I. Pre-operative preparation

q Secure written consent
q Take standard pre-op photograph
q Give prophylactic antibiotic at least 1 hour prior to surgery
q Wash face and neck with soap and water
q Position patient on the operating table (semi-recumbent position)
q Clean face and neck with alcohol swab
q Placement of operative marking

II. Operative Techniques

q Sepsis and Antisepsis
q Application of sterile drapes
q Infiltration of local anesthesia
q A small stab incision is made just under the chin
q Passing of a tiny scissor upward toward the mark made for the new dimple and free the skin under the dimple site from the underlying muscle
q Passing of blade 15 through the original incision line ,carries it to the outlined dimple site ,and cuts the muscle and underlying tissue all the way to the bone(as the cut muscle and tissue spread apart small space is created )
q The skin is now pressed downward into the space and help in place by a small mold that is taped into place.
q Stent is placed on the sticky cleft area and 3 layers of tape are placed across it onto the skin.
q Closure of incision site.
q Application of sterile dressings.

III. Pre-operative Care

q Take home medication
o continue prescribed oral antibiotic for 7 days
o analgesics for PRN basis
q Follow-up /check-up after 3 days
q When pressure mold is release 3 days later the union between the skin and the bone had created a depression.
q If the impression is too deep it can be massaged for several minutes over the next few days. This will break down some of the adhesions that are forming and produce a shallower dimple.