Key Takeaways
- The primary reason for “dog ears” or puckering at lipo incision sites is excess skin and lack of elasticity. This is especially true when liposuction is performed, yet the skin does not retract uniformly.
- The surgeon’s experience is key In the end, it all comes down to the experience of the surgeon. Careful incision placement is critical, so make sure you go with a highly skilled, board-certified provider.
- Considerations Have open conversations with your surgeon regarding your skin quality, body type, and realistic expectations. This is key to developing a lipo plan that minimizes the potential for puckering to occur.
- By adhering to post-lipo care instructions—such as wearing compression garments and practicing designated massage techniques—you can foster more even healing, leading to optimal results.
- Mild cases can be treated with non-surgical modalities such as radiofrequency or ultrasound. More severe deformities should be corrected with surgical revision for optimal results.
- By setting realistic expectations and accepting that some imperfections will occur, you can be much happier with your liposuction outcome.
In summary, you can treat dog ears or puckering near liposuction incisions by focusing on the minor folds or lumps. These dog ears or puckers form at the ends of healing cuts after liposuction. These areas can look like squishy bumps or wrinkled skin.
Specifically, they tend to show up in areas where the skin hasn’t stretched tautly enough over the new form. Here in Los Angeles, it’s in areas with more lax skin that patients first begin to see these differences, particularly around the trunk area at the waist and hips. Most patients notice these immediately after surgery, but some develop as the swelling resolves.
Most surgeons resort to these fixes which include massage, taping, or minor revision procedures. Understanding these options allows patients in Southern California to better plan for their healing journey and be aware of what to expect. The following section details how and why these problems occur, as well as how physicians address them.
What Causes Lipo Dog Ears?
Dog ears are a common complication postpartum liposuction. They manifest as unacceptable dog ears, or indents of skin and fat appearing at or near the primary incision lines. Such changes can be evident immediately postoperatively. They can appear months later, as the body continues to heal and swelling subsides.
Knowing what causes lipo dog ears is an important step in preparation and expectation setting for anyone thinking about getting liposuction. There are a number of reasons—a combination of factors related to the body’s intrinsic characteristics and the surgical technique.
1. Excess Skin After Fat Removal
When fat is removed from underneath the skin, there tends to be excess skin left over that no longer has an area to cover. This excess skin may gather at incision sites, forming lipo dog ears. The risk is mainly determined by how much lipo fat is being removed.
It also depends on if the skin will shrink to cover the new shape. Every body responds differently. For instance, some individuals lose massive amounts of weight and are left with extra skin. On the other hand, there are those whose skin will bounce back beautifully.
To avoid having too much or too little skin left over, surgeons historically have to guess how much skin will be left. If needed, they can excise excess skin during the surgery.
Skin tightening alternatives—such as radiofrequency skin tightening, laser skin tightening, or even a surgical skin lift—can be performed to address sagging skin following lipo. These techniques help the skin to shrink and adjust to the body’s altered contours. Some individuals are prone to develop puckering. This is particularly relevant for patients whose skin was previously overstretched or atrophic before undergoing the surgical procedure.
2. Skin Elasticity Plays a Role
Skin elasticity is the skin’s ability to stretch and then return to its original state. When the skin is elastic, it has a greater chance of conforming rather than puckering post-lipo. Individuals with thicker, more pliable skin—usually younger patients or those who have undergone procedures like dog ear correction surgery—heal with much better results. Age, sun exposure, smoking, and genetics all impact skin elasticity. There are even proactive measures that can be taken to improve elasticity before surgery, such as regular moisturizing and staying hydrated.
Many dog owners also turn to collagen-boosting skin care or consult their surgeon on topical treatments that allow the skin to recover with greater efficacy. In the healing process, being attentive to spots that begin to crinkle or crease prematurely is key. In some cases, mild massage or the use of compression clothing can facilitate optimal healing and help direct the skin to settle more smoothly, especially after dog ear revision surgery.
Engaging in these practices can enhance the surgical outcome, making it essential for patients to follow postoperative care instructions. By focusing on improving skin elasticity, individuals can achieve a more pleasing appearance and meet their aesthetic goals effectively.
3. How Incision Placement Matters
The location of the incisions impacts their potential for how the skin will heal and whether lipo dog ears will appear. Proper incision placement, along natural skin lines or body curves, not only helps to conceal scars but minimizes tension at the wound margins.
