Excess Skin Removal Surgery: What Are ‘Dog Ears’?

Causes and Solutions for Dog Ears after Skin Removal Surgery

When losing a considerable amount of weight or after undergoing bariatric surgery, some people are left with excess skin that can be physically uncomfortable. Excess skin removal surgery, also known as body contouring, is a procedure that can address this issue, helping to reshape the body. However, a common concern that arises regarding the excess skin removal surgery is the formation of ‘dog ears’.

In this blog, Sydney Plastic Surgeon Dr Jake Lim will discuss what ‘dog ears’ are, why they occur, and how they can be managed or prevented. Dr Lim believes in a patient-centred approach, where open communication and realistic expectations are essential. During consultations, he discusses potential outcomes, including the possibility of ‘dog ears’, and the options available should they occur. It’s important for patients to feel informed and comfortable with all aspects of their surgery, including understanding and preparing for any potential minor complications.

Download Dr Lim’s 2024 Abdominoplasty Guide

What Are Dog Ears?

When discussing skin removal surgery, understanding the term “dog ears” is essential. Dog ears refer to small pockets or folds of skin that can form at the ends of a surgical incision. These irregularities can disrupt the otherwise smooth and aesthetically pleasing results of the procedure. It’s worth noting that dog ears are not unique to any specific type of skin removal surgery; they can occur in a variety of procedures aimed at removing excess skin and reshaping the body’s contours.

When Does this Complication Occur?

Dog ears can potentially develop after a range of plastic surgery procedures, primarily those involving the removal of excess skin. Here are some of the common procedures during which dog ears may be a concern:

1. Abdominoplasty (Tummy Tuck): Abdominoplasty is a surgical procedure designed to remove excess skin and fat from the abdominal area while tightening the underlying muscles. Due to the natural contours of the abdomen, dog ears can sometimes form at the ends of the incisions
2. Brachioplasty (Arm Lift): Brachioplasty is a surgery that aims to remove excess skin and fat from the upper arms. The curved and dynamic nature of the arm’s structure can make it susceptible to the development of dog ears
3. Mastopexy (Breast Lift): Mastopexy is a procedure to lift and reshape sagging breasts. Depending on the extent of skin removal and the individual’s unique breast shape, dog ears can occasionally occur at the incision sites
4. Thighplasty (Thigh Lift): Thighplasty is performed to remove sagging skin and improve the contour of the thighs. The thighs have natural curves, and the removal of excess skin in this area may lead to dog ears
5. Body Lift: A body lift involves the removal of excess skin from multiple areas of the body, often including the abdomen, thighs, buttocks, and hips. Given the complex nature of this procedure, the potential for dog ears can be more significant

Why Do ‘Dog Ears’ Occur?

The formation of dog ears in skin removal surgery can be attributed to many factors and aspects involved in reshaping the body’s contours. These factors include:

• Natural Body Contours: Our bodies do not have flat or uniform surfaces; they have curves, contours, and irregularities. These natural variations can make it challenging to achieve perfectly smooth results in areas like the hips, abdomen, arms, thighs, or underarms. The plastic surgeon must navigate these contours while removing excess skin, which can sometimes lead to the formation of dog ears
• Skin Elasticity and Quality: The quality and elasticity of an individual’s skin can vary from person to person. Factors such as age, genetics, sun exposure, and smoking history can significantly impact how the skin responds to surgery. Skin with reduced elasticity is more prone to forming dog ears as it struggles to adapt to the newly reshaped contours
• Extent of Skin Removal: In cases where a substantial amount of skin needs to be removed, achieving a perfectly smooth contour can be more challenging. The more significant the skin removal, the more likely it is for some degree of gathering or puckering to occur at the incision sites. This is particularly relevant in procedures like body lifts where multiple areas of the body are addressed simultaneously
• Tension along the Incision Line: Achieving balanced and even tension along the incision line is crucial in preventing dog ears. If the plastic surgeon does not distribute the tension uniformly, it can result in the gathering of excess skin at the ends of the incisions, leading to the formation of dog ears
• Individual Anatomy: Each patient’s unique anatomy and body composition play a significant role in the development of dog ears. The plastic surgeon must take into account these individual factors when planning and executing the procedure to minimise the risk of dog ears

It’s important to note that while meticulous surgical planning and technique can significantly reduce the chances of dog ears, they may still occasionally occur.

Download Dr Lim’s 2024 Excess Skin Guide

How to Prevent ‘Dog Ears’?

Preventing the occurrence of dog ears is a crucial objective for plastic surgeons, as it contributes to achieving the desired aesthetic results and patient satisfaction. Dr Jake Lim, a highly experienced plastic surgeon, employs meticulous surgical planning and techniques to minimise the likelihood of dog ears. Here are some strategies used to prevent them:

• Precise Marking: Before the surgical procedure, Dr Lim carefully marks the areas of skin to be removed. This process takes into account the natural contours of the body. By marking these areas accurately, the plastic surgeon can plan incisions that follow the body’s curves, reducing the potential for dog ears
• Gradual Tension Adjustment: During the surgery, adjustments are made to ensure that the tension along the incision line is as even as possible. Balancing tension is crucial in achieving a smoother contour without the formation of dog ears
• Extended Incisions: In some cases, extending the incision slightly can prevent dog ears by distributing the tension over a larger area. Dr Lim may opt for this technique when it is appropriate and can enhance the overall result

Despite these precautions, it’s important for both patients to acknowledge that dog ears can still occasionally occur. Fortunately, there are effective solutions available to address them.

