Pearls to Manage Dog-Ears

Dr. Zena Nawaz, a surgeon at Baylor, discussed techniques for managing dog ears, which are common issues encountered in cutaneous surgery. She highlighted the key factors influencing dog ear formation, including tissue dynamics and surgical technique, and shared her insights on ideal wound geometry to prevent their development. Dr. Nawaz provided three main strategies for minimizing scar length while maintaining cosmetic results: first, she suggested excising dog ears after closing the circular defect rather than pre-planning excisions, allowing better tissue redistribution. Second, she introduced the 'three bite technique,' which involves anchoring the dog ear to the deep plane of the tissue to flatten scars. Finally, she mentioned that in areas like the hand or pre-tibia, minor dog ears (under 4mm) may resolve on their own over time, potentially reducing surgery time and discomfort. Dr. Nawaz emphasized the importance of flexibility in approaching surgical excisions, suggesting that not all cases require perfect geometry and that sometimes, minimal intervention is sufficient for optimal healing.