Dog Ear Revision After Plastic Surgery: What to Expect

Medically reviewed by Brianna Smith on April 6, 2026.

A dog ear is a protrusion of tissue that can develop in areas where an asymmetrical shape or a large amount of tissue is removed. This results in the formation of long or uneven incisions that are closed under tension, leading to a puckering of skin that looks like a dog’s ear. This may be seen with patients who have had tummy tucks (or abdominoplasty), breast lifts, breast reductions, and mastectomies or top surgery.

We recommend that patients wait at least 6 months after top surgery for their swelling to subside, so we can determine if dog ears will require surgery to remove. After 6 months, all GCC patients can request a dog ear revision procedure, no matter how small the dog ears are. If the procedure is solicited 12 months after the initial surgery, we will waive your surgical fee.

What is a Dog Ear?

For top surgery patients, dog ears refer to the puckering or bunching up of excess tissue, usually located at the sides of the chest near the armpit. Rarely, they may also appear near the center of the chest. This concern is most common among patients who have undergone a double incision top surgery and had large amounts of tissue removed.

For a visual explanation of why dog ears happen and how they can be removed, you can watch this video, created by Dr. Mosser.

Why Might I Want a Revision to Remove Dog Ears?

A dog ear removal is one of the most common reasons for a revision after top surgery. Dog ears can cause aesthetic concerns or discomfort such as dysphoria or chafing against the arms. We accommodate patients’ preferences for pursuing a revision towards dog ears of any size

Requesting a Surgical Removal of Your Dog Ears

Before seeking a revision procedure, we recommend that patients wait 6-9 months after top surgery. Oftentimes, dog ears may disappear within the first 3-6 months post-op as swelling subsides (aka ‘false dog ears’). If dog ears are actually a result of excess tissue, they will remain after the recovery period and can be removed in a later revision surgery.

Why do Dog Ears Happen After Top Surgery?

Dog ears are not the result of an error or complication after surgery, but rather, a common outcome based on the following factors:

Amount of Tissue Removed

• Larger amounts of tissue removed can increase the risk of dog ears. When larger amounts of tissue on the chest are removed, longer incisions need to be pulled closer together. This results in wound closure with excess tension.

Prior Breast Reduction Procedure

• Patients who have undergone a breast reduction before top surgery will likely have excess skin or tissue that puts them at increased risk for dog ears. The incisions may need to be extended laterally or joined near the center, resulting in one long incision across the chest. You can read more about joining incisions at the center of the chest here.

Age, Weight, and Skin Quality

• As we age, our skin becomes less elastic and smooth resulting in loose skin. In addition, dramatic weight loss can leave excess skin behind which may require removal of a larger surface area of skin. Having looser, less elastic skin can increase the likelihood of dog ear formation.

Can Dog Ears be Prevented?

Dog ears cannot always be prevented. For some patients, not all loose or excess skin can be removed in the first surgery, making dog ears almost a certainty. For patients who have less excess skin that needs to be removed, the chances of dog ears may be lower. Ways to considerably minimize the chances of having dog ears in top surgery include:

Incision Length 

Having a slightly longer incision, which may extend further towards the back or joined in the center of the chest may prevent dog ear formation

Tissue Volume & Weight Fluctuation

The more tissue removed during surgery, the higher the likelihood of patients developing dog ears. Significant weight loss, which leads to excess or loose skin can also contribute to dog ear formation due to the need for more skin removal.

Patient Compliance

Following your top surgeon’s post-op care instructions is very important to minimize the risk of dog ears. That said, even with optimal surgical technique and post-op compliance, some patients will still develop dog ears.

How are Dog Ears Treated?

While some dog ears may resolve spontaneously as inflammation subsides, dog ears are generally treated with a revision procedure after top surgery. It is recommended to wait 6-9 months after top surgery before considering a dog ear revision to allow for any swelling to resolve. 

What to Expect? From the Consultation to the Revision

The amount of excess tissue left behind will help determine the appropriate type of revision procedure. During a free consultation, one of our board-certified surgeons will make an assessment about which procedure type would be best suited to remove your dog ears.

Generally speaking, dog ear revision procedures are short and straight-forward. If general anesthesia is required, patients will likely undergo the revision in an ambulant surgical center. Otherwise, the revision can be performed in-office. Either way, patients can expect to go home soon after the revision.

Liposuction

This procedure can remove any excess fat, but will not affect removing excess skin. Depending on the remaining excess tissue, this procedure may limit the amount of tissue removed.

Excision Under Local Anesthesia

Dog ears less than 5 inches in length may be removed under local anesthesia. This means that the area will be injected with a numbing solution and the patient will be awake during the procedure. If preferred, this can also be done under general anesthesia.

Excision Under General Anesthesia

Some sedation might be required if the dog ears are 5 inches or more in length. After this revision, the contour of the incision is typically close to perfect. The easiest way to see the treatment is by watching this video on dog ears that Dr. Mosser has created.

Dog Ear Revision Surgery: Before and After Photos

Recovering from a Dog Ear Revision

Recovery from a dog ear revision is generally easier than recovering from a top surgery procedure since less tissue is removed. You can keep the following points in mind for the healing process:

• Pain is typically minimal and can be managed with over-the-counter medications.  
• We encourage patients to take up walking after the operation and avoid strenuous activity until 6 weeks have passed.
• Drains are usually not required unless a larger amount of tissue is removed.
• Patients may opt for an earlier post-op appointment (after 3 days) to remove bandages and can usually shower after the incisions have been assessed.
• Swelling is still expected so a post-op binder may need to be worn. Some surgeons will also recommend that their patients follow a low-sodium diet to minimize swelling. 
• Keeping incisions clean with your usual routine hygiene (e.g., showering). Contact your surgeon if any redness, swelling or warmth is observed. 
• Scar care treatments and scar massage can begin 3 weeks after the procedure to help reduce scar texture and discoloration.

Cost of Dog Ear Revision

Patients who have successfully had their top surgery covered by insurance will typically have the revision covered. For patients who paid for their initial surgery with the GCC entirely out-of-pocket, the surgeons’ fees for revisions may be waived; this fee waiver is available to patients who request their revision before the 12 month pos-top mark. However, other fees such as those for the facility and anesthesiologist are not waived and must be paid.

Conclusion

• Dog ears are sometimes seen after a double incision top surgery when large amounts of tissue are removed.
• You can talk to a surgeon in a free, virtual consultation about how to minimize, prevent or remove dog ears based on your anatomy. 
• Since some dog ears may resolve spontaneously, it is recommended to wait 6 to 9 months after top surgery to determine if a revision is necessary.
• Most dog ear revisions are accomplished by surgically removing the excess tissue under anesthesia, depending on how much tissue is present.
• Patients who get their top surgery covered by insurance have a good chance of getting their revision procedures covered as well.
• You can watch this animated video to learn more about dog ears in detail.

Sources

• Kang, AS,  Kang, KS. A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm. Plastic and Reconstructive Surgery – Global Open 8(9):p e3102, September 2020. | DOI: 10.1097/GOX.0000000000003102