Cheek Piercing

Pixie AciaCheek or ‘dimple’ piercings are an unusual piercing that TV Shows such as LA Ink have popularised. Many people believe that they are just like a normal facial piercing, such as a lip piercing, but they tend to be more complicated than that due to their long and often difficult healing times and risk factors.

There are a lot of different bodily structures in the area that this piercing passes by which can interact with the piercing and can cause some unique problems to occur. This guide attempts to explain the risks associated with cheek piercings and how to limit them.


TL;DR –Too much information? For a shorter version try our quick reference guide here!

Cheek Piercing Risks

Tooth damage: Due to the way these piercings sit between the jaws, tooth damage is a big concern as it is very easy to bite down on the back plate, chipping teeth due to the bars needing to be so long to accommodate the swelling. Another risk to the teeth from the jewellery is the way it can rub directly against the teeth themselves causing gum and teeth erosion – permanent damage that cannot be fixed by a dentist.

How to help: The best way to help to stop this is to get pierced with PTFE bars which are lighter and more flexible so shouldn’t damage your teeth in the same way. Having a labret rather than a barbell will also help as it means there will be  flat plate inside your mouth rather than a ball. Not playing around or chewing on your jewellery helps as well!


Long healing time: Cheek piercings are notorious  for taking a really long time to heal due to the high amount of movement in the area. They can take between 1 and 3 years to fully heal to the point where they no longer need to be nursed. As with all piercings this doesn’t mean that they will hurt the entire time (as they heal from the outside inwards), but it does mean you may find yourself with occasional discharge, swelling, or general upset. A longer healing time, as well as meaning a lot of work on your part, often means a higher risk of complications such as bumps, scarring or infections. It is worth mentioning also that, as this piercing is on your face, it is not easy to hide it from others when it is flaring up and may attract negative attention.

How to help: There are many ways to help give yourself a good chance at healing quickly, though you cannot force your body to heal faster than it can so patience with this piercing is a must! Some suggestions for ‘happy’ healing are:

  1. A piercer who is clued up on anatomy and understands the piercing will give you the best head start by choosing good jewellery and placement. PTFE bars are strongly recommended.
  2. Gentle non-invasive cleaning (as explained here) will help to maintain and encourage healing.
  3. Regular downsizing of jewellery will help the piercing not get irritated or damaged from knocks and movement.
  4. Not fiddling with the jewellery will lessen the chance of infection and prevent damage.
  5. Taking a vitamin C and zinc supplement or multivitamin can help to support your body while it heals.

Swelling: The swelling that accompanies cheek piercing is quite bad, similar to that of tongue piercings. Unlike other piercings that exhibit a lot of swelling, however, cheek piercings can remain swollen for a couple of weeks and can continue to swell on and off throughout the first few months of healing time. Swelling increases the risk of jewellery embedding in the face and limits the healing process (which is said to not be able to start before the swelling subsides) which may be why this piercing takes so long to heal.

How to help:  Treat the swelling as soon as it appears and continue to do so for at least a day after it is no longer visible. Cooling is the most effective method of reducing swelling so using ice packs, eating softened shaved ice or ice lollies (hardened ice can knock or upset the piercing), drinking icy drinks and using anti-inflammatory painkillers (as long as you are ok to) are good ways to do this. The most effective treatment is the use of icy drinks as the cold liquid ‘carries away’ heat – cooling the area more effectively. Anti-inflammatory herbal remedies can also really help; Chamomile tea can be very effective as can taking regular Arnica supplements.

Avoid triggers which could cause swelling. This includes:

  1. Not playing with the jewellery,
  2. Taking care when moving around the piercing (not to knock it)
  3. Treating the piercing with saline soaks when it looks upset or has crusties (avoids irritation)
  4. Not taking part in very physical sports or activities for a while (again avoids knocking the piercing)
  5. Being careful to rinse out your mouth after eating
  6. Avoiding very spicy foods for the first few weeks (avoids irritation)
  7. Avoiding chemical and antibacterial products on the piercing (including make up)

Permanent Scarring: While all piercings tend to leave a mark in one form or another (even if it’s very unnoticeable) the scarring from cheek piercings is considered more severe. They are likely to leave permanent, deep, dimples on your face which can range in size from pimple-like to the size of a penny. This effect of the cheek piercing on the facial tissue is so well known that there are some people who choose to use them as a cheap form of dimpling surgery. The longer healing times and type of tissue in the area also makes the piercing more prone to more obvious ‘regular’ scarring too such as deep red marks or bumpy white tissue.

