Natural dimples are the result of skin being attached to the facial muscles that are beneath the skin, usually the cheeks, sometimes the chin. (Kirk Douglas had perhaps the most famous dimpled chin in the world.) When the muscle flexes, as when you smile, the skin is drawn down.
The surgery -- requests have almost tripled in the past few years -- creates strategically located dimples on the cheeks for an aesthetically pleasing appearance. It’s noninvasive, usually does not require general anesthesthesia and requires little down time for the patient.