The “cleft of Venus,” more commonly called “dimples of Venus” or simply back dimples, refers to the pair of small, symmetrical indentations visible on the lower back just above the buttocks. Their anatomical name is fossae lumbales laterales. They sit directly over the posterior superior iliac spine, the bony prominence where the pelvis and sacrum meet, and they get their poetic name from Venus, the Roman goddess of beauty. Despite the cultural fascination they attract, these dimples are a straightforward anatomical landmark with some surprisingly meaningful connections to spinal and pelvic structure.
Where Exactly Venus Dimples Sit
Each dimple marks the spot where skin and a thin layer of subcutaneous tissue are tethered to the underlying bone of the posterior superior iliac spine (PSIS). The PSIS is the uppermost rear point of the iliac crest, the broad wing-shaped bone you can feel at the top of your hip. Because there is very little fat or muscle padding between the skin and this bony landmark, the attachment creates a visible depression. In most people who have them, the two dimples appear roughly symmetrical, sitting a few centimeters apart on either side of the spine, at about the level of the second sacral vertebra.
This location is not random. The area where Venus dimples form is a major structural crossroads. The thick thoracolumbar fascia, a dense sheet of connective tissue that runs the length of the lower back, converges here. At the base of the lumbar spine, all layers of this fascia fuse into a composite that attaches firmly to the PSIS and the sacrotuberous ligament, a fibrous band connecting the sacrum to the pelvis.1PubMed Central. The thoracolumbar fascia: anatomy, function and clinical considerations Because several layers of fascia, ligament, and bone all anchor at the same spot, the skin above can dimple inward where it attaches to these deeper structures. People with thinner subcutaneous fat layers in this region tend to show the dimples more prominently.
How Venus Dimples Form During Development
Venus dimples are not scars, defects, or the result of exercise. They form during fetal development as part of normal skeletal and connective tissue growth. As the pelvis ossifies (converts from cartilage to bone) in the womb and during early childhood, the posterior superior iliac spine takes its final shape and the overlying ligaments and fascia anchor to it. The visible dimple appears wherever the skin’s attachment to the underlying PSIS is especially short and direct, with minimal intervening fat.
Whether someone develops visible Venus dimples depends largely on body composition and individual skeletal geometry. People with lower body fat in the lumbosacral region are more likely to show them, which is why the dimples sometimes appear or disappear with changes in weight. But skeletal shape matters too. The angle and prominence of the PSIS, the curvature of the sacrum, and the overall architecture of the pelvis all influence how shallow or deep the dimple appears. This is why two people at the same body-fat percentage can differ: one may have prominent dimples and the other may have barely visible ones.
Genetics plays a role in determining skeletal geometry and fat distribution, so Venus dimples do tend to run in families. However, no single gene has been identified as responsible for them. They are best understood as a surface expression of normal anatomical variation rather than a discrete inherited trait like eye color.
The Link to Pelvic Structure
Venus dimples are not just skin deep. A study examining their relationship to spinal and pelvic anatomy found that people with visible dimples of Venus had a measurably higher pelvic incidence angle compared to those without them. The pelvic incidence angle is a fixed measurement of how the sacrum sits relative to the hip joints; a higher angle generally means the pelvis is tilted more forward. The same study found that a one-unit increase in pelvic incidence angle more than doubled the likelihood that a person would have visible Venus dimples.2PubMed Central. Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint
The study also found that people with Venus dimples had more sagittally oriented facet joints in the lower spine. Facet joints are the small interlocking joints on the back of each vertebra that guide spinal movement. When these joints are angled more toward the front-to-back plane, the spine allows a different balance of flexion and rotation compared to joints angled more side-to-side. Alongside this, the sacral slope (how steeply the top of the sacrum tilts forward) and the coronal canal diameter (the side-to-side width of the spinal canal) were both greater in the Venus-dimple group.2PubMed Central. Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint
What does this mean practically? A higher pelvic incidence angle is associated with greater lumbar lordosis, the inward curve of the lower back. People with more pronounced lordosis often have a posture that makes the lower back curve look deeper and the buttocks more projected. This pelvic geometry also happens to make the PSIS more prominent relative to surrounding tissue, which is part of why the dimples become visible. So Venus dimples are not merely a cosmetic feature layered on top of the skeleton. They are a visible surface marker of a particular pelvic shape.
