A dog ear in plastic surgery is a small mound or pucker of excess skin that forms at the end of a surgical incision when the wound is closed. The name comes from its shape: the bunched-up tissue resembles a pointed, folded ear. It’s one of the most common minor complications in any surgery that involves cutting and closing skin, and while it can be frustrating to discover after a procedure, it’s usually straightforward to address.
Why Dog Ears Form
Whenever a surgeon removes skin and stitches the remaining edges together, the two sides of the wound need to match up evenly. If one side is longer than the other, or if there’s more tissue at the ends of the incision than the closure can accommodate, the extra skin has nowhere to go. It bunches upward into a small cone or ridge, typically at one or both ends of the scar.
This happens for a few reasons. The original incision may not have been perfectly elliptical, the surrounding skin may have different elasticity on each side, or the natural curves of the body can make it nearly impossible to get a perfectly flat closure. Areas with loose or fatty tissue are especially prone to it. Dog ears are not a sign of surgical error. They’re a predictable trade-off that surgeons sometimes accept to avoid making an incision longer than necessary.
Procedures Where Dog Ears Are Most Common
Dog ears can technically appear after any surgery that involves a skin incision, but certain procedures carry a higher risk because of the amount of tissue being reshaped. Tummy tucks (abdominoplasty) are among the most common culprits, particularly at the ends of the hip-to-hip incision where excess skin and fat tend to gather. Mastectomies, breast reductions, and breast lifts also frequently produce dog ears near the outer edges of the chest. Body contouring procedures after major weight loss, facelifts, and even simple mole or lesion removals can all result in this issue.
In mastectomy specifically, several techniques have been developed to address the problem at the time of surgery. These include Y-shaped closures, fish-shaped incisions, triangular advancement flaps, and L-shaped techniques, all designed to redistribute the excess tissue at the outer end of the incision so it lies flat rather than bunching up.
How to Tell a Dog Ear From Normal Swelling
In the first weeks after surgery, it can be difficult to know whether a bump near your incision is a true dog ear or just post-operative swelling. Swelling tends to be soft, diffuse, and roughly symmetrical along the incision line. It usually feels puffy and may change throughout the day. A dog ear, by contrast, creates a distinct, pinchable fold or ridge right at the end of the scar, with a noticeable step between the skin above and below the incision line. It looks more like a defined bump or cone than a general puffiness.
The clearest way to distinguish the two is time. Swelling gradually decreases over weeks to months. A dog ear stays the same size or becomes more obvious as the swelling around it resolves.
Many Dog Ears Flatten on Their Own
One of the most important things to know is that not every dog ear needs surgical correction. In a study tracking 77 patients with a total of 140 dog ears over six months, 81% showed complete resolution without any treatment. Younger patients and women tended to see the most regression. Small dog ears, particularly those under 4 millimeters on the trunk or hands, are the most likely to flatten as the tissues heal and settle.
Because of this, most surgeons recommend a waiting period of at least six months before considering any revision. For dog ears under 8 millimeters in height, observation alone is the standard first approach. Rushing into a correction too early means you might undergo a procedure you never actually needed.
How Dog Ears Are Corrected
When a dog ear persists and bothers you, the size of the bump determines the approach. For moderate dog ears (under about 15 millimeters), surgeons can often fix the problem with suture techniques that gather the excess tissue and pleat it flat along the middle of the wound, without removing any additional skin.
For larger dog ears, or when suturing alone doesn’t work, a small surgical revision is needed. The most common method involves excising a triangular piece of the extra skin. In one widely used approach, the surgeon makes a short cut at a 90-degree angle to the end of the existing scar, lifts the excess tissue as a small triangular flap, trims it, and lays the skin flat. This technique corrects the dog ear without making the overall scar longer, which is a significant cosmetic advantage over older methods that simply extended the incision.
Other correction shapes include crescent-shaped or elliptical excisions, and a “hockey stick” technique where the new cut angles away from the original scar at about 120 degrees. The choice depends on the location, the amount of excess tissue, and the surgeon’s preference. Most dog ear revisions are minor procedures done under local anesthesia in an office setting, and recovery is considerably easier than the original surgery.
Cost and Insurance Coverage
Whether a dog ear revision is covered by insurance depends on why the original surgery was performed and whether the dog ear causes functional problems. If your initial procedure was medically necessary (a mastectomy for cancer, for example) and the dog ear causes irritation, chafing, or difficulty with clothing, insurance is more likely to cover the revision. If the original surgery was cosmetic, like a tummy tuck or facelift, the revision is almost always considered cosmetic as well.
Medicare, as a general rule, does not cover cosmetic surgery unless it’s needed because of accidental injury or to improve the function of a malformed body part. Most private insurers follow similar guidelines. Some plastic surgeons include one revision in their original surgical fee, so it’s worth asking about revision policies before your initial procedure. Out-of-pocket costs for a dog ear revision vary widely depending on the size and location, but because it’s typically an in-office procedure under local anesthesia, it’s far less expensive than the original surgery.
What to Expect if You Have One
If you notice a bump at the end of your incision in the weeks after surgery, the most productive step is patience. Give your body at least six months to heal. During that time, the tissue remodels, swelling resolves, and a significant majority of dog ears flatten without intervention. Wearing compression garments as directed can help the tissue settle more evenly.
If the dog ear is still present after six months and it bothers you, whether because of how it looks, because it catches on clothing, or because it creates a visible bulge under fitted tops, a revision is a well-established, low-risk fix. The procedure itself is brief, the recovery is measured in days rather than weeks, and the aesthetic results are generally excellent.