What Causes Pointed Protrusions on Either End of Abdominoplasty Scar?

These abdominoplasty dog ears are a direct result of the operating surgeon's technique, and proper initial incision design can MINIMIZE (but not completely eliminate) how often this occurs in tummy tuck patients. Extending the incisions laterally (more to the side) can also eliminate them, but the scar length is increased.

Hence, the trade-off every surgeon and patient has to be aware of!

Either the surgeon tries to keep the scar as short as possible and sometimes gets a pair of dog ears (which do diminish over time, but may require an additional small, local anesthesia operation to remove), or a long(er) incision is chosen to reduce the likelihood of getting dog ears in the first place.

Proper design and skillful execution can minimize the tendency for dog ears, but scar length is an issue for many patients, so when any plastic surgeon tries to keep the scars short, sometimes dog ears result. Big ones should be fixed at the time of the initial surgery, for they will NEVER soften and settle to a completely flat and normal contour. But small ones do indeed get better, and just as your friends seem to be OK with their "squishy-squishy" dog ears, if small dog ears are all they have, no further surgical revision is needed.

You, on the other hand, are honest enough to explain that you would not like these, and should share this with your surgeon, who can take your request to heart and extend the incisions slightly, diminishing the likelihood for dog ears. The mathematical analysis of dog ear prevention, formation, and correction is beyond the scope of this forum, but understand that individual patient anatomy has a factor in this whole "dog-ear" equation, not just a surgeon's measurements, marking, incisions, and surgical technique.

But, the more skilled and experienced the surgeon, the less the likelihood for dog ears, or if they do occur, the lower the likelihood they will be large and require a larger touch-up procedure. Discuss with your surgeon the cost policy for revisional or touch-up surgery, where it is done, and if there are charges for the OR and anesthesia  at the hospital or surgical center. Best wishes!

This happens on occasion with abdominoplasty. There are options. A completely non invasive option would be CoolSculpting. This can freeze the fat and deliver an improved contour. More traditional options are some liposuction, or resection of skin/soft tissue. This is a much smaller procedure than the original surgery and is usually well tolerated. The cost will depend on the extent of the surgery, the method used, the cost of the surgery center, and if the original surgeon is doing it. Please speak with your Board Certified Plastic Surgeon. Together, you will figure out a plan.

Dog ears, excess of skin at the end of the incisions, after a tummy tuck are generally due to a lack of intra-operative attention and meticulousness. Once the upper abdominal skin is brought down during the abdominoplasty there are methods that we use to assess the need to take care of the dog ear. This generally includes slight extension of the incision to a point that there is smooth transition. This takes a little time and passion to do. If not done, then patient will come back later for a fix. So, dog ears are preventable. If they do occur they can be fixed very easily. Best of luck

Irregular scars at the end of tummy tuck incisions are referred to as "dog ears"; which are raised areas of skin. These can be avoided at the time of surgery by careful incision planning as well as by liposuction of this area so that the "corners" are flat. If this is recognized at the conclusion of a tummy tuck, the incision can easily be extended a few centimeters and the extra skin is trimmed until the contour is flat.

Best wishes,

Dr. Bruno

It sounds like what you are describing is what most people call "dog ears."  This is an out-pouching of skin at either end of the incision in an abdominoplasty.  This happens when the surgeon make the incision too short or the patient demands a mini-incision.  It is physically impossible excise skin and bring the edges together smoothly while trying to cheat the incision shorter.  This only leads to "dog ears" or irregularities in the skin contour.  Without pictures or seeing you in person, it is impossible to give you specific advice.  However, if you draw a line from your pubis (top of your pubic hair) to your belly button and measure the distance, your incision will have to be at least three times this distance - oriented horizontally in your lower abdomen.  This usually is just a little sider than the distance from hip bone to hip bone.  Another way to guide your incision length is to look at your lower abdominal skin fold.  If your skin is hanging over, follow the distance laterally (to the side) as far as the fold extends on your sides.  This is usually the approximate length of the necessary incision.

 

Good Luck.

What you are describing is a term known as dog ears. Dog ears are formed when there is a mismatch in the amount of excess skin and fat removed as it relates to the length of the scar. If the surgeon tries to close an incision and doesn’t excise enough skin, then, the edges on both sides of the scar to pucker creating unnatural results. The good news is that it can be fixed easily by just excising the excess skin and fat.