How to help: Its important to consider, before getting pierced, how scarring on your face may effect you as some people can find it very upsetting and difficult to live with. Also, if you get pierced and aren’t sure you like yourself with dimples, you should take the piercings out as soon as possible to reduce the likelyhood of scar tissue forming. Using oils such as rosehip, vitamin e, hazelnut or helichrysum (Among others) and massaging the area after removal can help to break down any scar tissue that has formed and reduce its visibility somewhat.


Cysts: Unfortunately cheek piercings are quite prone to trouble with cysts. Pressure from the jewellery on the unique skin and membrane in the cheek area, the piercing process itself or blocked saliva ducts can cause cysts which have a tendency to keep reoccurring. They usually start with a hard marble sized lump underneath the skin and progress into raised, flaky, lumps on the face. These lumps are sacks of fluid which frequently pop and can easily become infected. These cysts can also leave additional scarring such as large red or purple marks. (More information on cysts can be found here.)

How to help: There area few things you can to do help avoid cysts:

  1. First make sure the jewellery your piercer is about to use is long enough to limit the amount of pressure placed on the cheek, ideally they need to be around 30mm long to start with although this all depends on your anatomy. This is because cheek piercings swell a lot and so can cause the jewellery to become tight if there isn’t enough room.
  2. Next make sure that your jewellery is downsized slowly as swelling can reoccur in cheek piercings even after the first month.
  3. Finally check that your piercer isn’t planning on placing them past the first molar – this increases your risk of the piercing interrupting a saliva duct because it is closer one of the major glands known as the parotid gland which supplies a lot of your saliva – meaning there is more likely to be more ducts in that area.

Leaking: Minor salivary ducts run very close to where this piercing is placed and can often also end up being pierced through or blocked. This placement can cause your body to redirect the flow of saliva out the piercing hole instead of into your mouth, meaning your piercing will leak liquid. If your body cannot heal this, the flow of saliva will make its own fistula (tunnel) into the piercing meaning it will leak constantly and some people have even found that the leaking continues even after the piercing is removed and surgery or cauterisation of the tissue is required to make it stop.

How to help: Don’t panic too much as this isn’t a particularly common side-effect of cheek piercing but since it has been known to happen we think it deserves a mention. The best way to help avoid this problem is to not allow yourself to be pierced beyond the first molar (As suggested above). However if you do notice the problem then its suggested the jewellery be removed as soon as possible to avoid it becoming ‘permanent.’


Alternatives

It may be important to note that there are a lot of piercers who will not preform this piercing. This could be because they read Elayne Angel’s book The Piercing Bible which recommends not performing this piercing due to the problems we have listed here. Some piercers have decided, therefore, that they do not want to risk potentially causing someone so much damage.  Many piercers also don’t think their general client base is suited to such a complicated piercing and are unlikely to take care of it properly or for so long, possibly tarnishing the piercer’s reputation.

Skin Diver Cheek Piercing

There are alternatives to the cheek piercing and these come in the form of little implants or ‘anchors’ known as skin divers and microdermals which sit in a little pocket of skin rather than going all the way through, so do not go deep enough to cause trouble inside the mouth.

However it is worth mentioning that they can be prone to rejection (‘coming out’) due to movement in the area and that there is some debate over whether skin divers are ‘viable’ piercings at all (with a lot of professionals only using microdermals now). These anchor piercings still leave scars on removal too but they tend to be much smaller and less deep with little chance of  dimpling.

An example of Skin Diver cheek placement by Denise Wiltshire from Transfix Piercing.