If you’re thinking about getting cheek piercings (a.k.a. dimple piercings), there are a few things you should know before you take the plunge. Cheek piercings can be risky if not performed properly by a professional piercer, so this is one type of piercing you don’t want to rush into getting. You’ll need to carefully research piercers and make sure you pick one who’s experienced to perform your cheek piercings. It’s also important to brush up on proper dimple piercing aftercare and to learn how to spot and address problems quickly to ensure your new cheek piercings heal well and enhance your appearance for years to come. It may sound like a lot of work for a mere pair of piercings, but fortunately all the cheek piercing information you need is right here!
Important Cheek Piercing Info
Cheek Piercing Risks – As with any piercing, professionally-placed dimple piercings have the highest success rate. This is not a piercing you should try to perform on yourself or let a friend do for you. Cheek piercings are a delicate business and should only be performed by experienced professional piercers. They have to be very carefully placed to avoid the parotid ducts (saliva glands in your cheeks) while being positioned to either enhance existing dimples or give you the appearance of having dimples.
If either of your parotid ducts were to be damaged during the cheek piercing process, the damage could never be fully repaired. It would leave you susceptible to infection and could cause saliva to constantly stream down the outside of your cheek. If you were to experience that issue, you’d have to see a doctor to have the tissue cauterized–a process that could leave a nasty scar and that wouldn’t fully repair your damaged parotid duct. Your doctor would also likely prescribe you an antibiotic to prevent infection. Infections in the head are some of the most dangerous because of the close proximity to your brain. Do everything in your power to avoid developing an infection in a new cheek piercing; choose an experienced piercer, perform proper cheek piercing aftercare, and address any issues that arise quickly.
Choosing a Piercer – When choosing a piercer, worry less about the cost of the piercings and more about the piercer’s success rate. You should look for a few top-rated piercing shops in your area and/or get the names of highly-recommended piercers near you from friends or online sources like our forum. Look at each piercer’s portfolio, either online or in person. Ideally, you should look for cheek piercing pictures that show people both immediately after being pierced and once they’re fully healed. Talk to each piercer about their experiences doing dimple piercings. Ask how they check to make sure the placement they’re suggesting won’t damage your parotid ducts. When you find a piercer who can both show you that they’ve successfully performed cheek piercings and discuss the process with you in an educated manner, you’ve found a winner.
Selecting Cheek Piercing Jewelry – Cheek piercing studs are essentially just extra-long labret studs. Expect your starter dimple piercing jewelry to be longer than you’d like; it’ll need to be long enough to allow room for your cheeks to swell post-piercing (i.e. anywhere from 5/8″ – 1-1/2″ long, depending on the thickness of your cheeks). Studs in that size range may only be available in stainless steel or titanium, so you’ll need to chew carefully during the healing process to avoid chomping down on one of your dimple piercing barbells and cracking a tooth.
Once you’re fully healed, which typically takes 8-12 weeks but can take up to 6+ months for some, you’ll be able to swap out your starter jewelry for more closely-fitting cheek studs. At that time, you should see if your piercer can outfit you with BioPlast labret studs, which are made of a softer, more flexible material than titanium or stainless steel cheek piercing jewelry. BioPlast is hypoallergenic, so it’s great for people with sensitive skin, and it’s less likely than metal jewelry to cause oral health issues like gum recession or damage to your teeth.
Cheek Piercing Aftercare
Your piercer should give you dimple piercing aftercare instructions to take home with you, but you can supplement that information with our cheek piercing care tips below. If you follow all of our suggested dos and don’ts, your cheek piercings will have a better chance of healing properly.
Immediately after getting cheek piercings, you should do the following:
- Stay well. If you get lots of good quality sleep, drink plenty of water to stay hydrated, eat nutritiously, and practice good hygiene overall, you’ll bolster your immune system so it can focus all of its energy on healing your new cheek piercings.
If you were to get run down and catch a cold, the bug would distract your immune system and could put you at higher risk for developing a cheek piercing infection or other piercing issue.