Solutions to Correct ‘Dog Ears’

Dr Jake Lim and his surgical team are well-prepared to handle any issues related to dog ears that may arise after skin removal surgery. Here are some solutions that can be employed to correct dog ears:

• Immediate Post-Operative Adjustments: In some cases, dog ears may be noticeable immediately after surgery. During this crucial post-operative period while the patient is still under anaesthesia, minor adjustments can be made to refine the surgical results and reduce the appearance of dog ears
• Revision Surgery: If dog ears persist after the initial healing period, a minor revision surgery can be performed. This is usually a straightforward procedure that can be done under local anaesthesia. Revision surgery is a reliable method to eliminate dog ears and achieve the desired aesthetic outcome
• Non-Surgical Options: In certain situations where dog ears are minimal, non-surgical treatments such as laser therapy or radiofrequency treatments may help smooth out the skin and improve the overall appearance. These non-invasive options can be discussed with Dr Lim during follow-up consultations

FAQs about Dog Ears and Excess Skin Removal Surgery

Can I combine multiple skin removal procedures in one surgery?

• Yes, it’s possible to combine multiple skin removal procedures into one surgery, commonly referred to as a “body lift.” This approach can address excess skin in several areas, such as the abdomen, thighs, buttocks, and arms, simultaneously. Combining procedures can lead to different results and potentially reduce overall recovery time. However, the decision to combine surgeries should be made in consultation with a skilled plastic surgeon such as Dr Jake Lim, taking into consideration your individual health, goals, and safety.

What is the recovery process like after skin removal surgery?

• The recovery process after skin removal surgery varies depending on the specific procedure and individual factors. Generally, patients can expect some swelling, bruising, and discomfort in the initial days and weeks following surgery. It’s essential to follow Dr Lim’s post-operative instructions diligently, including wearing compression garments, managing pain, and avoiding strenuous activities. Recovery times can range from a few weeks to several months, with full results becoming visible as swelling subsides.

Are there any long-term scarring concerns with skin removal surgery?

• Scarring is a common concern for many patients undergoing skin removal surgery. While scars are an inevitable part of any surgical procedure, experienced plastic surgeons take great care to minimise their visibility. Incisions are usually placed in natural creases and folds to make them less noticeable. Over time, scars tend to fade and become less prominent, and there are also scar management techniques and treatments available to further improve their appearance.

Will insurance cover the cost of skin removal surgery?

• In most cases, skin removal surgery is considered elective and cosmetic, so it is not covered by insurance. However, there are exceptions. If the excess skin is causing significant medical issues such as rashes, infections, or physical discomfort, insurance may cover some of the costs of the procedure as a medical necessity. It’s essential to consult with Dr Jake Lim and your insurance provider to understand the specific criteria for coverage.

What can I do to maintain my results after skin removal surgery?

• Maintaining the results of skin removal surgery involves adopting a healthy lifestyle that includes regular exercise, a balanced diet, and staying hydrated. Weight fluctuations can impact the longevity of your results, so it’s important to maintain a stable weight. Additionally, protecting your skin from excessive sun exposure and following a skincare regimen can help preserve the quality and appearance of your skin.

Can Dog Ears be prevented through patient actions?

• While the prevention of dog ears primarily relies on surgical planning and technique performed by the plastic surgeon, patients can contribute to the prevention process by maintaining a stable weight and optimal skin health before surgery. Ensuring that the skin is in the best possible condition can potentially reduce the risk of dog ears. However, the primary responsibility for preventing dog ears lies with the surgeon’s expertise and precision during the procedure.

How long does it typically take for dog ears to resolve after surgery?

• The timeline for the resolution of dog ears can vary depending on individual factors, the extent of skin removal, and the specific surgical procedure. In some cases, minor dog ears may improve within a few weeks to months as the surgical area heals and swelling subsides. Persistent dog ears may require revision surgery for complete correction, and the timing for this will be determined by the plastic surgeon during follow-up consultations.

Further Reading about Surgery with Dr Jake Lim

• Read Dr Jake Lim’s Body Procedures after Weight Loss Surgery Page
• Read Dr Jake Lim’s Extended Abdominoplasty Surgery Page
• Read Dr Jake Lim’s Blog about What Can I Do To Optimise My Surgical Results?
• Read Dr Jake Lim’s Blog about Healthy Food and Supplements during the Post-Operative Period
• Read Dr Jake Lim’s Blog about Typical Emotions Experienced after Plastic Surgery
• Read Dr Jake Lim’s Blog about Cosmetic Surgery for Men

Medical References about Dog Ears and Skin Removal Surgery

• Dog ear: an overview of causes and treatment – PMC
• Axillary skin flaps (dog ears)
• Aesthetic Refinement of the Dog Ear Correction: The 90° Incision Technique and Review of the Literature
• Dog-ear’s prevention during Inverted-T breast lift and reduction
• Surgical techniques to avoid lateral dog ear