“Dog ears” are a common concern for individuals undergoing a tummy tuck, also known as abdominoplasty. This article explores why these small tissue bulges can occur after the procedure and the methods available for prevention and correction. Understanding these factors can help set realistic expectations for surgical outcomes.
What Are “Dog Ears”?
“Dog ears” are conical or triangular folds of skin and fat that can form at the ends of a surgical incision. These protrusions typically appear along the horizontal incision line, often near the hips or outer thighs. The term is descriptive because their appearance resembles a dog’s folded ear. They may not be immediately visible after surgery due to swelling, often becoming noticeable three to six months post-procedure as swelling subsides.
How Surgical Factors Contribute
Surgical planning and technique play a role in “dog ear” formation. The length and placement of the incision are factors. If the incision is too short for the amount of skin and fat needing removal, excess tissue can bunch up at the ends.
Achieving smooth contouring is challenging where tightened abdominal skin meets untightened flank skin. Inadequate or uneven fat removal, particularly in the flanks or at incision ends, can leave bulging fatty tissue. Liposuction of adjacent areas can help create a smoother transition.
The distribution of tension across the incision line during closure is important. Uneven tension can cause the skin to pucker at the ends. Surgeons use precise techniques, such as progressive tension sutures, to distribute pressure evenly and minimize tissue bunching.
Individual Patient Considerations
A patient’s unique biological characteristics influence “dog ear” development. Skin elasticity is a significant factor; skin that has less ability to retract and redrape smoothly after surgery may be more prone to forming bulges. Patients with reduced skin elasticity may find it more challenging to achieve a perfectly flat contour.
A patient’s pre-existing body shape and anatomy, such as wider hips or significant fat deposits in the flanks, can make achieving a seamless transition more difficult. The amount of excess skin and fat a patient has before surgery also plays a role. Patients with a very large amount of redundant skin and fat may be more susceptible to “dog ears,” as achieving a seamless transition becomes more complex.
While some initial bulges may resolve as swelling decreases, persistent “dog ears” indicate that the issue will not improve without intervention.
Strategies for Prevention and Correction
Preventing “dog ears” begins with a thorough pre-operative assessment and detailed surgical planning. This includes careful incision design, ensuring its length and placement are tailored to the patient’s specific anatomy and the amount of tissue to be removed. Combining liposuction of adjacent areas like the flanks and hips with the tummy tuck can help achieve a smoother overall contour and reduce the risk of bulges.
Surgeons can also employ advanced closure techniques, such as tension-free suturing, to distribute skin tension evenly across the incision line. Despite careful preventative measures, “dog ears” can still occur in some cases, affecting approximately 20% of abdominoplasty patients.
If “dog ears” do form and persist after post-surgical swelling has resolved, typically around six months, they can often be addressed with a minor revision procedure. This corrective surgery usually involves a local excision of the excess skin and fat, often performed under local anesthesia in an outpatient setting. The procedure is generally quick, lasting about 30 minutes, and involves removing the excess tissue and re-suturing the area to create a smoother contour. For cases where the “dog ear” is primarily composed of fat, liposuction may be used as the primary or an adjunctive correction method.