- Avoid smoking. Nicotine and cigarette smoke are double trouble for healing cheek piercings. The nicotine will slow down your body’s ability to heal, and the smoke can dry out the tissue around your new cheek piercings as it passes over them. Ideally, you should try to quit smoking before getting your cheeks pierced. If you can’t give it up entirely, at least switch to an e-cigarette, nicotine patch, or nicotine gum during the dimple piercing healing process. That way you’ll avoid the drying effects of smoke, if not the systemic impact of nicotine.
- Keep your dimple piercings clean. Since cheek piercings are external piercings with an oral side, you’ll have to perform oral and external piercing aftercare. Swish with sea salt solution (1/4 teaspoon sea salt dissolved in 1 cup of warm, sterile water) for 5 minutes twice a day, and rinse your mouth with sea salt mouthwash for at least 30 seconds after eating to dislodge any food debris trapped in your fistulas (piercing holes) or around your cheek piercing jewelry.
You’ll also need to apply a saline rinse like Recovery Piercing Aftercare Spray to the external side of your piercings 3-6 times per day. Ideally, two of your daily applications should be full sea salt solution soaks, where you apply a series of saline-saturated cotton balls to the outside of your cheek piercings for a total of 5 minutes per session. You can use either store-bought saline wash or homemade sea salt solution for the full soaks, but saline spray tends to be much easier to use for quick rinses in between, especially when you’re on the go.
It isn’t necessary to use an antiseptic mouthwash to clean your healing cheek piercings; in fact, it’s best to just use alcohol-free sea salt mouthwash and external piercing spray on them. Sea salt is scientifically proven to aid in the healing process while being gentler on healing piercings than anything else. That said, if you really want to use an antibacterial solution or feel that you need to because you’re experiencing signs of infection or other piercing problems, try a product like X-Pressions Extra Strength Antiseptic Piercing Aftercare Solution or swabs.
Alternatively, you can dilute hydrogen peroxide per the bottle’s instructions for use as an antiseptic mouthwash, but be forewarned that the taste isn’t super pleasant. Whichever type of antiseptic mouthwash you try, just use it once a day initially. If you’re having a problem and don’t see signs of improvement after a couple days, increase to swishing with an antibacterial rinse or swiping the tissue around the inside of your cheek piercings with an antiseptic swab twice a day.If the tissue around the outside of your cheek piercings gets dry, you can add 2-3 drops of tea tree oil to 1 cup of homemade sea salt solution to moisturize your skin during your twice-a-day external soaks. (Save money and get high quality ingredients for homemade sea salt solutions by purchasing our Recovery Sea Salt & Tea Tree Oil Combo Pack.) Tea tree oil has infection-fighting antiseptic properties in addition to being a natural moisturizer, so it’s a great way to enhance sea salt solution. If you use store-bought saline spray instead of making homemade sea salt solution, just put a single drop of tea tree oil on a saline wash-soaked cotton ball before applying it to your piercing. Never add tea tree oil to your sea salt mouthwash; it’s intended for external use only.
- Avoid trauma. There are a number of things that can traumatize healing cheek piercings, like brushing your teeth too vigorously and playing with your dimple piercing jewelry.
Trauma can make you more susceptible to infection, developing excess scar tissue, migration/rejection, and more, so it’s important to protect your cheek piercings. Keep your hands off your jewelry as much as possible! You could transfer bacteria from your hands to your jewelry and/or push bacteria into your healing fistulas. Any time you do have to touch your jewelry, wash your hands thoroughly first or put on a pair of gloves. If you develop crusties (dried lymph) around your cheek piercing jewelry, never twist, turn or slide your studs to break them up. Instead, saturate crusties with saline wash to soften them, and then gently wipe them away with a clean tissue or cotton swab. When brushing your teeth, eating and talking, be cognizant of your healing cheek piercings. If any particular activity seems to make them throb more, avoid it or learn to work around your cheek piercing jewelry. For instance, if you have a tendency to bang into your cheek studs when brushing your teeth, make sure you slow down when working on the sides of your mouth. You may also want to get a softer-bristled toothbrush and/or one that’s made out of a more flexible type of plastic.
There are also a handful of things you absolutely should not do after getting cheek piercings:
- Do NOT take aspirin, drink alcohol, or consume excessive amounts of caffeine. These things can thin your blood, which can make it harder for your piercings to clot properly if they bleed periodically during the early days of the healing process. Once occasional bleeding has stopped, you should still keep your alcohol consumption as light as possible to protect your immune system and allow it to focus its full attention on your healing cheek piercings.
