While it sounds like an adorable part of an animal, dog ears are a type of minor deformity that is common and sometimes unavoidable following the surgical closure of wounds. It may occur in any operation, but in plastic and cosmetic surgery, dog ears are observed mostly after abdominoplasty (tummy tuck), or a panniculectomy wherein incisions are elliptical.
How Do Dog Ears Happen?
The term dog ears technically refer to the protruding skin or tissues at the extreme ends of a closed incision. In plastic surgery, dog ears are common in procedures that involve skin tightening and require elliptical incisions like the tummy tuck. A tummy tuck is a surgical procedure that removes the resulting excess, sagging skin after weight loss. It likewise tightens loose muscles in the midsection or abdomen that separated due to improper core exercises techniques and pregnancy.
Primarily, the formation of dog ears depends mainly on the incision made during a tummy tuck. The incision length, placement, and shape can all lead to having dog ears post-tummy tuck.
- Incision length – Dog ears usually arise due to shortened incisions during a tummy tuck. Shorter surgical cuts are harder to suture close; thus, the skin at one or both ends of the incision tend to fold and protrude.
- Incision placement – The location of the surgical incision not only leads to the formation of dog ears but also affects the length of the cut. Placing an incision lower in the abdomen, like in a mini tummy tuck where it is just above the pubic bone, would require a shorter incision because the pubic region is a smaller area compared to the upper abdominal area. Thus, upon closure of incision, the skin can likewise bend and fold forming dog ears.
- Incision shape – Tummy tuck incision is elliptical, going from hip-to-hip across the lower abdomen. A non-standard form of an incision as such can become challenging to suture close as wound edges may become misaligned. The skin may scrunch up, resulting in dog ears at one or both ends of the closed incision.
Skin quality can also contribute to having dog ears following a tummy tuck surgery. The skin can become loose after constant exposure to environmental factors that cause skin aging. Its underlying collagen and elastin, which are connective tissues that provide support, breaks down, making the skin less manageable. Thus, when suturing incision during a tummy tuck, the loose skin tends to wrinkle at the ends of the incision.
Treatment for Dog Ears After a Tummy Tuck
Dog ears are a minor deformity that resolves on its own if the extended skin is small enough to resorb. However, if there is a sizable portion protruding at the closed incision, revision surgery can be performed under local anesthesia.
The revision surgery depends on whether the protruding skin is due to poor skin laxity or excess tissues. Based on these cases, revision surgery is often performed as:
- Excision of the Extended Skin – This method involves extending the incision longer before cutting away the excess skin. While it does eliminate the deformity, it results in longer scars due to the extension of the initial surgical cut.
- Liposuction – Sometimes, it’s not just skin that forms dog ears. The residual fat that remained from prior weight loss can add bulk to the formed dog ears. Thus, liposuction touches up the area along with the removal of the extra skin.
Can You Prevent The Formation of Dog Ears?
In general, there is no way of telling who is more prone to forming dog ears following a tummy tuck or any other surgery. That’s also why most plastic surgeons, including myself, advise patients to wait at least six (6) months after their tummy tuck surgery. This period provides ample time for the wounds to heal and to determine if the patient will form dog ears or not in his/her suture site.
While there is no way to determine whether a patient will form dog ears, there are ways to avoid having the deformity. These includes:
- Have a skillfully planned incision. This method involves the expertise and skill of the patient’s plastic surgeon. While longer incisions do entail having longer scars, proper placement of the surgical cut along with less skin tension during suturing would make the resulting scar thin and well-blended after 6 to 18 months. Make sure that you discuss with your plastic surgeon your desires and expectations, including scarring possibilities. In that way, your plastic surgeon will be able to suggest an appropriate incision plan based on your goals.
- Keep your skin healthy before undergoing a tummy tuck. Healthy skin can equate to having good skin quality, which can be beneficial after skin tightening procedures. Maintaining the elasticity of the skin through a proper skin care regimen would enable your skin to be pliable to the new contour of the body after a tummy tuck. Thus, there will be no excess skin that forms dog ears following surgery.
Realistic Expectations and a Skillful Plastic Surgeon
The occurrence of any deformity like dog ears following a tummy tuck or any surgery can be bothersome. Complications are always a risk but can be prevented given that a board-certified plastic surgeon guides you. It is essential that you relay your goals and expectations from the procedure to them during the consultation. Their years of study, training, and skill in performing tummy tuck allows them to develop a surgical plan that minimizes complication and unsatisfactory results.