Venus Dimples vs. Sacral Dimples
One of the most common points of confusion is between Venus dimples and sacral dimples, and the distinction matters because only one of them occasionally raises a medical concern. Venus dimples sit over the PSIS, several centimeters above the gluteal cleft, on either side of the spine. Sacral dimples are small pits or depressions that appear lower, near or within the natal cleft (the crease between the buttocks), much closer to the coccyx. Sacral dimples are especially common in newborns and infants, where they are routinely checked during pediatric exams.
The reason sacral dimples get medical attention is that, in rare cases, a dimple in the sacral area can signal an underlying spinal anomaly called occult spinal dysraphism, a condition in which the spinal cord or its surrounding structures did not close completely during fetal development. However, the evidence consistently shows that simple sacral dimples, defined as small, midline, shallow depressions close to the anus with no other skin abnormalities, are not associated with spinal dysraphism and do not require imaging.3PubMed Central. Sacral dimple: clinical perspectives of lesions hidden beneath the skin As an isolated finding, simple sacral pits are not useful markers of underlying spinal problems.4PubMed. The value of ultrasonic examination of the lumbar spine in infants with specific reference to cutaneous markers of occult spinal dysraphism
The dimples that do warrant further evaluation are atypical ones: those that are unusually large, deep, located off the midline, or accompanied by other skin markers such as hair tufts, skin tags, or hemangiomas. In those cases, spinal ultrasound in newborns or MRI in older infants is recommended to check for tethered cord or other anomalies.3PubMed Central. Sacral dimple: clinical perspectives of lesions hidden beneath the skin Venus dimples, being located well above the sacral region and directly over normal bony landmarks, carry no such clinical implications. They are purely a feature of surface anatomy.
Are Venus Dimples More Common in Women?
The popular perception is that Venus dimples are primarily a female feature, and the name itself reinforces this idea. In reality, both men and women can have them, and the anatomical structures involved are identical regardless of sex. What differs is visibility, and that comes down to body composition and pelvic shape.
Women, on average, have wider pelvic structures and a different distribution of subcutaneous fat compared to men. The female pelvis tends to have more lateral flare and a broader sacrum, which can make the PSIS landmarks more prominent beneath the skin. Hormonal differences in fat storage also play a role: women tend to carry more subcutaneous fat in the gluteal and hip region overall, but the fat layer directly over the PSIS can remain thin enough for the dimples to show through, especially in leaner individuals. Men with low body fat in the lower back can show equally prominent dimples, but because male fat distribution patterns more often fill in the lumbosacral area, the dimples may be obscured.
The cultural dimension reinforces the perception gap. Venus dimples are more commonly photographed and discussed in the context of women’s bodies, so many people simply do not realize men have them too. In clinical and anatomical literature, the dimples are described as a normal variant in all adults, with no evidence that one sex is genetically more predisposed to forming them.
What the Thoracolumbar Fascia Has to Do With It
The thoracolumbar fascia (TLF) is a large, diamond-shaped sheet of connective tissue that covers the muscles of the lower back. It is far more structurally important than it might sound. The TLF transmits forces between the upper body and the pelvis, stabilizes the lumbar spine during lifting and twisting, and serves as an attachment point for muscles including the latissimus dorsi, the gluteus maximus, and the deep core stabilizers.
At its lowest point, the TLF converges into a thick composite where all its layers fuse together before anchoring to the PSIS and the sacrotuberous ligament.1PubMed Central. The thoracolumbar fascia: anatomy, function and clinical considerations This fusion point is exactly where Venus dimples appear. The fascia essentially pulls the skin inward at its attachment to the bone, creating the visible depression. This is why the dimples are bilateral and symmetrical: the TLF attaches to both the left and right PSIS in the same way.
The TLF’s role in force transmission also explains why Venus dimples sometimes become more visible during certain movements. When you extend your back, engage your glutes, or twist at the torso, the fascia tightens and pulls more firmly against the PSIS. This can deepen the dimples momentarily. It is also why strengthening the posterior chain through exercises like deadlifts or hip thrusts sometimes makes the dimples more prominent: as the surrounding muscles develop and body fat decreases, the fascial tethering point becomes more conspicuous.