Do NOT use mouthwash containing alcohol. Alcohol can dry out healing piercings and delay the healing process, so it’s best not to swish your mouth with anything but alcohol free mouthwash during the first 12 weeks after getting pierced, if not longer.
- Do NOT do anything that could unnecessarily introduce bacteria into your healing piercings. There are a number of things that could put you at higher risk for developing an infection in your healing cheek piercings, like wet kissing, engaging in oral sex, chewing on foreign objects, eating or drinking after someone else, playing with your jewelry, and submerging your piercings in communal water (e.g. swimming pools) or even your own bath water. You absolutely must avoid these things during the cheek piercing healing process to minimize your chances of developing an infection.
- Do NOT apply creams, oils, balms, or ointments to your healing dimple piercings. Everything from hand cream to triple antibiotic ointment should be off limits during the cheek piercing healing process, because such things can clog your fistulas, trapping in bacteria and potentially leading to infection. If the skin around the external side of your cheek piercings gets dry, add tea tree oil to your sea salt solution rinses to re-moisturize your skin as described in the “Keep your dimple piercings clean” bullet above. Drinking more water will also help re-hydrate your skin.
- Do NOT change your jewelry prematurely. Long starter cheek piercing jewelry can be annoying and may not look as attractive as close-fitting studs, but it’s important to leave it in until all swelling has subsided. You may feel like you’re safe as early as a week after getting pierced, but swelling can recur at any time during the cheek piercing healing process, usually without warning. You might get a microscopic bit of food debris or dirt trapped in one of your fistulas, bang them or otherwise irritate them a few weeks into the healing process, and your cheeks could immediately swell in response to the irritant. For that reason, it’s important to keep your extra-long starter cheek jewelry in for at least 6-8 weeks after getting pierced, and preferably for the full 8-12 week healing process. After that, if you haven’t had any cheek piercing problems, there’s no reason you can’t ask your piercer to swap out your starter jewelry for closer-fitting labret studs–preferably ones made out of BioPlast, which will be gentler on your mouth and less likely to trigger oral health issues.
Identifying & Addressing Cheek Piercing Problems
There are a handful of different issues that may present with cheek piercings. The sections below provide details about what symptoms you should look out for and what to do if you experience any of these cheek piercing problems.
Lymph Excretion
It’s perfectly normal for any healing piercing to excrete lymph, which is a clear fluid that tends to dry to a whitish crust that most people refer to simply as “crusties”. (See sample photo of lymph around a healing piercing to the left.) Lymph alone shouldn’t concern you. However, if you notice that the discharge coming from your cheek piercings has turned yellow or gotten thicker and more pus-like, you may be developing a cheek piercing infection that will require enhanced aftercare and/or an antibiotic to address. As long as the discharge stays clear-to-white in color, though, no special treatment is required. You can just soak the crusties with piercing aftercare spray to soften them if they’re bothering you, and then gently wipe them away with a clean tissue or cotton swab. Lymph excreted inside your mouth will stay wet rather than drying into crusties; you can swish it away easily using an alcohol free mouthwash.
Allergic Reaction to Jewelry Materials
Some people have such sensitive skin that they can’t tolerate stainless steel jewelry or cheek piercing jewelry made from other metals. Those with sensitive skin should ask for titanium or BioPlast jewelry at the time their cheeks are pierced. If you didn’t know how sensitive your skin would be to your starter jewelry, that’s okay; you can go back and have your piercer replace it with a more hypoallergenic alternative if you begin to experience signs of an allergic reaction.
Metal allergies tend to present as itchy, red skin around piercing sites. If you believe you’re having an allergic reaction to your cheek piercing jewelry, make an appointment with your piercer ASAP. In the meantime, you can take an antihistamine drug like Benadryl to soothe your irritated skin and stop the itching. It may make you sleepy, though, so get someone else to drive you to your jewelry change appointment, if needed.
