CASE REPORT

Bilateral dimples that are rarely seen in the lower alignment of the
mouth corners (Fovea inferior anguli oris)
R Kosif, M Diramali, S Sertel Meyvaci

R Kosif, M Diramali, S Sertel Meyvaci. Bilateral dimples that are rarely which appeared in the alignment of her mouth corners and below 17.49
seen in the lower alignment of the mouth corners (Fovea inferior anguli mm when she was laughing. This dimple was named as fovea inferior anguli
oris). Int J Anat Var. 2017;10(4): 99-100. oris in our article. Additionally there was fovea buccalis in her right cheek.
There was a dimple background in the student’s family. Her grandmother
ABSTRACT had the same bilateral dimples while the mother had bilateral fovea buccalis.
Sacral Dimples take place in both gender with no specific preponderance, and Fovea inferior anguli oris occurs as congenital in the interception points of
may state unilaterally or bilaterally and are genetically inherited as a dominant m. orbicularis oris, m. depressor anguli oris and m. depressor labii inferioris
trait. Besides the most seen dimples in our face, buccal and mental; rarely muscles. The frequency of occurrence is unknown.
inferior to the level of anguli oris, fovea inferior anguli oris can also be seen. Key Words: Rarely seen dimple; Fovea inferior anguli oris
Bilateral dimples have been found on a 20-year-old female medical student

INTRODUCTION The dimple background in her family: It is learned that bilateral fovea
buccalis are present on her mother but not on her father and sibling,
D imples are usually seen as a charming characteristic of facial beauty.
They take place in both genders with no specific preponderance, may
state unilaterally or bilaterally and are genetically inherited as a dominant
and also her grandmother has the same bilateral dimples (fovea inferior
anguli oris).
trait (1). Anatomically, dimples are regarded to be occasioned by insertion
of fascial bands of muscles into dermis or dermal tethering effect of muscles
which may be bifid. Dimples which are located on the face look attractive
and are described a mark of good fortune and welfare in a great deal of
cultures (2,3).
Face dimples appear as marked depressions of varying depth and size. Cheek
dimples are frequently and situated at various distance laterally to the
angles of the mouth. They may be unilaterally or bilaterally expressed. Their
appearance may be enhanced by smiling and they are therefore also called
smiling dimples (4). Fovea Mentalis (chin dimple): The terms cleft chin, chin
cleft, dimple chin or chin dimple attribute to a dimple on the chin which is a
Y- shaped fissure on the chin with an underlying bony peculiarity. Especially,
the chin fissure comes after the fissure in the lower jaw bone that concluded
from the incomplete fusion of the left and right halves of the jaw bone, or
muscle, during the embryonal and fetal development. For other individuals,
it can develop in time, often because one-half of the jaw is longer than the
other, causing to facial asymmetry. This is a hereditary trait in humans, where Figure 1) Normal posture
the dominant gene triggers the cleft chin as the recessive genotype presents
without a cleft. However, it is also a usual example for variable penetrance
with environmental factors or a modifier gene conceivably influencing the
phenotypical expression of the actual genotype. Cleft chins are common
among people arising from Europe (5). There is another type of dimple that
can be encountered rarely, such as fovea mentalis in the lower part of the
mouth. It is observed at the bottom and single or double sided of the mouth
corners.
CASE REPORT
A rare dimple was encountered on a 20-year-old female medical student.
Bilateral dimples were found 17.49 mm (measured by digital caliper) below
the corner of her mouth that were not noticed in normal posture but when
she was laughing (Figures 1 and 2). This facial chin dimple appeared in the
alignment of her mouth corners and emerged at the interception points of
m. orbicularis oris, m. depressor anguli oris and m. depressor labii inferioris
muscles (Figure 3). This dimple was named as fovea inferior anguli oris in Figure 2) The fovea inferior anguli oris bilateral and fovea buccalis right side that emerged
our article. There was also a fovea buccalis observed slightly on the right side. while laughing

Department of Anatomy, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
Correspondence: Dr. Rengin Kosif, Department of Anatomy, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. Telephone 037425346563043, e-mail:
[email protected]
Received: November 09, 2017, Accepted: November 21, 2017, Published: November 27, 2017

This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://
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Int J Anat Var Vol 10 No 4 December 2017 99

the child has a 50-100% chance of inheriting the gene, based on how the
parents inherited theirs (6). When a person smiles, the shorter muscle on
the face upraises the facial skin. This situation creates a slight depression in
the skin, which refers to as dimple (7). Variations of the zygomaticus major
muscle lead cheek dimples to form. The mentalis muscle, which appears
around the jawbones, fails to close at the chin thereby leaving a gap. Hence,
the appearances of chin dimples or cleft chin deformity.
In this case, a gap congenitally occurs at the interception points of the m.
orbicularis oris, m. depressor anguli oris and m. depressor labii inferioris
muscles, and when the lower lip is pulled down, a dimple appears while she
is laughing. Two different dimples fovea buccalis and fovea inferior anguli
oris are seen same female person. There has been limited research on the
anatomy of dimples and there is no study showing the frequency of this
different kind dimple and multi-dimple according to genus.
REFERENCES
1. Omotoso GO, Adeniyi PA, Medubi LJ. Prevalence of Facial Dimples
Figure 3) Location of the fovea inferior anguli oris amongst South-western Nigerians: A Case Study of Ilorin, Kwara State of
Nigeria. Int J Biomed Health Sci. 2010;6:241-4.

DISCUSSION AND CONCLUSION 2. Argamaso RV. Facial dimple: Its formation by a simple technique. Plast
Reconstr Surg. 1971;48:40-3.
The fact is that dimples are essentially genetic imperfections that are derived
from shortened facial muscles. Dimples are caused by a deficiency in the 3. Saraf S, Pillutia R. Complication of dimple creation. Indian Dermatol.
subcutaneous connective tissue that develops in course of the embryonic Online J. 2010;1:42-3.
progress. A variation in the pattern of the facial muscle may also lead up 4. Pentzos Daponte A, Vienna A, Brant L, et al. Cheek dimples in Greek
dimples. Dimples frequently take place on both, a single dimple on one side children and adolescents. Int J Anthropology. 2004;9:289-95.
is a rare phenomenon (6).
5. Kosif R. Anatomical Skin Dimples. Innov J Med Health Sci. 2015;5:15-8.
The genetics of dimples is basically rather interesting. They are a dominant
trait, which signifies that it only takes one gene to inherit this defect. If 6. Jitesh S, Kumar S. Evaluation of Gelasin in South Indian Population. J
neither parent has dimples, their children shouldn’t have them either, unless Pharm Sci Res. 2016;8:828-31.
they experience a spontaneous mutation. If one parent has them, the child
has a 25-50% chance of inheriting the gene, since it implies that parent 7. Khallaf ANM, Hassan M. Check Dimple Creation - A New Technique:
inherited the gene from one or both parents. If both parents have dimples, Our Experience of 100 Cases. AAMJ. 2014;12:178-85.

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