this type of dimple is recommended among those with the leptoprosopic shape. For those with the euryprosopic facial shape, bilateral dimples are recommended, and for mesoprosopic individuals, either can be done. When choosing which side of the face to create the dimple, preference should be given to the side with the dominant hand. • If an existing unilateral dimple is present and the patient would like a dimple on the contralateral side, the dimple should be made at the same level as the existing dimple or at the point of a pre-existing faint dimple. • For the mesoprosopic facial form, the point of the dimple should be 4mm anterior to the KBC point. The shape of the dimple can be long, short, narrow, or circular. For patients with the leptoprosopic facial form, the dimple should be positioned at the KBC point and ideally should have a long, narrow shape. For a euryprosopic facial form, the dimple should be positioned 3mm above and behind the KBC point or at the level of the Cupid's bow horizontally, and ideally should be short and circular in shape. • Ultimately, regardless of facial form, the positioning, size, shape, and number of dimples should be based on each individual patient's preference. If the patient has no specific requests, then the clinician can use dimple characteristics associated with the patient's facial form as a guide for determining the optimal position, size, shape, and number of dimple(s). TABLE 1. Total number of dimples DIMPLES UNILATERAL BILATERAL TOTAL RIGHT LEFT Number 51 45 120 (240) 336 Percentage 44.4 55.6 100 TABLE 2. Distribution of facial form, n (%) EURYPROSOPIC MESOPROSOPIC LEPTOPROSOPIC TOTAL 36 (16.7) 132 (61.1) 48 (22.2) 216 (100) TABLE 3. Demographic, socioeconomic, and baseline characteristics of participants MESOPROSOPIC UNILATERAL BILATERAL AT KBC NOT AT KBC TOTAL People 60 72 132 Dimples 60 144 87 117 204 LEPTOPROSOPIC UNILATERAL BILATERAL AT KBC NOT AT KBC TOTAL People 30 18 48 Dimples 30 36 36 30 66 EURYPROSOPIC UNILATERAL BILATERAL AT KBC NOT AT KBC TOTAL People 6 30 36 Dimples 6 60 30 36 66 KBC: Khoo Boo-Chai's point FIGURE 6. Euryprosopic facial form with unilateral dimple

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