Swollen Cheeks
Swelling is a common response to new piercings of all types, including cheek piercings. Your piercer should outfit you with extra-long starter cheek piercing jewelry to prevent the jewelry from pressing into your cheeks if they swell, as they likely will. If you find that you’re having excessive swelling that’s causing your jewelry to press into your cheeks in the manner shown to the left, take a non-steroidal anti-inflammatory like acetaminophen (Tylenol) or Ibuprofen (Advil), if you can tolerate it. (Note that Ibuprofen may cause additional bruising, so acetaminophen is preferable.) You could also apply a cool compress to your cheeks to try to reduce the swelling, using a clean washcloth soaked in cold water or a gel ice pack wrapped in a clean, thin towel, like a paper towel. If you can’t get the swelling down quickly or sufficiently enough to remove the pressure your jewelry is putting on your healing fistulas, then visit your piercer ASAP. S/he will replace your cheek piercing jewelry with longer studs to prevent necrosis (tissue death), infection (which often follows necrosis), excessive bruising, bleeding and hypergranulation issues that can arise from prolonged pressure on a healing piercing.
Bruising, Hematomas & Hemorrhaging
Some people bruise more easily than others. If you develop bruises around your new cheek piercings, time should heal them. Just avoid blood thinners like aspirin as well as non-steroidal anti-inflammatory drugs like Ibuprofen (Advil), because both things could make your bruising worse. If you have bruising and need to take an anti-inflammatory because of swelling, stick with acetaminophen-based drugs like Tylenol and generic alternatives.
Hematomas are the only type of bruising that can be concerning. A hematoma is a collection of clotted blood outside of the blood vessels that causes inflammation and swelling, giving the bruised tissue a raised, three-dimensional appearance (see example below). Hematomas occur when a vein, artery, capillary, or blood vessel wall is damaged during the piercing process, causing blood to leak into tissue where it doesn’t belong. If the bleeding doesn’t cause swelling, it’s just a regular bruise like the one shown to the right, known medically as a contusion or ecchymosis; if it does give the area a raised appearance (with or without visible coloration), then it’s more likely a hematoma caused by the piercing needle.
The body can usually heal damaged blood vessels by clotting and forming fibrin patches. However, if you have extensive damage to the vessels in your cheeks, 
bleeding may continue–particularly if you’ve been thinning your blood by taking aspirin or drinking alcohol, or if your jewelry is too tight and putting pressure on the damaged blood vessel. If you experience excessive bleeding, known as hemorrhaging, or you develop a large hematoma that concerns you, see if your piercer can help by inserting longer dimple piercing jewelry. If that doesn’t solve the problem and your bleeding continues or your hematoma gets even larger, you may need to see your doctor for help. S/he may give you something to help your blood clot properly if you’re still hemorrhaging or tell you it’s just a matter of time before your body heals fully if you have a hematoma.
Cool compresses and acetaminophen can help reduce swelling and soothe your inflamed cheek(s) while you’re waiting for bruising or a hematoma to subside. If you apply washcloths soaked with cold water to your cheeks, just make sure you use a fresh one each time. Gel ice packs are also helpful, because they don’t get quite as cold as actual ice. If you use one, though, you should wrap it with a thin, clean cloth; that way the ice pack isn’t directly against your skin, but the cold can still penetrate the cloth.
Infected Cheek Piercings
Despite your best efforts to care for your new cheek piercings, there’s always a chance you’ll develop an infection in one or both. The signs to watch out for are skin that’s hot to the touch, red streaks radiating from your piercing(s), discharge of thick, yellowish pus, swelling, and occasionally fever. If you begin to experience any of these symptoms, ramp up your piercing aftercare regime. 
Start doing 3 full 5-minute-long sea salt solution soaks/rinses per day, mist the outside of your piercings and swish your mouth briefly a few times a day in between full soaks (especially after eating), and consider adding an antiseptic mouthwash to your regime. Add tea tree oil to your external soaking solution to take advantage of its natural antiseptic properties, and use a product like Tattoo Goo’s X-Pressions Antiseptic Piercing Rinse to clean the inside of your mouth more thoroughly once or twice a day. If you don’t see improvements within a couple days of ramping up your cheek piercing aftercare regime or if your symptoms of infection get worse at any point, contact your doctor right away. S/he will be able to prescribe an antibiotic, if one is needed.
