Full TT - Is this a Dog ear? Help! (photos)

Had a full abdominoplasty 7/15 noticed in 11/15 had (what looked like a pocket of fat at the end of my scar on the right side)I notice the puckering when my underwear sits under the scar. In 12/15 did a f/u with my PS and he said I would need lipo. On 3/16 had procedure. Went back in 9/16, because I still have the same problem. My PS asked me "what would you like me to do?" and said it was d/t weight loss. Can some one please help me on this? I also have current picture 11/16. Thank you.

Doctor Answers 9

Full Tummy Tuck, Unfavorable Result with Dog Ear

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Your primary concern about a dog ear could be predicted from the pattern drawn for the skin resection in the first photograph.  A dog ear forms when the angle of closure at the end of incision is too wide.  Ninety degrees is really wide. I start my planning with the angle at about thirty degrees. If it is narrow and the tissue above, below and lateral to it is thinned, either by liposuction or surgical undermining during the procedure and closure, there will not be a dog ear.  If the tissue is bunched up at the ends because it  is too thick to come together in a flat plane, or if the angle was too wide, as is the case here as well, then  a  "standing cone" or dog ear results.

If the dog ear is quite small and there is just a little fat pushing the cone up, then conservative local liposuction under the end will flatten it.  If there is excess tissue bunched up, then that tissue has to be removed by slightly extending the incision and taking out the bulging tissue excess.  In the 9/15/16  picture it looks like the lateral right scar is depressed, and there is excess flank fat contributing to a dog ear look.  It appears that further surgical revision of the right lateral scar and liposuction of the waist flank area would remove this appearance.

It is also noticeable that the scar is visible and high.  To avoid this problem it is my recommendation that all the abdominal skin be pulled up tightly by the patient in the standing position. Then with bikini underwear on, the outlines of the bikini are marked and the location of the incision is marked within those boundaries.  With the tension pre set, it will not be possible to have the scar pulled up on the abdomen during the closure. Pre-marking without doing this, or with the patient lying down and not flat makes the scar location unpredictable and more likely to be high and visible. This problem cannot be corrected because the distance between the umbilicus and the scar is set. 

You should consider a second opinion from another experienced board-certified plastic surgeon to explore further treatment options

Mountain View Plastic Surgeon
5.0 out of 5 stars 54 reviews

Revision abdominoplasty

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Based on your photos it appears that you would benefit from aggressive liposuction and additional skin removal in lateral and possibly posterior (back) aspect. Your initial abdominal scar seem to be too high. 

You should discuss these issues with your surgeon and/or consider a second opinion consultation with another plastic surgeon. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 22 reviews

Tummy tuck

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It appears to me that your incision was placed higher than usual; hence some of the tissue that should have been removed was not. Also, given your body structure, I would have extended the incision longer at the sides.

However, what you have is correctable but will require another surgery to remove the excess tissue.

Matthias Solomon, MD
Dallas Plastic Surgeon

Dog ear

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Yes - that is a dog ear.  It can be excised, and the area made flatter.  It will require extending the scar a little bit around the back. Your PS should know this, and offer it to you.

Full TT - Is this a Dog ear? Help!

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It does appear to be a dog ear. To remove it- I would suggest a very aggressive extension of the lateral incision with possibly additional liposuction to reduce the volume. This combination of treatment should eliminate the dog ear.

Extend incisions

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To get the dog ears flat you will need your scars extended significantly. Yes weight can affect results but the dog ear cannot be treated in any other way than to excise it and chase the scar around the back. It is always difficult to fully comment on results without seeing your preop photos standing and looking at the extent of tissue around the flanks and at the back. You may be best to obtain a second opinion. 

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 179 reviews

Revision/Extension Tummy Tuck

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A "dog ear" is a not-so-wonderfully named item at the end of a tummy tuck incision that shows the tightening of the surgery ending with the incision/scar. An extension of the incision with removal of skin and fat is a best solution in my opinion anyway. The amounts to a revision on one hand and an extension on the other. 

Best Regards,

John Di Saia, MD

John P. Di Saia, MD
Orange Plastic Surgeon

Full TT - Is this a Dog ear? Help!

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Judging from your photos, you do appear to have a "dog-ear" (a pucker at the end of any removal of tissue). To correct this would take both another liposuction in the area of the dog-ear and an excision of more skin lengthening the scar. With that said, you should wait until all of the swelling subsides, which may take 6 months or so. Visit your PS again for his/her opinion, and you may also consider a second opinion from a certified ASPS plastic surgeon with lots of experience.

Best of luck to you, and thank you for your question and photos.

Bulge after liposuction

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Thank you for asking about your tummy tuck revision.

  • It is hard to tell from photos what is going on because an exam is needed to asses skin, fat and muscle.
  • the most recent photo suggests that things have improved compared to earlier photos.
  • You may still be swollen - it can take 12 - 18 months for all swelling to subside.
  • If you have gained weight, losing the weight will help.
  • if it is residual fat, further liposuction should flatten it.
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

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.