For example, placing incisions in the folds under the arm or along the bikini line can help the skin pull evenly as it heals. Some common incision areas are the underside of the belly, inner thighs, and beneath the arms. Each area has its unique risks for pucker.
Longer incisions can radiate tension, reducing chance of folds, but potentially creating longer scars. The shorter the incision, the more potential it has to bunch up, particularly if a significant amount of fat is removed.
4. Surgeon Technique and Experience
A surgeon’s skill and know-how greatly influences the final appearance of skin after liposuction. As a rule, the more experienced your surgeon is, the better they’ll be at removing the appropriate amount of fat, but sculpting the skin.
They can employ additional contouring while in surgery to flatten problem areas that can create dog ears. Reviewing patient reviews and before-and-after photos from previous patients can give you an idea of what you can expect from a particular surgeon.
During in-person or video pre-surgery consults, individuals can inquire about the surgeon’s approach to contouring and skin management techniques. This goes a long way towards creating clear expectations and lessening surprises.
5. Wound Closure Methods Impact
Proper wound closure technique can influence final scar quality and dog ear development. Different closure methods like stitches, staples, or surgical glue each have their advantages and disadvantages.
Here’s a simple table:
| Closure Method | Pros | Cons |
|---|---|---|
| Stitches | Strong hold, good for tension areas | May need removal, scar risk |
| Surgical glue | Quick, less scarring for small wounds | Not for high-tension spots |
| Staples | Fast, good for large areas | More visible scars |
Good surgical closure can help distribute tension, preventing the skin edges from rolling or forming a ridge. Should the surgical closure become too tight or uneven, puckering may occur. The best technique varies based on the location, quality of skin and how much tissue was excised.
6. Your Body’s Healing Response
Everyone has a different healing process. For some, the swelling resolves and the dog ears disappear over a few months, while others find that the puckers remain. Monitoring for signs such as increased swelling, pain or delayed healing is a good idea.
So, healthy habits—plenty of restorative sleep, nourishing whole foods and no tobacco—are key to letting the body heal itself optimally. If issues do appear, the medical team might recommend massage or increased compression. Sometimes, they will even suggest a minor revision surgery to repair persistent dog ears.
7. Underlying Tissue Factors
The tissue supporting the skin plays a role as well. Thick layers of fat or uneven liposuction can lead to dog ears. Muscle tone determines the body’s contour, thus weak or lax musculature may not provide a firm substrate for taut skin.
Individuals with a history of surgery in the field may have fibrotic or indurated tissue, increasing the susceptibility to puckering.
Preventing Dog Ears Before Surgery
Dog ears—small bulges of skin at the ends of lipo incisions—can be avoided when patients and surgeons plan ahead together. It begins well before surgery, with honest conversations and smart choices. Choosing the best surgeon is key.
Being upfront about your skin and surgical goals, in addition to informed pre-operative planning, can go a long way in reducing the risk.
Choosing Your Surgeon Wisely
Body contouring should be a top priority. Not every surgeon has the same body contouring mindset. Verify and ask for specialization; board certified is a must and ask to see those who specialize in lipo and lipo abdominoplasty.
Interview several, inquire about their methods to avoid dog ears forming and request to see before-and-after pictures. Some surgeons use the 3:1 rule—keeping the scar length at least three times the height of the skin being removed lowers the chance of puckering.
Some utilize unique angles, such as 30-degree corners, to eliminate dog ears. An experienced surgeon will anticipate where incisions will be hidden, low and inconspicuous, and lengthen scars only if absolutely necessary.
Honest Talk About Skin Quality
Flank and love handle lipo, as an example, can increase the chances of dog ears if you have loose skin. During your consultation, have an honest conversation regarding scarring, healing, and the limitations of your skin.
Inquire about how skin can be prepared—often there are treatments that can increase elasticity ahead of surgery.
Pre-Op Planning and Design
Coordinate with your surgeon to develop a plan of where incisions will be made and how much excess skin will be excised. These drawings or mock-ups go a long way toward establishing clear design goals.
Know the risks: when the abdominal skin taken is tall compared to the scar, dog ears can show up. When you follow all the pre-op planning and design steps, you create better results and save on unexpected costs.
