What Are Dog Ears After Surgery and How Are They Fixed?

A dog ear is when we close a surgical incision and there's a little pooch at the end of it — shaped like the ears of a dog. It's a cosmetic irregularity that happens when we close incisions that aren't the same length, or when a piece of tissue has been removed.

Dog ears are most common in surgeries that involve removing tissue, such as:

• Tummy tucks
• Breast reductions
• Skin cancer excisions

When the incision is a straight line where we open and close the same length, dog ears are pretty rare. Breast augmentation, for example, rarely produces dog ears because we're not removing tissue — we're closing the same incision we opened.

When I know I'm closing incisions of different lengths (or removing tissue), I use several strategies to minimize dog ears:

When closing a wound with tissue removed, we try to close the edges first and leave any redundancy or unevenness in the middle of the incision. The middle tends to flatten out beautifully over time. Redundancy on the outer edges, however, is much more likely to cause lasting irregularity.

We always want to keep incisions as small as possible — but too small is a problem. An incision that's too short dramatically increases your risk of dog ears. Incision length needs to be balanced with the amount of tissue being managed.

I can dissect laterally to elevate the skin and make it more mobile. This allows the tissue to sit down more nicely without needing to extend the incision.

Sometimes removing fatty tissue in the area helps the dog ear flatten. It's another option that avoids lengthening the scar.

An important point: dog ears often get better on their own. Leaving a minor dog ear after surgery isn't malpractice — despite what you may read on TikTok. In many cases, it's the best choice because most small dog ears flatten out with time.

If you're 6+ months out from surgery and you still have a dog ear that hasn't flattened, there are several options:

If there's extra fatty tissue at the ends of the incision, a Kybella injection (a fat-dissolving medication) can cause the dog ear to shrink and sink in.

For many patients, we can do a minor revision in the office under local anesthesia:

• Numb the edges of the incision
• Extend the incision slightly
• Remove the extra tissue
• Reclose the area

Most patients tolerate this easily and can return to normal activity quickly.

If the dog ears are large, or if you're someone who doesn't tolerate being awake for procedures, we can do the revision in the operating room. This gives us access to better anesthetic agents and all of our surgical tools.

When you fill out your surgical paperwork, you'll see consent forms listing pages and pages of potential complications. Most of what's listed is quite rare. Dog ears may be listed on a breast augmentation consent, but it would not be a common complication for that particular surgery.

• Dog ears are pooches at the end of an incision from unequal closure
• Most common in tissue-removal surgeries (tummy tuck, breast reduction, skin cancer excision)
• Minor dog ears often flatten on their own — patience is often the best medicine
• Persistent dog ears can be fixed with Kybella, in-office revision, or OR revision
• This is a normal surgical issue — not malpractice