How common are dog ears in breast reduction surgeries and how can we avoid getting them?

Dog ears, in the context of breast reduction surgery, refer to excess tissue at the ends of a surgical incision that can create a puckered or folded appearance. While they’re not uncommon, their occurrence varies among individuals. To minimize the likelihood of dog ears, it’s essential to choose a skilled and experienced surgeon who can carefully plan and execute the procedure. Good preoperative planning, proper marking of incision lines, and precise closure techniques can help reduce the risk. Additionally, following postoperative care instructions, including wearing compression garments and avoiding excessive strain on the incisions, can contribute to optimal healing.Discuss your concerns and expectations with your surgeon during the consultation to ensure they understand your goals and can address them effectively during the surgery.

Dog ears, or standing cones, are most often seen in breast reduction surgery when the incision is carried into the armpit, but it can also sometimes happen at the cleavage. It is most often seen in larger reductions, often when there is significant excess skin and fat that extends to the back along the path of the bra. Plastic surgeons try to minimize scars, but sometimes we have to "chase the dog ear" around the side to give a better result. Usually, we will know this is needed before surgery and talk to the patient about the very real possibility of a necessary scar to improve the contour of the armpit. The trade off might be having a nice looking reduction, but an unsightly roll in the armpit if it is not removed. Moreover, "chasing the dog ear" can lead a surgeon all the way to the surgical table in some cases. This is obviously where the surgeon would have to stop. On the other hand, smaller reductions can even have dog ears, but this is often an attempt of the surgeon to minimize the scar with the understanding that a large proportion of small dog ears will just go away over time. Patience is key here! It may be best to wait 9 months or more to let the small dog ear settle before making a decision. I would say that 80-90% of dog ears will go away, or be acceptable in the end. But, as it has been said before, this is usually a small revision done in the office under local anesthetic. And please remember, your surgeon wants the best for you, so if you get a dog ear just sit down and have a discussion with them. I'm sure they will be happy to explain why it happened and what the plan is for the future.