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Topic: Dog Ears?

Forum: Living Without Reconstruction After a Mastectomy — Discuss prostheses, swimsuits, bras, and other options for women not having reconstruction or waiting for reconstruction.

Posted on: Aug 28, 2008 06:52AM - edited Aug 11, 2009 01:23AM by lisa-e

lisa-e wrote:

I am going to have a bilateral mastectomy.  I am trying to decide if I should have reconstruction or not.  When I saw my surgeon, he asked me to see a plastic surgeon so I could make an informed decision.    She said one thing that bothered me and I wanted to ask you all your opinion.

She said that if I did not have immediate reconstruction, I would have large dog ears, ie flaps at the end of the scars, as I am quite busty.   Do you think this is true? I have called my surgeon, to get his opinion.  The idea of being flat does not bother me, but the idea of having extra skin on my chest does.

Thanks!

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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Aug 28, 2008 08:48AM Erica wrote:

I know women of all different sizes who were able to achieve a nice flat chest after a bilateral mastectomy. There's no reason I can think of that you would have to wind up with dog ears. Please check out the Photographs section on my website, BreastFree.org, and click on the last set of photos, "A breast surgery journey," to see pictures of a woman before and after a bilateral mastectomy.

I specifically asked my surgeon to make my incisions symmetrical and my skin nice and flat. She was able to do that. If your surgeon knows you don't want reconstruction, then I believe he can make sure no dog ears remain. 

From your post, I couldn't tell who said you'd wind up with dog ears--was it the plastic surgeon you consulted? If so, that's ironic, because some women who wind of up with dog ears go to a plastic surgeon later to have them removed. I'd check it out with your breast surgeon and find out if he can leave you nice and flat with no dog ears. 

Good luck! 

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree
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Aug 28, 2008 09:11AM lisa-e wrote:

Erica, thanks for the reply.  I have looked at your website and it has been helpful.

 The plastic surgeon was the one who said I would wind up with dog ears.  I have called my breast surgeon to see what he says.  

 I felt like the plastic surgeon was really pushing reconstruction over no reconstruction.  She also has a fancy new office to pay for.

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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Aug 28, 2008 09:56AM flash wrote:

I had mast and the surgeon made me absolutely flat.  She did suggest that it would be better to leave more skin (dog ears) if I was going to do some recon later.  However, after discussion, I opted for flat. Scar is a straight line across.

multifocal multicentric IDC, DCIS, pagets et al. - er+,pr+ her2+++, mast,chemo, ooph, hyst Dx 10/10/2007, Paget's, Grade 3, ER+/PR+, HER2+
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Aug 28, 2008 10:02AM hipchik47 wrote:

Hi Lisa, I have to tell u I have dog ears. My breast surgeon told me I would have then and sure enough I do.  They are under my arms and not on my chest.  I consulted with a plastic surgeon  to discuss implants (I had a bilat].  He said he would not do immediate recon because I could get an infection...a50/50/ chance. He said he would be glad to see me in 6 months to do recon.I wanted to be completely flat after surgery so he came to my surgery to draw lines for breast surgeon to follow.  I am not completly flat I am lumpy, so I was very dissapointed with my results.   Since my breast surgeon told me I would have dog ears(flab under my armpits) I am ok with it.  I don't like the fact that my chest is lumpy, but I can live with it.  Most women do get immediate recon who want recon so I do not know why my ps said no recon 4 me.  Some women get infections and complications after recon, some don't.  I am happy with no recon.  Hope this helped lisa good luck  Barbara

Most people don't know that there are angels whose only job is to make sure you don't get too comfortable and fall asleep and miss your life. "Storypeople" 1994 Dx 10/15/2007, DCIS, Grade 2, 0/1 nodes, HER2+
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Aug 28, 2008 10:04AM otter wrote:

I think what flash said is the main point.  If you are considering having recon in the future, your PS might want to leave extra tissue to make the recon easier.  That produces the dog ears.