Surgical Techniques to Minimize Risk
Fixing dog ears or puckering around lipo incisions often involves a detailed preoperative surgical plan, particularly in dog ear revision surgery. Skilled plastic surgeons in the U.S. focus on prevention, employing tried-and-true techniques to ensure optimal healing, resulting in a smooth and flat appearance. The surgical approach may vary based on each patient’s specific cosmetic concerns.
Smart Incision Design Choices
Selecting the shape and location of an incision can have a tremendous impact. Surgeons often use the 3:1 rule—making sure the scar length is at least three times the height of the removed skin. This allows the skin to rest flat and minimizes puckering.
For abdominoplasty, ensuring that incisions are as low and hidden as possible are the norm in Los Angeles and throughout the U.S. Angles play an important role. When two incisions intersect, surgeons choose angles greater than 30 degrees to reduce dog-ears.
Some employ a fusiform (football-shaped) excision that tapers to 30 degrees. This allows the edges of the skin to come together evenly.
| Incision Type | Risk of Dog Ears | Visual Result |
|---|---|---|
| Straight | Moderate | Easier closure |
| Curved | Low | Follows body lines |
| Fusiform (30°) | Lowest | Flat, smooth edges |
Careful Tissue Handling Methods
Careful tissue handling techniques demonstrate the value we place on the body’s ability to heal itself. Maintaining a robust blood supply is essential.
Best practices include:
- Use light touch; avoid pulling or squeezing tissues.
- Keep tissues moist during surgery.
- Work in layers, not all at once.
- Watch blood flow while closing.
These precautions reduce inflammation and tissue necrosis, making puckering less likely to occur.
Advanced Closure Techniques
Systematic, layered closure first closes underlying skin in horizontal steps. This provides the wound with additional tensile strength and encourages the resulting scars to heal thin and flat.
Most surgeons place deep sutures or stitches under the skin before closing the skin over the top. Good closure habits include:
- Use absorbable stitches for deeper layers.
- Place skin stitches with even tension.
- Avoid tying knots too tight.
- Remove stitches on time.
The way a wound is sewn up makes a big difference in the appearance of the scar. Scars tend to have the best appearance if treated in the first three months. If dog ears appear, a minor revision procedure is possible once swelling subsides.
Post-Lipo Care for Smooth Results
Quality post-lipo care has a direct influence on how well your skin heals. It reduces the risk of puckering or “dog ears” around your incisions. Healing does take time, so don’t expect immediate results. It may take several months for the final shape to appear.
Aftercare after lipo, healthy habits and diligent follow-up steps greatly influence how smooth your results become.
Importance of Compression Garments
Wearing compression garments reduces swelling and in turn, promotes new, beautiful body lines. Compression garments are designed to hold the skin tight against the tissue below it. In LA, most doctors recommend wearing these for a minimum of four to six weeks, if not longer.
Waist-high, high-waist shorts and full-body styles are popular choices. So it’s all about the fit! Of course, a garment that’s too loose will be ineffective. One that’s overly tight will do you more damage than benefit.
Massage Techniques May Help
A few minutes of gentle massage each day can help smooth the skin and possibly reduce the risk of puckering. Gentle rolling and circular movements aid in fluid movement and softening of hardened areas. Lymphatic drainage, gentle tapping, and light kneading techniques are typical.
Many feel that the money spent on a single session with a qualified therapist results in the most efficient healing time. Typically the initial massages begin around the two-week post-op mark, and just two to three brief sessions per week can make a significant difference.
Follow Your Surgeon’s Advice
Going forward, don’t plan to do anything except always follow your surgeon’s advice. This may involve specific instructions for wound care, limits on activity levels, and guidance on maintaining a healthy diet.
A checklist may look like: wear your garment, keep wounds clean, avoid heavy lifting, and watch for odd swelling. Stay connected to your physician, and be present for routine follow-up appointments.
If you notice unusual bumps, puckering, or redness, contact your physician immediately. Remember that healing takes time. Some problems appear late, and they can sometimes be easily corrected.
Non-Surgical Ways to Improve Puckering
Post-liposuction, these puckers, known as “dog ears,” frequently appear around the incision sites. This redundant skin or tissue may be superficial or more profound. In Los Angeles, we have a large number of women who are looking for non-surgical ways to improve these puckering areas.
