Dog Ears After Surgery: Causes, Symptoms and Treatment

A “dog ear” — also called a standing cone deformity — is a fold of excess or puckered skin that can form at the end of a surgical incision. It’s one of the most common reasons patients consider dog ear surgery after a procedure that removes a significant amount of skin, and it’s genuinely one of the easiest complications to correct. This guide covers what dog ears are, why they form, how to tell them apart from hypertrophic scarring, which procedures are most likely to cause them — including dog ears after tummy tuck, by far the most common context we see — and exactly how dog ear revision surgery works.

What Are Dog Ears After Surgery?

Following a procedure where an incision is made and then rejoined, some irregularity is completely normal in the early weeks as the skin and underlying tissue swell — this is often called a “pseudo-dog-ear” and generally settles on its own within three to six months as swelling resolves. In a smaller number of cases, genuine excess skin remains outside the incision boundary, creating a permanent puckered fold or nodule.

A dog ear isn’t a sign of poor surgical skill — it can occur even with a highly experienced surgeon, for reasons that aren’t always obvious at the time of the original procedure. Where it does occur, it should not be the deciding factor against having a procedure that would otherwise be genuinely beneficial, since it’s straightforward to correct with a simple scar revision procedure, either as a standalone treatment or alongside wider revision surgery.

Dog Ear vs Hypertrophic Scarring

These two concerns are often confused, but they look, feel, and are treated differently:

Dog Ear

• A puckering of excess skin forming a nodule, affecting the shape and contour of the surgical area
• Soft and flexible, the same tone as the surrounding skin
• Forms outside the incision border
• Caused by atypical healing and skin position after surgery

Hypertrophic Scarring

• An overdevelopment of scar tissue from excess collagen production during healing
• Firm and immobile, often reddened or darker than the surrounding skin
• Forms within the incision border
• Generally caused by genetic predisposition or tension on the incision during healing

What Are the Symptoms of a Dog Ear?

Dog ears typically become apparent within the first few weeks of recovery. Signs include:

• Skin puckering: a raised fold of skin, usually at the end of the incision, healing less evenly than the rest of the scar
• Uneven body contour: the raised or puckered skin affecting the overall shape of the treated area
• Discomfort: depending on location, the dog ear can catch or rub against clothing, causing irritation

Though it can feel like a minor, localised concern, a dog ear can genuinely affect confidence and satisfaction with an otherwise successful result — worth taking seriously rather than dismissing as purely cosmetic.

Which Procedures Cause Dog Ears, and Where Do They Form?

Any procedure that removes a significant amount of skin along a linear incision carries some risk of a dog ear forming at the ends. The location and likelihood depend entirely on the procedure:

Dog Ears After Tummy Tuck

By far the most common context we see. A tummy tuck (abdominoplasty) incision runs hip to hip, and dog ears after tummy tuck typically form at the outer ends where the incision meets the flanks. Risk varies by technique: a mini tummy tuck, with its shorter, more limited incision, carries lower risk than a full tummy tuck; an extended tummy tuck, which continues further around the flanks, and a Fleur-de-Lis tummy tuck, with its additional vertical incision, both carry a genuinely higher risk simply because more incision length and more tissue repositioning is involved.

Breast Reduction and Breast Lift

Following breast reduction or a breast lift, dog ears can develop at the outer end of the incision near the ribs, or at the inner end near the breastbone, particularly where a significant volume of tissue has been removed.

FTM/N Top Surgery

Following FTM/N top surgery, particularly a double-incision mastectomy, dog ears most often form towards the outer sides of the chest near the ribcage, or the inner sides near the sternum — the same anatomical pattern as breast reduction, since the incision and tissue removal are broadly similar.

Arm Lift

An arm lift (brachioplasty) incision runs the length of the upper arm, and dog ears can form at either end — near the armpit, or towards the elbow — where the incision has to taper to a close.

Thigh Lift

A thigh lift incision typically sits in the groin crease, and a dog ear can develop where it meets the inner thigh, particularly in patients with significant skin excess following major weight loss.

Buttock Lift and Body Lift

A buttock lift, or a more extensive lower body lift or upper body lift, involves a long, often circumferential incision — genuinely one of the higher-risk procedures for dog ears simply because of the sheer length of incision and the volume of tissue repositioned. This is a well-recognised trade-off of more extensive body contouring after major weight loss, and one we discuss openly at consultation.

Facelift and Neck Lift

Following a facelift or neck lift, dog ears can occasionally form underneath the ear or within the hairline, where the incision curves around the ear itself.

What Causes Dog Ears After Surgery?

Primarily, dog ears result from a large amount of skin being removed, creating an imbalance at the ends of the incision. A surgeon may sometimes leave a small dog ear deliberately, with a plan for it to settle naturally as part of expected healing — seeing one in the early weeks is not automatically a cause for concern.

Incision Shape

Where a curved incision is closed as a straighter line — often done deliberately to properly realign underlying tissue, distribute tension evenly, and reduce visible scarring — excess skin at the ends can bunch into a dog ear. Most resolve naturally; a minority don’t.

Tissue Imbalance

An imbalance between the amount of underlying fat and tissue versus the overlying skin can cause skin to gather unevenly at the ends of an incision. Getting this balance exactly right can be genuinely difficult even for a highly experienced surgeon.

