Some gestures are universally understood. For example:

He nodded.

or

The audience burst in applause.

Because those gestures are universally understood, giving them description or explanation is redundant: you wouldn't say "he moved his head up and down, signifying assent".

On the other side of the spectrum, there are gestures that are culture-specific, and not likely to be understood by your audience. (Or they might be unique to some fantasy culture.) To use @DoubleU 's example,

With her index finger, she gently scraped the side of her cheek - a subtle way of saying 'ugly'.

Because your readers are unlikely to understand what the gesture means, you need to explain.

If a particular gesture is going to be used more than once throughout the narration, you can describe it once, give it a name, and use the name from then on:

Kneeling upright and with her back straight in formal mipa rari, she composed herself [...]Kuni leaned back on his pillow and stretched out his legs in a modified thakrido position, with one leg over the other, the way a man sat when he was with his mistress. (Ken Liu, The Grace of Kings, chapter 3)

(It doesn't particularly matter if mipa rari and thakrido are names of existing poses in a real culture, or a fantasy terms for something in a fantasy culture. What matters is that from then on, the author can use the terms as often as he likes, conveying both an image and a meaning.)

Alternatively, a gesture might be common, but have different meanings depending on context. @MatthewDave 's example of a cutting motion is an example of such a gesture. Here too you'd need to say what is meant by the gesture, unless your context makes it very clear. Or, you could have fun with it, having characters misunderstand each other's non-verbal communication:

As methods of human communication go, a wink is quite versatile. You can say a lot with a wink, For example, the new nun's wink said:
Where the hell have you been? Baby B has been born, we're ready to make the switch, and here's you in the wrong room with the Adversary, Destroyer of Kings, Angel of the Bottomless Pit, Great Beast that is called Dragon, Prince of This World, Father of Lies, Spawn of Satan, and Lord of Darkness, drinking tea. Do you realise I've nearly been shot?
And as far as she was concerned, Sister Mary's answering wink meant: Here's the Adversary, Destroyer of Kings, Angel of the Bottomless Pit, Great Beast that is called Dragon, Prince of This World, Father of Lies, Spawn of Satan and Lord of Darkness, and I can't talk now because there's this outsider here.
Whereas Sister Mary, on the other hand, had thought that the orderly's wink was more on the lines of:
Well done, Sister Mary - switched over the babies all by herself. Now indicate to me the superfluous child and I shall remove it and let you get on with your tea with his Royal Excellency the American Culture.
And therefore her own wink had meant:
There you go, dearie; that's Baby B, now take him away and leave me to chat to his Excellency. I've always wanted to ask him why they have those tall buildings with all the mirrors on them.
(Terry Pratchett and Neil Gaiman, Good Omens)

The most complicated are the gestures that are likely to be understood when seen, especially in context, but don't have a one-word description like "nod" or "shrug". Writing is a textual medium, not a visual one. As such, it is stronger in conveying some things, and weaker at others, compared to film, for example. With those, I think you have several options.

You can skip the particulars of the gesture entirely, and go straight to its meaning:

He made an obscene hand gesture

It doesn't particularly matter which hand gesture.

Or you could actually describe the particular movement. The trouble with that approach is that it takes longer than the actual movement, it is cumbersome. You would do it, I think, only when you want to linger on a particular moment.

I laid my hand on my heart, held it there for a moment, and then moved it over and touched my palm against his breast. (Juliet Marillier, Daughter of the Forest, chapter 15)

See also the question Describing body language? for more information.

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