Don’t fret if your doctor tells you it’s best to remove your cheek piercing jewelry. If you contract an infection, it’s actually better to leave your jewelry in to avoid developing an abscess. Just take your antibiotic as instructed and keep up with your enhanced cheek piercing aftercare regime, and you should start seeing signs of improvement within a couple days. If you do decide to remove your cheek piercing jewelry, make sure you continue cleaning the inside and outside of the fistulas 3-6 times per day until they’re fully closed to avoid developing an abscess.
Cheek Piercing Scars
There are 3 types of scars that can develop around cheek piercings or over top of the spots where retired cheek piercings once were: keloid scars, hypertrophic scars and atrophic scars.
Keloids are fairly uncommon; their formation tends to be a genetic issue that affects a fairly small percentage of the population. If you know you’re prone to keloids or that they run in your family, avoid all piercings–especially facial piercings that could leave you with highly-visible, ugly scars. If you’ve gotten piercings before without issue, then it’s unlikely you’ll suddenly start developing keloids when you get your cheeks pierced. 
(Most people who think they’ve developed a keloid are actually suffering from hypergranulation issues.) If you develop a scar at all, you’re much more likely to develop a hypertrophic piercing scar than a keloid. Hypertrophic scars tend to be flesh-tone scars with slightly textured/bumpy tops that form immediately around a piercing site rather than growing out-of-control beyond a piercing site the way reddish-brown, taught, lumpy keloid scars are prone to do.
If you retire your cheek piercings at some point, you may also develop an atrophic scar at one or both piercing sites. Atrophic scars are recessed, skin-tone scars with slightly-textured surfaces that form when new skin cells fall short of completely filling closed piercings. They tend to be minimally noticeable compared to the other two types of scars.
Keloids typically require medical intervention to address. They can be lasered off, surgically removed, frozen off, or treated by a physician in other ways. Silicone scar therapy gel may be used in combination with one of the other treatment methods, and it’s one of the best, least-invasive treatments for hypertrophic and atrophic scars. Just massage the gel into your scar twice a day for as many weeks or months as it takes to diminish the scar’s appearance significantly. Alternatively, if you’d prefer a more natural treatment option, you can massage jojoba oil into your scars twice a day to minimize their appearance. Just don’t start a scar treatment until your cheek piercings are fully healed; the gel or oil you use could clog your fistulas, trapping in bacteria and potentially leading to a cheek piercing infection.
Hypergranulation Issues
Hypergranulation is the body’s response to continuous pressure and/or excessive moisture at a piercing site. Since cheek piercings penetrate your oral cavity, there’s a chance saliva alone will trigger hypergranulation. Combine that moisture issue with jewelry that’s too tight, and you’re a perfect candidate for developing a hypergranulation issue.
Hypergranulation typically presents as either a single red bump that’s so taut it appears fluid-filled or as angry red, puffy skin around a piercing site that may have an appearance similar to keloid scars. (Most people who develop hypergranulation issues think they have a keloid scar when they don’t, so pay close attention to your symptoms before jumping to any conclusions about the type of piercing issue you’re experiencing.) If you develop a hypergranulation issue, visit your piercer as soon as possible and ask him or her to replace your jewelry with longer cheek piercing studs. Once the pressure is off your piercings, you should ramp up your cheek piercing aftercare regime the same way as we recommend in our Infected Cheek Piercings section. With time, proper dimple piercing aftercare and less pressure on the wounds, your hypergranulation issues should subside.
Additional Cheek Piercing Information
If you want to learn more about cheek piercings, how to care for them, what types of jewelry work best in cheek piercings, and so on, check out these other related articles from our Piercing Information Center:
- Choosing a Piercer
- Cheek Piercing FAQs
- Oral Piercing Aftercare
- Body Piercing Scars
- Piercing Retainers
- Modifying Your Labret Length & Balls
You can also visit our gallery to see cheek piercing pictures or read about other people’s dimple piercing experiences in our forum. If you’d like to share photos of your own mods, post comments about other people’s pictures, or submit questions to the forum, you’ll need to sign up for a Painful Pleasures account.
References
Hematoma Article on Medicinenet.com
