Dimple creation surgery can simulate this naturally occurring process.  To create a dimple, a small painless incision is made in the inside of your cheek. There is no incision or scar on the outside skin.  A small absorbable suture is passed through the inside of the cheek and catches the undersurface of the skin where the dimple is desired.  When this suture is tied it causes a dimpling in the overlying skin.  At first there is a dimple present even without smiling, but after several days, or sometimes a few weeks, the dimple is only present while smiling or moving the face.  The scarring between the inner skin and muscle will cause a permanent dimple even after the suture is absorbed.