Fortunately, mild dog ears usually resolve themselves over a period of a few months. Non-surgical treatment options are available, and it is essential to keep scars clean and take care of them during the first three months. This results in more level scars, reducing the likelihood of puckering.
Radiofrequency or Ultrasound Treatments
Radiofrequency and ultrasound treatments are non-surgical skin tightening methods that can also help with dog ear correction surgery. Devices such as Thermage and Ulthera deliver heat to the skin, promoting collagen development and tightening mild to moderate puckering. This procedure effectively addresses minor cosmetic concerns and is suitable for patients with mild dog ears, offering a pleasing result without the need for invasive surgery.
These nonsurgical techniques are relatively safe for all skin types and require little recovery time. For optimal healing, patients may need a series of treatments spaced weeks apart to achieve their desired outcomes. Ultrasound therapy, like Ultherapy, penetrates deeper into the dermis, making it an excellent choice for those seeking to enhance their body contour while minimizing discomfort.
Both techniques carry minimal risk, although some redness or swelling may occur for several hours afterward. Patients in Los Angeles have enjoyed improved skin texture thanks to these advancements, showcasing how effective they can be for achieving aesthetic goals and addressing issues like dog ears.
| Treatment | Sessions Needed | Downtime | Effectiveness | Patient Satisfaction |
|---|---|---|---|---|
| Radiofrequency | 3-6 | None | Mild-Moderate | Moderate |
| Ultrasound | 2-4 | None | Mild | Moderate |
| Massage/Taping | Ongoing | None | Mild | Low |
Limitations of Non-Surgical Fixes
Non-surgical fixes are making a difference, but not enough to produce major results. Contractures that are mild produce the best results, and it takes time to see improvement. Others require several treatments to achieve the aesthetic they desire.
Non-surgical options may fall short when dog ears are large or firm, the skin is very loose, or there is a lot of leftover fat. Surgical revision is typically much more straightforward.
It can be less expensive long term, as non-surgical treatments tend to be expensive and time-consuming.
When Surgical Revision is Needed
Dog ears or puckering around liposuction incisions usually present as a dog-eared look or puckered skin at the end of scars. For others, these little bumps may persist as they continue to heal over time. When they go wrong, though, often revision surgery is the only option to make things right.
Revision is only needed in two scenarios. It is necessary when the incision is short relative to the excised tissue or when medium dog ears remain after the initial months. A key concern for many folks who have had double incision top surgery is the appearance of dog ears. Indeed, research confirms this is the leading reason patients pursue a second procedure.
Surgeons carefully calculate their incisions so as to avoid creating this threat. Even with all the extra preparation taken, puckering can still happen—especially when the skin edges aren’t straight or flat or if there’s loose skin from several previous surgeries.
What Revision Surgery Involves
Revision surgery for dog ears is a precise repair. The process usually involves cutting away surplus skin and sewing the surrounding area back together with the edges aligned or flat. Compared to the original surgery, revision is usually much more minimal and not as involved.
Wedge excision, scar lengthening, and limited liposuction are common techniques. Most revision surgeries are finished within a few hours and allow you to return home the same day. Recovery is shorter—typically one to two weeks.
Timing Your Revision Procedure
Surgeons typically recommend a wait of 6-9 months post-lipo before doing a revision. This allows swelling to decrease and tissue to relax, which may allow small dog ears to resolve on their own. Important factors to consider include how well your scar is healing, your skin elasticity, and your comfort level.
Surgeons will recommend scar management for several months prior to re-operation.
Understanding Revision Outcomes
Understanding Revision Outcomes Results of surgical revision are highly variable. Healing, skin type and how your body heals all play a factor in the outcome. Risks such as infection, additional scarring, or skin irregularities may occur but are usually mild.
Most patients experience increased confidence and comfort following their repair.
Managing Expectations About Results
You could say the same about any surgical procedure, whether it’s a liposuction or a tummy tuck, infusing each procedure with both excitement and trepidation. Patients generally desire flawless, unblemished skin, but the actual outcome is usually more aligned with consistent, progressive improvement.
Dog ears” or puckering around lipo incisions show up as little folds or bumps of excess skin. As a result, they often form at the distal ends of cuts. It’s human nature to want the outcome to appear perfect, but nature heals bodies in imperfect ways.
