This is a weird term in surgery. A dog ear is when you get protrusion of the skin that sticks out, hence the term dog ear.
Why does a dog ear happen? It can happen any time we are tightening the skin. The junction of where you stop tightening skin to the untightened skin has a transition. When you are pregnant and stretch out your belly, you also stretch out your love handle skin and your back skin. We don’t cut out the skin 360 degrees though for a tummy tuck. We tend to stop around the hip area. We try to blend that transition area from where we are cutting out skin to where we don’t so it lies flat, but sometimes it doesn’t settle like we want it to. Dog ears are most often seen in tummy tucks or breast reductions and breast lifts– big skin tightening procedures. But you can see it in small surgeries like when you remove a mole.
How do you fix it?
- If the issue is fat, you can do liposuction to help flatten it out.
- If the issues is skin, you can cut out skin, which makes the scar longer.
Why don’t we just fix it during surgery?
We try. I don’t leave the operating room with someone who has a big dog ear. I want it to be flat. But as we try to help the transition from where we cut out skin to where we don’t, there is always a little transition. We know tissue forces stretch and contract and settle after surgery to smooth the area out. We take advantage of that. The million dollar question – is a longer scar needed?
We always want to minimize scar. When we do a surgery, your scar is your scar for life. We want it to be short. We want it to be flat. We want it to be pretty.
Longer scars can be problematic if you don’t scar well. How do you heal? Do you pigment? does your scar elevate? Do you keloid? Until you heal and are months out, we don’t know.
Also shorter scars are better in clothing and when out of clothing. When you are doing a surgery like a tummy tuck, the scar is long. Keeping it from wrapping around your hips helps make it easier to hide under bathing suits and underwear.
Dog ear revisions are usually an in office procedure. They can be done under local anesthesia in the office, so they aren’t a big surgery. But we wait to do them, not to torture you, but skin stretches and settles over time after surgery. I take photos of my patients so I can show them the changes. The more your body settles and the skin elasticity contracts, the smaller and smoother the transition. If it persists, when you are 9 months to a year out, we can see what to do. How did you scar? Is it fat? Is it skin? A dog ear excision will extend the scar, and I usually draw it out on my patients so they can see how much longer it will get. Is the amount of improvement worth it for the lengthening of the scar? It’s your decision to make. I don’t do them often, but if it is bothering you, come in and we can review the cause and treatment.