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Written By: Dr. Ahmad Saad, Health Content Writer
Medically Reviewed By: Dr. Gopal Grandhige, MD, FACS, Board-Certified Surgeon
Last Reviewed: May 19, 2026
Dog ears after a tummy tuck are caused by excess skin that bunches or folds at the ends of the abdominal incision during closure. They form at the lateral edges of the cut the transition point where skin removal stops and are one of the most predictable complications of abdominoplasty when surgical technique doesn’t account for them. Knowing what drives this outcome helps patients ask the right questions before choosing a surgeon, and resources like the American Society of Plastic Surgeons offer useful patient safety guidance when researching procedures.
Several factors contribute to dog ear formation: the amount of loose skin being removed, the natural limitations of skin elasticity, and how the surgeon handles the incision endpoints at the close of the procedure. The more redundant skin a patient has going in, the longer the incision needs to be and the higher the likelihood of puckering at the ends if not actively managed during surgery. Patients exploring body contouring options will find that this risk is consistently noted across abdominoplasty literature. Weight history and body composition also play a role. The Harvard Health resource on diet and weight management outlines how these factors affect skin quality over time.
At Formation, Dr. Gopal Grandhige treats dog ear prevention as a non-negotiable part of every abdominoplasty. Before closing, he inspects and corrects any skin irregularities directly on the operating table using liposuction or direct excision. For patients who develop minor puckering during the healing phase, treatment options range from compression garments to a minor in-office revision.
During an abdominoplasty, excess skin and fat are excised through a lower abdominal incision. This incision sits roughly in the same position as a C-section scar typically near the upper edge of the pubic area and extends outward toward the hips. Its length depends on how much redundant skin needs to be addressed. Dog ears develop at the lateral ends of this incision: folds or flaps of skin that fail to lie flat against the body, creating visible puckering at the incision corners. Patients considering abdominoplasty for men or women should understand this risk as part of their pre-surgical research.
These folds are a well-documented risk following a tummy tuck. They aren’t painful or medically dangerous; they’re simply an aesthetic concern. Other procedures can produce similar scarring issues. C-section scars, for example, frequently pucker or become indented over time, and surgical correction may be needed to improve their appearance. The Cleveland Clinic’s overview of body contouring covers how incision placement and skin quality affect surgical outcomes across multiple procedures.
Dr. Gopal Grandhige performs a high volume of tummy tucks each year alongside Dr. Ahmad Saad, and the surgical team at Formation applies meticulous attention to technique to deliver the best possible outcomes. Abdominoplasty is one of Dr. Grandhige’s primary areas of focus. So what does his approach look like when it comes to minimizing or eliminating dog ears?
Prevention happens at the very end of every abdominoplasty. Before closing, Dr. Grandhige inspects the incision line for any skin flap, loose tissue, or puckering. The most effective way to avoid a dog ear is to actively look for it on the operative table and address it before the procedure is complete. Two primary methods are used: liposuction or direct excision. The first step is to use liposuction for men techniques or comparable approaches to flatten any pucker by removing excess fat so the skin lies smooth. If that isn’t sufficient, the incision is extended slightly and the excess tissue is excised. Both techniques are essential to preventing dog ears surgically, and they carry a high success rate in Dr. Grandhige’s experience. Research published in peer-reviewed surgical literature supports active intraoperative management of lateral incision endpoints as best practice.
That said, the risk never reaches zero. No tummy tuck leaves the operating table with visible puckers or dog ears on the surgical table, that rate is zero. But healing doesn’t always follow a straight line. Poor skin elasticity during recovery can allow small dog ears to develop even after a clean closure. This is one of the more frustrating realities of the procedure: the transition zone where skin removal ends is inherently vulnerable to minor puckering despite a technically sound operation. Patients curious about how body composition and weight history affect skin elasticity may find the NIDDK’s weight management resources a helpful reference point.
Surgeons who don’t actively address this area during closure are more likely to produce large dog ears as a result of inadequate technique. By making zero dog ears at closure a non-negotiable standard, the vast majority of patients who undergo procedures through Formation’s men’s aesthetic surgery program or women’s services avoid the issue entirely. Even so, small ones can occasionally develop during healing and may require follow-up treatment. Reviewing the Formation before and after gallery gives prospective patients a realistic view of surgical outcomes and scar placement.