An optimistic yet realistic mindset sets patients up for success—and will help them achieve the most from their surgery. After all, improvement over the status quo should take precedence over pursuing some unrealistic perfection.
Typical expectations are a smooth abdomen, scars that you can’t see, no skin redundancy, healing in a week or two. Or that stretch marks will disappear. Or that results will be permanent. Establishing clear, realistic goals will mitigate disappointments and increase overall contentment.
Perfection vs. Improvement Mindset
An improvement mindset, rather than a perfection mindset, helps keep the ride fun and fulfilling. As with any surgery, bodies will continue to change over the course of weeks and months. Scars can be several inches above the lower abdomen and take time to heal and fade.
Undergoing surgery can’t guarantee that all stretch marks or loose skin will disappear. Try these reminders:
- “Healing is a process.”
- “My body is stronger every day.”
- “Small changes add up.”
Reducing the expectation of perfection allows room for what actually happens, which often brings more peace and satisfaction.
Discussing Potential Imperfections Early
Open conversations with your surgeon prior to surgery are key. Other important matters to discuss are scar location, folds of skin, time to heal, potential dangers, and work necessary to achieve optimal results.
Trust is earned when both client and provider acknowledge the limitations of surgery as an answer.
Trusting the Healing Process
Trusting the healing process is essential after procedures like dog ear revision surgery. Recovery takes time—final results can take many months, especially with surgical interventions that involve body contouring. Respecting the healing process is crucial, as healing time is different for everyone, particularly after cosmetic surgery.
Good self-care plays a vital role in the recovery from dog ear correction surgery. Staying in touch with your skilled plastic surgeon helps ensure you have the support you need and can recognize any cosmetic concerns early on. Following postoperative care instructions is key to achieving a pleasing result.
- Wear your compression garment.
- Eat balanced meals.
- Stay active, as advised.
- Go to all follow-up visits.
Remember that the dog ear revision surgery cost varies, and understanding your surgical approach can help set realistic patient expectations. Engaging in good self-care not only aids in optimal healing but also contributes to the overall aesthetic goals you have for your new contour.
Conclusion
Dog ears or puckering near lipo incisions are complications that occur more frequently than people realize. Fortunately, most surgeons in the U.S. Employ some tested, proven methods to prevent these bumps both prior to and following surgery. Proper preparation, intelligent surgical technique, and diligent post-op care contribute to a flawless result. Non-surgical fixes, including massage or skin-tightening devices, are effective as well, but occasionally a minor revision is the most efficient solution. Everybody else just heels and moves on with their lives. The skin’s elasticity, age and healing process affect the outcome tremendously. Have concerns about what you’re experiencing post lipo? Contact a local, board-certified surgeon today. They’ll brainstorm, provide constructive criticism and put together tangible concepts that align with your vision.
Frequently Asked Questions
What are “dog ears” after liposuction?
What are “dog ears” after liposuction? Dog ears, which can be addressed through dog ear revision surgery, occur when there’s an irregularity in the way excess skin fails to retract after liposuction, creating a bulge or raised area.
Are dog ears common after liposuction?
Are dog ears, a common concern after procedures like liposuction, a side effect? The risk is minimized by proper technique and skilled plastic surgeons performing the surgery.
Can dog ears go away on their own?
Occasionally, mild dog ears do resolve on their own with reduction in swelling and accompanying skin tightening over a few months, but deeper folds may require dog ear correction surgery for optimal healing.
How can I prevent dog ears before surgery?
Work with a board-certified plastic surgeon in Los Angeles who specializes in dog ear revision surgery to achieve optimal healing. Maintaining stable weight and good skin elasticity can significantly reduce the risk of complications during this minor procedure.
What non-surgical options help with puckering?
Massage, skin-tightening treatments, and compression garments are effective for mild puckering after procedures like dog ear revision surgery. To achieve the best results, always follow your surgeon’s recommendations.
When is revision surgery needed for dog ears?
If dog ear correction surgery is needed after the skin heals, your surgeon will assess the situation and recommend the best approach to achieve a flatter contour and optimal healing for excellent top surgery results.
How long does it take for swelling and puckering to resolve?
Swelling and a bit of puckering usually improve over three to six months, as time and tenderness are essential for achieving excellent top surgery results.