A tummy tuck, or abdominoplasty, is a surgical procedure designed to remove excess skin and fat from the midsection, often tightening the underlying abdominal muscles. While the procedure results in a flatter profile, some patients notice small, raised skin folds at the ends of the horizontal incision line. These are commonly referred to as “dog ears.” Though typically a minor concern, they can detract from the smooth, contoured look a patient desires.
How Dog Ears Form
Dog ears are folds of skin and fat tissue that bunch up where the surgical incision ends. This puckering occurs because the skin is pulled tightest in the center of the abdomen, but the tension tapers off dramatically at the lateral ends of the incision line. The remaining tissue beyond the incision point has not been fully contoured, leading to a noticeable bulge.
This mechanical phenomenon results from an imbalance between the amount of fat and the overlying skin, compounded by tension. Factors like poor skin elasticity or significant excess tissue in the flanks increase the likelihood of dog ears forming. They are often not immediately visible after surgery due to swelling, but become more apparent over the first few months as inflammation subsides.
Prevention Through Pre-Surgical Planning
Prevention begins long before the procedure, starting with the selection of a plastic surgeon. A skilled surgeon will conduct a thorough pre-operative assessment of your skin quality, body shape, and the amount of excess tissue to determine the best approach. Patients should also aim to maintain a stable goal weight for several months prior to surgery, as significant weight changes can increase the risk of these folds forming.
During the operation, the surgeon employs several techniques to minimize the risk of dog ears. One primary method involves extending the horizontal incision slightly further out onto the hips or flanks, which allows for a smoother, more gradual tapering of the tissue removal. This extended tummy tuck is particularly beneficial for patients with substantial tissue excess in the lateral abdominal areas.
Targeted liposuction of the flanks and surrounding areas is another preventative measure. By removing excess fat from the ends of the incision, the surgeon can “feather” the transition zone, ensuring a more uniform thickness of tissue. Additionally, the use of advanced tension-free suturing techniques helps to distribute the tension evenly across multiple tissue layers, reducing the chance of the skin bunching up at the incision endpoints.
Post-Operative Techniques to Minimize Skin Folds
Following the surgeon’s post-operative instructions minimizes the appearance of residual skin folds. Continuous usage of a prescribed compression garment is one of the most effective strategies. The garment applies gentle, consistent pressure to the surgical site, helping the remaining skin retract and conform smoothly to the new contour. Wearing the garment also helps manage post-surgical swelling, which can temporarily exaggerate the appearance of small folds.
Gentle lymphatic drainage massage can also be beneficial, particularly in the weeks following surgery once approved by the medical team. This technique helps push trapped fluid out of the tissues, reducing localized swelling and encouraging the skin to settle flat against the abdomen. Focus the massage gently on the areas surrounding the lateral ends of the incision, but avoid direct pressure on the healing scar line itself.
Managing inflammation and internal swelling directly impacts the final contour. Following a low-sodium diet helps reduce fluid retention, lessening the puffiness that can make minor folds appear more prominent. While strenuous activity must be avoided, incorporating early, gentle mobility, such as short walks, aids circulation and supports healing. This controlled movement helps prevent the skin from settling in a bunched position while it heals.
Options for Revision and Correction
If a dog ear persists six months after the initial procedure, once swelling has subsided, a minor corrective procedure is generally required.
Liposuction
For folds primarily composed of fatty tissue, a surgeon may recommend focused liposuction. This minimally invasive approach removes the excess fat deposits to smooth the contour. It is often performed under local anesthesia with minimal recovery time.
Surgical Excision
When the protrusion is mainly excess skin, the solution is typically a minor surgical excision. This involves reopening a small portion of the original incision, excising the triangular piece of excess skin, and neatly re-suturing the area. This straightforward procedure usually takes less than an hour and can often be performed in an office setting under local anesthesia.