The most common revision, after a tummy tuck, is excision of the skin, redundancy at the lateral aspect of the incision line often called dog ears. This happens because plastic surgeons fail to extend the procedure far enough along the sides, creating an undesirable contour. If, in doubt, the excision should be taken longer rather than shorter. To do an extended tummy tuck, requires repositioning the patient during surgery, and this is time consuming and labor-intensive. It adds to operating room cost, and for that reason some plastic surgeons may be tempted to cut corners And do a standard tummy tuck when in fact, patient would benefit from an extended procedure. When removing skin laxity from a surgical perspective, it cannot be done so with an non-acute angle. If you pinch and lift the skin on the back of your hand you will see the skin fold becomes longer the more you lift your skin up. This is a bit what happens on your abdomen. The incision needs to gradually come to close of patients will be left with “dog ears” I always encourage people to have more consultations then they may think necessary. The more plastic surgeons, you talk to the more likely you are to find the best provider. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patient who have similar body characteristics to your own. Look carefully at the amount of skin laxity, and how this continues to the side and look at the Contouring in the after pictures and how far the incision went. Make sure you’re looking at the patients from different angles. An experienced plastic surgeon should have no difficulty showing you the before, and after pictures of at least 50 previous patients. Being shown a handful of preselected images of representing the best results of the providers career for a patient who don’t have a body characteristics that are similar to your own is insufficient to get a clear understanding what average results look like in the hands of each provider. It’s exceedingly rare that somebody makes an incision That’s too long. Plastic surgeons often err on making the incision too short, Like I mentioned earlier it is one of the most common reasons patients end up with revision surgery. My best guess is at least 1/3 of patients who have full tummy tucks end up with dog ears that could have been prevented had the surgeon made a better plan of action and paid more attention to detail. Have each surgeon point out (consider having them make a dot with a sharpie pen) exactly how far the scar will go and specifically if they plan on turning or repositioning you during surgery. Without turning the patient it’s not really possible to do a proper “extended TT”. I suppose there is some subjectivity here but in general your better off having a longer scar not a shorter one. Best, Mats Hagstrom, MD