The DIEP flap procedure is a popular choice for breast reconstruction because it uses your own abdominal skin and fat, which preserves muscle integrity and provides a natural look and feel. However, a common issue that arises post-surgery is the formation of dog ears—excess skin and fat at the ends of the incision. These can affect the overall aesthetic results, which can keep you from appreciating the true aesthetic results of your surgery. In this article, we discuss the factors that can lead to DIEP flap dog ears and how they can be managed or corrected.
What are DIEP flap dog ears?
Dog ears are a common occurrence following DIEP flap breast reconstruction surgery. They refer to small folds or protrusions of excess skin and fat at the ends of the surgical incision. These can appear raised and are named “dog ears” because they resemble the ears of a dog. They are a cosmetic concern rather than a medical one and can cause some discomfort or dissatisfaction with the overall appearance of the surgical site.
In most cases, dog ears develop due to the way the skin heals and settles post-surgery. While they may resolve on their own over time, some patients may need additional treatments or minor corrective surgery to smooth out these areas.
Why do dog ears develop?
Dog ears develop due to a combination of factors related to skin healing, the extent of tissue removal, and the surgical technique used. Here’s a closer look at the primary reasons:
Skin elasticity
Your skin’s ability to stretch and return to its original shape can vary based on age, genetics, and overall skin health. If your skin is less elastic, it might not conform smoothly to the new contours created by the surgery, leading to excess skin gathering at the ends of the incision. This is particularly noticeable in areas where the skin has been stretched significantly or where there is a substantial amount of redundant skin post-reconstruction.
Amount of tissue removed
When a large volume of tissue is taken from the abdominal area to reconstruct the breast, it leaves a considerable void. The remaining skin and tissues must be re-draped and sutured, which can sometimes result in puckering or folds at the ends of the incision. Our surgeons balance removing enough tissue for effective breast reconstruction while maintaining as much of the surrounding tissue integrity as possible to ensure a smoother, more natural contour.
Incision length and shape
Longer or curved incisions tend to have a higher risk of developing excess skin at the ends. The way the incision is closed and the tension applied during suturing can influence how the skin heals and settles. Our surgeons use various techniques to manage incision length and shape, such as using curved or angled incisions that follow natural body lines. Post-surgery care, including proper wound management, can further help ensure that the skin heals evenly.
Healing process
Each person’s body heals differently, and factors like wound care, physical activity, and overall health can impact how well the skin and tissues settle after surgery. Swelling and changes in the body’s contour as it heals can cause the skin to gather at incision ends. Following all post-operative care instructions is crucial. This includes managing swelling, avoiding strenuous activities that might stress the incision, and keeping the surgical site clean and well-moisturized to promote optimal healing.
How to correct dog ears?
Massage therapy
Massage therapy can be an effective non-surgical approach to managing dog ears. Gentle, regular massage around the affected area can help redistribute the skin and improve its appearance. This method works by promoting blood flow and encouraging the skin to conform more smoothly to the underlying tissues. Your surgeon or a trained therapist can demonstrate the appropriate massage techniques. To avoid complications or infections, start this therapy only after your incisions have fully healed.
Compression garments
Wearing compression garments post-surgery can help manage dog ears by applying consistent pressure to the area. This reduces swelling and promotes a smoother contour. These garments are designed to support the tissues as they heal and can be especially beneficial during the initial recovery phase. Your surgeon will recommend the best type and duration for wearing compression garments. Ensuring a proper fit is crucial, as too much pressure can cause discomfort, while too little may not provide the desired effect.
Scar management products
Scar management products, such as silicone sheets and gels, can improve the appearance of dog ears. These products work by hydrating and flattening the skin, reducing the prominence of any folds or protrusions. Silicone sheets can be worn under clothing and are easy to use daily. Combining these products with other treatments like massage therapy can enhance their effectiveness. Always follow your surgeon’s advice on when to start using these products to avoid interfering with the healing process.
Surgical correction
In cases where non-surgical methods are insufficient, a minor surgical procedure may be required to correct dog ears. This procedure, often performed under local anesthesia, involves excising the excess skin and fat to create a smoother contour. The incision is then carefully closed to minimize the risk of recurrence. Choosing an experienced surgeon, like those at the New York Group for Plastic Surgery, for this correction is crucial to achieving optimal results.
By choosing a practice like the New York Group for Plastic Surgery for your DIEP flap reconstruction, you can confidently restore your desired contours with natural-looking results. Please schedule a consultation if you need help managing the DIEP flap dog ears.