Skin Quality

Reduced skin elasticity and tone increases the chance of a dog ear forming, since the skin is less able to remodel and settle into a smooth scar. This can result from:

• Significant weight loss: see our guide on loose skin vs fat for more on how skin laxity develops
• Pregnancy and breastfeeding: abdominal and breast skin stretches and retracts, affecting tone
• Ageing: collagen and elastin naturally break down over time

Reduced skin quality isn’t a barrier to a good surgical outcome, but it can make achieving a perfectly smooth, balanced incision more challenging. This is one reason why patients undergoing body contouring after weight loss — where skin quality is often more compromised than average — are counselled specifically about dog ear risk before surgery.

Swelling

Normal post-operative swelling can cause the temporary appearance of a dog ear in the early weeks, resolving as swelling settles — this “pseudo-dog-ear” is not the same as a genuine, persistent one.

Can Dog Ears Be Prevented?

Dog ears are often genuinely preventable through good pre-operative planning and post-operative care, though depending on the procedure and the amount of skin removed, it isn’t always possible to close an incision without a small dog ear forming initially:

• Surgical technique: precision liposuction at the incision ends can help underlying tissue lie flatter, reducing protrusion — this is a technique we frequently combine with tummy tuck and body lift surgery specifically to reduce this risk
• Silicone tape: commonly used post-operatively to reduce scarring and help skin fuse and remodel smoothly
• Compression garments: reduce swelling and help skin rejoin evenly
• Gentle massage: can help soften underlying tissue and smooth early puckering

If your surgeon anticipates any risk of a dog ear forming for your specific anatomy, they’ll discuss this with you before your procedure so you know what to expect and what aftercare steps to follow.

How to Get Rid of a Dog Ear

In the smaller number of cases where a dog ear doesn’t resolve with time and non-surgical measures, dog ear revision — a form of scar revision surgery, sometimes also called wound revision — is a straightforward procedure to remove it and refine the result of the original surgery.

We generally recommend waiting six to nine months before considering dog ear revision, since many resolve on their own or improve significantly with silicone tape and time before that point.

As a standalone procedure, dog ear surgery is most often performed under local anaesthetic and typically takes less than 30 minutes. The area is numbed, the excess skin is removed, and the incision is closed with fine sutures; where excess fat is contributing to the protrusion, targeted liposuction may be used alongside it to flatten the area further.

Dog ear revision can also be carried out as part of wider revision surgery, where other concerns from the original procedure are being addressed at the same time. This includes a revision tummy tuck alongside further abdominoplasty refinement, a revision arm lift addressing both the dog ear and residual laxity along the brachioplasty scar, or a revision breast procedure combined with a breast lift for shape correction. Where skin quality itself is a factor, some patients also benefit from BodyTite at the same time, to improve tightening of the surrounding tissue rather than relying on excision alone. For scar concerns beyond dog ears specifically — including keloid, hypertrophic, or acne scarring — our dedicated scar revision page covers the full range of options, including surgical excision, Z-plasty, Fotona laser, Morpheus8, and steroid injection.

Recovery After Dog Ear Revision

Recovery from dog ear revision is genuinely one of the more straightforward procedures we perform. Some bruising and mild swelling in the first few days is normal and settles quickly. Most patients return to light daily activity within a few days, and small incisions usually heal fully within three to four weeks. Strenuous exercise and heavy lifting should be avoided for around four weeks to protect the healing incision. Where dog ear revision has been combined with wider revision surgery, recovery follows the timeline of the larger procedure rather than the shorter standalone timeline. Keeping the area clean and dry, wearing any compression garment as advised, and attending your follow-up review all support the smoothest possible healing.

What to Expect at Your Dog Ear Consultation

If you’re concerned about a dog ear following surgery — whether performed at Centre for Surgery or elsewhere — your consultation will focus on establishing exactly what you’re dealing with before recommending anything. Your surgeon will physically examine the area, distinguish genuine excess skin from residual swelling, and check whether what you’re seeing is a true dog ear or, occasionally, early hypertrophic scarring that needs a different approach entirely.

Where surgery was performed elsewhere, we regularly see patients seeking a second opinion or tertiary revision care, and we’re happy to assess and advise even where we weren’t involved in the original procedure. Your surgeon will explain honestly whether time and non-surgical measures are likely to resolve things on their own, or whether revision is the more appropriate route given how long it’s been and how the area has progressed. There’s no pressure to proceed with surgery at this stage — many patients are simply seeking reassurance that what they’re seeing is normal, and that alone is often enough.

If revision is recommended, your surgeon will talk through exactly what the procedure involves, realistic expectations for the resulting scar, and the likely recovery timeline for your specific case, so you can make a fully informed decision before booking anything.

Frequently Asked Questions

Why Choose Centre for Surgery for Dog Ear Revision?

Dog ear revision at Centre for Surgery is performed by a GMC-registered plastic surgeon at our purpose-built, CQC-regulated Baker Street clinic, rated “Good” overall. Our surgeons perform the full range of procedures where dog ears can occur — tummy tuck, breast reduction and lift, FTM/N top surgery, arm lift, thigh lift, buttock lift, body lift, facelift, and post-weight-loss body contouring — so they bring genuine experience in both preventing and correcting them.

Pricing

Standalone dog ear revision under local anaesthetic is priced individually based on the area and extent involved, confirmed at consultation. Where it’s carried out as part of wider revision surgery, it’s included within the overall procedure quote. Your initial consultation is £100, redeemable against the cost of your procedure if you proceed. Finance is available through Chrysalis Finance, subject to status.

Book Your Consultation

Phone: 020 7993 4849
Email: contact@centreforsurgery.com
Address: 95-97 Baker Street, London W1U 6RN