Cheek dimples have been proven by anatomic studies to be the result of an underlying muscle defect or unique muscular anatomy. They occur because of a split or defect in the zygomaticus muscle which runs from the underside of the cheek bone down into the lips. While appearing as a slight indentation at rest, the act of smiling contracts the muscle and pulls the overlying skin inward deepening the dimple. This anatomic knowledge makes it possible to surgically create cheek dimples or help to make them less noticeable.

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