What is the Best Way to Improve Dog-ears on a Forehead Scar?

Two years ago, my daughter had a hemangioma surgically excised from her forehead. The hemangioma was about the size of a nickel. She is now left with a linear scar (which we were prepared for), however we were never informed of the potential dog-ears that could develop. The dog-ears draw a lot of attnetion to the scar; if it were just a flat, linear scar (as we were told it would be), it would actually look ok. What can be done to improve the dogears? Lasers? Or is another surgery necessary?

Doctor Answers 3

Most "dog ears" will resolve over time

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with just massaging the area. It may take some months, though. Other options are injections of Kenalog or an excision. Personally I recommend to massage and wait. 

Best regards,

Dr. Robert Kasten 

Mainz Dermatologic Surgeon

Dog-ears on a forehead scar

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Since there is a chance the dog ears could spontaneously resolve with further growth of your daughter, the conservative thing to do at this time would be to wait.  At age 9 or so, the child would be mature enough to undergo a procedure under local anesthesia and to participate in the decision-making process.  Regardless, for persistent dog ears, another surgical procedure would likely be required to correct them. 

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Treatment of dog ears after surgery

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Anytime a surgeon peforms a skin excision there is a risk of dog ears or skin pleats occurring at the ends of linear skin closures, especially if the excision was circular in shape. Sometimes these are not fully visible at the time of surgery because of swelling with local anesthetic, body position etc. Small dog ears resolve on their own with time. Larger dog ears have to be surgically removed and in doing so always increase the length of the final scar. Children are still growing and so may resolve dog ears on their own that a full grown adult cannot. If your daughter is young and you can wait it out the final scar will be smaller. If the dog ears are really bothering you you will have to have them excised thereby lengthening the final scar line length.

Aaron Stone, MD
Los Angeles Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.