My breast surgeon (surgical onco) had me meet with a PS before my mast, to see what options were available.  He did a very nice job explaining things, but I decided not to have recon, ever.  So, the last thing I told my BS before they wheeled me into the OR (she had stopped by to see me in pre-op) was to make my chest nice and flat, with a smooth scar--no extra tissue.  That's pretty much what she did.  There is a little extra puffiness under my arm, but it wasn't left intentionally.  It just ended up that way.  My surgeon said it's common for breast surgeons to sit patients upright (while anesthetized) to see how the tissue will lie when it's sewn up.  I think they try really hard to do what we want them to do, if they know what that is.

otter 

Dx 2008, IDC, Stage IA, Grade 2, 0/3 nodes, ER+/PR-, HER2-
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Aug 28, 2008 10:21AM dreamwriter wrote:

My surgeon did not tell me about dog ears and told me no reconstruction so there was no reason to leave extra skin.  But I am not Cheryl Tiggs so I tuck it in my bra and live on......

Laugh until it really IS funny. Dx 12/20/2005, 6cm+, Stage IV, Grade 3, 18/18 nodes, mets, ER+/PR+, HER2-
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Aug 28, 2008 09:34PM - edited Aug 28, 2008 09:36PM by lisa-e

Thanks everyone!

I called my breast surgeon yesterday and he will get back to me this morning.

It is such a difficult decision to make, especially because I feel some time pressure. I'd like to have more time to gather information and get second opinions, but it all takes a lot of time. My friend recommended her plastic surgeon - but he is in SF and I can't get an appointment for over a month. I would also have to find a new breast surgeon. But I like my breast surgeon - he is the best of the lot, so far and I don't want to find a new one.

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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Aug 28, 2008 10:30PM Sher wrote:

I had bilaterals on July 21 and I have dog ears - big time!   Before the surgery I spoke with the breast surgeon and the plastic surgeon (who was supposed to assist, but did not) about the possibility of reconstruction.  I'd had radiation to the left breast 8 years ago, so expanders and implants not an option.  And I decided I did not want to go through other types of reconstruction, so I made that clear and said I wanted my chest flat.  The surgeon told me it was not possible to make my chest completely flat because of worries that it would be too tight.  She said I could always get it cleaned up later...........which is exactly what I did not want - more surgery!  I was prepared for a little excess, but nothing like I have been left with.  If I wear just a t-shirt without a bra or camisole, the humps and bumps clearly show through.  The cancer side isn't too bad, I think because the surgeon tried to incorporate or remove the lumpectomy incision as well as axillary dissection incision - right on my bra line and maybe even because of skin/tissue changes due to radiation.  That side was smaller to begin with, too.  The proph side is awful and looks like not all the breast tissue was removed on either end.  It's only been just under 6 weeks and I understand it can take months to reshape, but I already have an appointment with the plastic surgeon as I'm pretty sure this, in no way, can ever reshape!

From what I've found since my surgery, thin women usually get better results.  Heavier women who already have tissue excesses will still have excesses after mastectomy, especially more around the side.  And the breast being gone makes those excesses look larger.  But that doesn't explain leftover skin flaps or dog ears.   

Dx 8/28/2000, IDC,
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Aug 29, 2008 12:18AM - edited Aug 30, 2008 08:50AM by Erica

Sher,

I'm sorry your surgery didn't leave you with as neat a result as you wanted. My breast surgeon, who heads the breast care center at a major teaching hospital, said that she is sometimes asked to "redo" mastectomies, where the original surgeon left breast tissue behind. So, apparently, all mastectomies aren't alike. I don't really understand why you should be left with lumps and bumps, let alone dog ears, just because you are heavier. Please let us know what the plastic surgeon says.

Barbara

BreastFree.org 

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree
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Aug 29, 2008 04:59AM Sher wrote:

My appointment is not until September 8th, but I've marked this thread as a favorite and will let you know. 

Dx 8/28/2000, IDC,
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Aug 29, 2008 06:25AM kerry32 wrote:

I saw a plastic surgeon recently after 4 months from bilateral no recon.  He explained the dog ears which i do have small ones - if there is extra fat that a small woman doesn't have it will be emphasised and you will have them.  He said the chub was there and then when you take the breast off and stitch you are left with that pooch and its just more obvious.  I wasn't greatly over weight but i was large busted.  He did say he could take care of it though if i want him to.