Can You Create or Enhance Venus Dimples?
Given their association with fitness and attractiveness, there is no shortage of online advice claiming that specific exercises can create Venus dimples. The reality is more nuanced. If your skeletal anatomy includes a prominent PSIS and the right fascial attachment geometry, reducing body fat in the lower back region through general fitness will make existing dimples more visible. Targeted exercises for the lower back and glutes can enhance the surrounding musculature, which frames the dimples more clearly. But no exercise can create the underlying bony prominence or fascial attachment that produces the dimple. If your anatomy does not predispose you to visible dimples, no amount of back extensions will change that.
Cosmetic surgery has stepped into this gap. Some plastic surgeons offer “Venus dimple creation” using liposuction to thin the fat layer over the PSIS, sometimes combined with sutures that anchor the skin to deeper tissue to mimic the natural tethering effect. These procedures are relatively niche and carry the usual risks of any cosmetic surgery. The results can look convincing when the underlying skeletal anatomy cooperates, but they tend to be less natural-looking when performed on individuals whose PSIS is not prominent.
Temporary dimple illusions have also become a trend in body makeup and photography, where contouring products or strategic lighting create the appearance of dimples for photoshoots. This highlights how much of what people perceive as “dimples” in images may be a product of posture, lighting, and muscle engagement rather than a permanent anatomical feature.
Venus Dimples as a Clinical Landmark
Beyond aesthetics, the dimples of Venus serve a practical role in clinical settings. Because they mark the exact location of the PSIS, they are routinely used as a surface landmark in physical examination and medical procedures. When a clinician needs to locate the sacroiliac joint, administer a sacroiliac injection, or assess pelvic alignment, the Venus dimples (or the PSIS underneath them) are the starting reference point.
In physical therapy and rehabilitation, asymmetry of the dimples can signal pelvic misalignment. If one dimple sits noticeably higher than the other, it may suggest a leg-length discrepancy, sacroiliac joint dysfunction, or muscular imbalance around the pelvis. This is not a diagnosis on its own, but it gives the clinician a quick visual cue to investigate further. The finding that Venus dimples correlate with a higher pelvic incidence angle also has implications for understanding individual spinal biomechanics. A person presenting with lower back pain and visible Venus dimples may have a pelvic geometry that predisposes them to specific patterns of lumbar stress, particularly at the facet joints.2PubMed Central. Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint
None of this means Venus dimples cause back pain or predict spinal disease. They are a normal variant. But like many surface landmarks, they carry information about what lies underneath, and that information is sometimes clinically useful in the right context.
Sacral Dimples in Newborns and When Parents Should Pay Attention
Because Venus dimples and sacral dimples are so frequently conflated, it is worth addressing the pediatric context directly. New parents sometimes notice a small pit or depression near the base of their baby’s spine and wonder whether it is a Venus dimple or something that needs medical evaluation. In newborns and infants, the relevant feature is almost always a sacral dimple, not a Venus dimple. Venus dimples typically do not become visually prominent until later in childhood or adolescence, when the pelvis matures and body composition changes.
A study reviewing imaging in over 300 infants diagnosed with sacral dimples found that ultrasound was the standard first-line evaluation tool for those examined within six months of birth.5PubMed Central. Outcome of ultrasonographic imaging in infants with sacral dimple The key features clinicians look for include the position of the conus medullaris (the tapering end of the spinal cord) and the thickness of the filum terminale (the thread-like strand extending below the cord). These are checked to rule out tethered spinal cord, a condition where the cord is abnormally anchored and can stretch as the child grows.
For parents, the reassuring takeaway is straightforward. A simple, shallow, midline pit near the bottom of the spine with no other skin changes is overwhelmingly benign. If a dimple is deep, off to one side, larger than expected, or accompanied by a tuft of hair, a skin discoloration, or any other unusual marking, it is worth bringing up with a pediatrician. The vast majority of sacral dimples never lead to any intervention beyond a reassuring ultrasound.