Should I be interviewing prospective surgeons about techniques they will use to avoid dog ear scarring?
How Do Doctors Minimize Dog Ears During a Tummy Tuck?
Doctor Answers (20)
Dog Ears after Tummy Tuck How to Minimize Excess Skin at Corners of Abdominoplasty
The main cause of Dog Ears, excess skin pouching at the sides or ends of the Tummy Tuck Incision, are most commonly caused by trying to use too short of a Tummy Tuck Incision.
As the Abdominal Slin is pulled down and removed by a Tummy Tuck, the Flank Skin on the sides of the Abdomen is also pulled down and creates a bulge or Dog Ear.
The Dog Ear can be removed by extending the incision and removing the skin, however most patients want the shortest Tummy Tuck Scar possible.
Typically we use Laser Assisted Liposuction to remove Fat and tighten the skin in the Dog Ear which works well for most people
Minimizing Doe Ears in a Tummy Tuck
In a tummy tuck the upper incision is longer than the lower since you are taking out the skin above where the incision is located. This results in a discrepancy regarding the lengths of the incisions and the upper (longer) incision needs to be worked in to the lower. Proper planning should balance the incision lengths and avoid dog ears, but there are instances where it is beneficial to tolerate a dog ear, allow the skin to contract for a period of time and revise it later. This can lead to a shorter scar, excising the excess at the time of the initial surgery will result in a longer incision but avoids the secondary procedure.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon
I agree with above answers. It is interesting that there seems to be a big deal about a very minor problem. I actually believe a surgeon can keep a scar a little shorter, accept a small dog ear that may go away, and easily correct it in the office if it does not
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How to avoid "dog ear" at time of tummy tuck
Only if you get a really good surgeon might you end up with a small dog ear needing office revision, a painless, easy procedure with neglible recovery, and in my practice, at no cost to you.
Small "Dog Ears" are no big deal after abdominoplasty. They occasionally occur at the ends of the abdominoplasty scar when your surgeon cares enough to provide for you the shortest, most inconspicuous scar possible. The best abdominoplasty scars are symmetric, flat, fine lines that are very low and very short.
If your surgeon doesn't care so much about the length of your scar, he will extend it longer around your sides, thus assuring you no dog ear, but a longer scar for the rest of your life. The best scar outcome is short with no dog ear, which we often achieve. It is better in my opinion to go for the short scar first and revise the dog ear if necessary than to make a long scar on every patient to avoid the dog ear that develops in only a few.
Dog ears or excess tissue at the ends of the incision should not be present
Although very, very small dog ears are always a possibility anything more than that should never really occur after a tummy tuck. It is essentially a geometric process where the incision length, shape, and closure come togther to eliminate or significantly reduce the chance of this occuring. Simply ask your plastic surgeon about the chance of dealing with this and if he/she will correct without a charge if they do occur.
All the best,
5 Very Useful points to know about dog ears
5. It is a myth that dog ears come simply because of an incision being too short.
4. An incision and thus scar can be kept as short as possible by using liposuction at the puckering ends to minimize the bulkiness of the tissue there.
3. "Cheating" the upper flap siightly medially (toward the center) can help lower the chance or dogears. Ask your surgeon if he does it.
2. The laser on the laserlipo (smartLIpo) may help to tighten the skin. Performed before the closure.
1. Most importantly. Make sure your surgeon has a huge number of great B&A's (before and afters) for tummy tuck pictures to show you. And ask for patients of his with whom you could speak about the process.
Avoiding dog ears during a tummy tuck
If the incision is placed in the proper location and extended far enough laterally (to the side) dog ears can be avoided in the vast majority of cases (>95%). Usually a dog-ear can be identified during the conclusion of the procedure and corrected at that time. This also has to do with the manner in which the skin flap is advanced and sewn into place.
If you still have a dog ear several months after the surgery once the swelling has subsided, you can always have your surgeon correct this under local anesthesia in the office.
"Dog ears" in tummy tuck incisions
Dog ears refer to when the very ends of the incision are bunched up and the skin sticks out a little. This can be avoided by careful planning (including the shape and length of the incision) and surgical technique. The length of the upper and lower borders of the skin that is removed in a tummy tuck are different, so when closing the incision the surgeon has to sew the borders in a way that lines up without bunching and creating areas that stick out. Dog ears often occur when there is an attempt to keep the incision shorter than it really needs to be. You can certainly let your plastic surgeon know you want to avoid dog ears, but this isn't something you should have to remind a surgeon to do. Better things to interview prospective surgeons on are their credentials, training, and prior surgical experience with tummy tucks. I recommend consulting with a surgeon certified by the American Board of Plastic Surgery, and ask to see some before and after photos of previous patients.
How Do Doctors Minimize Dog Ears During a Tummy Tuck?
Careful planning of the incision location, direction, and length can minimize the risk of lateral dog ear formation during a tummy tuck. I find that if a scar is too "flat" or horizontal and doesn't angle up a bit following the proper direction of the relaxed skin tension lines, dog ears seem to be more of a problem. incision closure is performed in such a way as to advance the skin a bit towards the center of the abdomen, and this also minimizes dog ear formation. The incision needs to be long enough for the amount of skin that is removed, otherwise dog ears will be a problem.
What is a dog ear and how do you avoid it.
Imagine you have a circle of paper and you cut a wedge out of it. If you bring the edges of the wedge together you get a cone (aka dog ear) The bigger the wedge, the taller the cone. Now visualize the wedge as the point where the upper and lower incisions of your abdominoplasty come together. The more skin you remove vertically the farther you will have to go horizontally to get an angle small enough to close the incision smoothly. Most women want short scars and big results which is when dog ears happen. I would rather explain this to my patients and do the procedure well the first time than hope a dog ear will go away only to find that it has to be excised later. Often I will do a little liposuction at the end of the incision to smooth things out a bit, but I don't leave dog ears. They bother women a lot. I know because I had one after my own abdominoplasty and hated it. The best thing to do it to look at each surgeon's photos. They will tell you if he/she accepts dog ears or not and if so, how big. Also ask if there will be a charge to excise a dog ear after the fact.