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Aug 30, 2008 02:51AM lisa-e wrote:

I was able to peak to my surgeon today.  He said that if I didn't want to have reconstruction in the future he would not leave any extra skin - so no dog ears.

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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Aug 30, 2008 04:33AM spar2 wrote:

my plastic surgeon did a lot of liposuction to my dog ears. Now it looks great

www.spar2.multiply.com Lets help make each other's life better
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Aug 30, 2008 05:03AM Erica wrote:

lisa-e,

That's great! Now you can decide between reconstruction or not without worrying about dog ears.

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree
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Aug 30, 2008 06:53AM wallycat wrote:

Barbara (Erica), I don't mean to speak for you, but your post made me a bit uneasy...I don't think doctors leave any breast tissue if they can help it.  I think the extra "stuff" is skin and sutures, not breast tissue!!  I know we can't get 100% removal, but I think that means a few scant cells they can't see or scrape off.....just hoping I am correct on this.

Lisa-e, I was a "D" cup and I brought a pic in for my surgeon and told him..."THIS.  Make me look like a 10 year old boy."  He did.  I didn't even care if my incisions were even (if they fade as well as most claim, who cares what they look like initially, was my thought), but he did an AMAZING job that is very even.

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Aug 30, 2008 08:08AM lisa-e wrote:

Wallycat - I told my surgeon if I don't have reconstruction I would like to be like my pre-pubescent self again.  He understood.

Erica, I am giving myself this weekend to come to a decision.   I am going to a local store that sells mastectomy bras etc. tomorrow.  A friend who also has bc  said that was helpful.   She chose reconstrution and her new breasts are very nice looking.  She still has expanders, but even so her breasts feel pretty natural to me.  On the other hand, I know another woman who chose not to have recontruction and she looks good to me too.  

A hard decision for me. 

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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Aug 30, 2008 08:49AM - edited Aug 30, 2008 08:52AM by Erica

Wallycat,

Definitely, the intention is always to remove every possible bit of breast tissue. But I guess occasionally tissue is inadvertently left behind. I really don't know anything beyond what my surgeon told me, that she sometimes has to re-operate. And I'm sure you're right, that the lumps and bumps left behind could also be due to extra skin and sutures.

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree
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Aug 30, 2008 12:04PM Sher wrote:

spar2 - Did you only have liposuction on the dog's ears without any incisions or other tissue removal? 

wallycat, were you smooth and flat immediately after surgery or did it take some time to smooth out? 

I think the surgeons try their best to remove all "breast" tissue, but when a woman is heavy and has other attached tissue - just fat, I guess - this is not removed.  At least it was not in my case.  Maybe surgeons don't think it's their job to do body contouring or plastic surgery type procedures, and so remove just the breast tissue, leaving the excess behind.   I've seen lots of women's posts who say one side of their chest is concave.  How then does that happen?  My cancer side is concave up to my collarbone, but the proph side doesn't have nearly as much tissue removed.  I just took a picture of myself, but it's pretty bad and I don't have the gumption to post it.  Maybe later..................

Dx 8/28/2000, IDC,
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Aug 31, 2008 02:31PM flash wrote:

I am extremely overweight. My mast scar was flat and perfectly smooth from the beginning.  My surgeon made sure to leave absolutely nothing. It did not seem to matter that I was extremely overweight.

multifocal multicentric IDC, DCIS, pagets et al. - er+,pr+ her2+++, mast,chemo, ooph, hyst Dx 10/10/2007, Paget's, Grade 3, ER+/PR+, HER2+
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Sep 1, 2008 10:15AM spar2 wrote:

I posted a picture on the reconstrution board of my foobs and no dog ears.

www.spar2.multiply.com Lets help make each other's life better
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Sep 1, 2008 10:21AM Sher wrote:

Oh, I misunderstood spar2.  I thought you just had mast without reconstruction.