The treatment approach closely mirrors the prevention methods used during surgery. The first line of treatment, however, is compression wraps. Post-operative swelling and bruising can cause puckering and unevenness along the ends of the incision. This is a normal part of healing and is managed with an abdominal binder or compression garment. At Formation, patients are instructed to wear the binder firmly after drain removal though it should not be worn tight in the early post-op period until specifically directed. Compression garments play a critical role in recovery by helping the body expel excess fluid, reduce swelling, and minimize bruising. For small areas of puckering, they carry a high success rate in flattening out irregularities. Patients who have undergone body contouring after bariatric surgery are often especially familiar with how compression supports post-surgical healing.
Compression also directly benefits the scar itself. Pressure from the binder is one of the single most important factors in achieving a flat, well-healed incision after surgery. It supports collagen remodeling and encourages the scar to settle smoothly. Burn patients with severe scarring are often instructed to wear compression over affected areas for a full year or more the same principle applies to tummy tuck recovery. Consistent compression wear is non-negotiable for the best possible outcome, a philosophy that aligns with Formation’s approach to surgical care.
Even with precise surgical technique and diligent compression use, some patients will still develop dog ears. When that happens, the primary treatment options are liposuction or surgical revision both performable under local anesthesia. Patients who want a minimally involved recovery may be good candidates for awake liposuction as a corrective approach. In some cases, targeted liposuction is enough to smooth the area. Others may need a minor surgical revision where a small amount of additional skin is excised. Either way, recovery is typically straightforward. The FDA’s General and Plastic Surgery Devices Panel provides additional regulatory context on the tools and devices used in these corrective procedures.
The psychological dimension of body image recovery is also worth acknowledging. Research from Psychology Today on body image highlights how visible post-surgical irregularities even minor ones can affect a patient’s confidence and satisfaction with results. For younger patients or those still forming their relationship with their appearance, KidsHealth’s body image resource offers additional perspective on how physical changes intersect with self-perception. Addressing dog ears promptly and effectively is part of delivering outcomes that hold up both physically and emotionally. Patients can read more about procedure-specific outcomes on the Formation blog or explore whether high-definition liposuction is an appropriate complement to their abdominoplasty plan.
Patients recovering from a tummy tuck who are also interested in complementary procedures can explore options like BBL for men or Botox for men to further refine their overall aesthetic result once fully healed.
Dog ears are a known risk of abdominoplasty, but they are far from inevitable. With the right surgical technique actively inspecting the incision line at the close of every procedure and addressing any puckering before leaving the operating table the overwhelming majority of patients finish their tummy tuck without this complication. At Formation, Dr. Gopal Grandhige treats zero dog ears at closure as a standard, not a goal. For the small number of patients who develop minor puckering during recovery, effective solutions exist: compression garments, liposuction, or a minor surgical revision. Understanding this complication ahead of time allows patients to set realistic expectations and take an active role in their recovery starting with something as straightforward as wearing their compression garment consistently. To learn more or schedule a consultation, contact Formation directly.
Not necessarily. Small dog ears that develop during healing can often be resolved with consistent use of compression garments. Those that persist may require a minor in-office procedure such as liposuction or surgical revision.
Dog ears are not painful or medically harmful. They are purely an aesthetic concern folds or puckers of skin at the ends of the incision that simply don't lie flat. Most patients describe them as bothersome in appearance rather than physically uncomfortable.
They typically become noticeable during the healing phase, after post-operative swelling begins to subside. In some cases, what initially looks like a dog ear is actually swelling that resolves on its own with compression.
Yes, in many cases. Compression garments are the first treatment approach and carry a high success rate for small puckers. When compression alone isn't enough, liposuction under local anesthesia is often sufficient to smooth the area without a full surgical revision.
Recovery from dog ear treatment is typically quick and straightforward. Most patients return to work and daily activities shortly after the procedure. Compression is worn afterward to support healing and optimize the final result.
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