The buried guide suture method: a novel technique to correct traumatic facial dimples

Facial dimple, frequently following blunt trauma, presents as soft tissue depression, which is particularly apparent during facial expression. The displacement of subcutaneous tissue can be detected and measured by high-frequency ultrasound. Limited surgical methods have been applied in these closed injury cases. It is challenging to reposition the subcutaneous tissue without incisions on unscarred skin. The authors propose a novel three-dimensional technique to suture and fix the subcutaneous tissue at a distance through a concealed incision. The buried guide suture method was used in the treatment of 22 patients suffering from traumatic facial dimples on the cheek. All the patients showed great improvement in their depressed deformity with minor complications. This technique provides an option to correct soft tissue depression without leaving visible scar, especially for the mimetic rupture caused by blunt trauma.Facial contusions occur frequently in children. Treatments for closed soft tissue injury are easily ignored due to no laceration on the epidermis. However, facial soft tissue depression might appear after the swelling subsides. It usually presents as a dimple that is not conspicuous at rest but exaggerates when patients smile or make other expressions.