Dx 8/28/2000, IDC,
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Sep 1, 2008 11:04AM spar2 wrote:

No I had one reduced and mastectomy on rt side. but had huge dog ears until the liposuction.  I don't know why they couldn't do it even if you don't have reconstruction.

www.spar2.multiply.com Lets help make each other's life better
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Sep 1, 2008 07:30PM kerry32 wrote:

How do you see these pictures on the Recon Board?  I have dog ears too and i'd like to see how it could look if i did the lipo - and i'm thinking about recon but so unsure.  I heard you pm timtam but when i go to pm there is no place to put her name in the To field??  Thanks

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Sep 1, 2008 07:53PM NancyD wrote:

Two ways to send a PM to tintam...1) find a post by her (look for "please help" thread; she posts there frequently), click on her name to the left, when her info comes up, click on the "send private messege to this member" text and you will be able to send.   2) Do a search for her in the member list, click on her name, and follow through as above.

I'm not a complete idiot. Some parts are missing. Dx 2/22/2008, IDC, Left, Stage IIIA, Grade 2, 4/10 nodes, ER+/PR+, HER2- Chemotherapy 3/22/2008 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Sep 3, 2008 02:25AM rumoret wrote:

My surgeon never asked if I was reconstructing...if so I don't remember. I do remember asking him about the dog ears (did not know the term then) and he said he left the extra skin should I decide to reconstruct. It does not bother me...plus the little ear in the center of chest turns up slightly and gives me a little cleavage.

Hugs to my Sisters, Dx 4/13/2006, IDC, 2cm, Stage IIA, Grade 3, 0/15 nodes, ER+/PR+, HER2-
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Sep 3, 2008 06:48AM mavrikt wrote:

Glad to see this topic.  In April, 2006 I had a bi-lat, proph left-side, with no reconstruction. I had considered reconstruction very carefully.  At that point, I felt my surgeon  wanted me to have it done while my onc wanted me to be comfortable with my decision.  I'm glad I chose no reconstruction. My surgery was 5 hours just for the bi-lat. 

Two weeks after my surgery though, I noticed I kind of had a hump in the middle.  Along with the a large dog ear on the right side.  (Dog ear - -What a term anyways...must have been a man!)  Anyway, my left side's nearly flat, yeah!  I've got plastic surgery scheduled for later this Fall to trim the large dog ear on the right, and hopefully remove my center hump. I truly am not happy to have more surgery, but I want to be comfortable with my appearance.  

One quick question for everyone:

If you have dog ears, do you find that fluid collects there for you?  And if so, how are you managing it?  I'm familiar with lymphatic massage, but this is not an area I can self-manage very easily.

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Sep 3, 2008 09:23AM Erica wrote:

mavrikt,

I'm glad you're happy with your choice of no reconstruction. I am, too.

I'm very flat after my bilateral mastectomy, no dog ears, but I do have a small amount of fluid on one side (about a 1" x 2" area). It doesn't protrude, but jiggles when I touch it. I had my surgery in October 2006. I asked my breast surgeon about the fluid a couple of weeks ago, during a checkup. She said it's not unusual to still have some fluid and that it would probably dissipate over time, though it could still take a while (even though it's been almost two years since my surgery!).

Lymphatic massage doesn't seem to make a difference and my physical therapist says it's not lymphedema, more like a tiny seroma. I believe the fluid accumulates there because that's where I had a radiation boost. Perhaps in your case, the dog ear provide an environment where fluid can accumulate. Have you asked your doctor?

I agree, dog ear is a term only a man could have coined!

Barbara

BreastFree.org

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree
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Sep 3, 2008 11:32AM kathimdgd wrote:

Sher,

  I had a bilateral on the 21st of August,and guess i went into the whole thing without knowing a whole lot about it.I just wanted the cancer removed,as i had been through many scares over the years.(i'm 70) So i decided to just do it ,as they say.I had never heard of dog ears,and i just assumed they would make a nice clean cut and take ALL of both breast off.Well like you i'm left with the dog ears,or as i call them pockets on each side.I was large busted,a D cup.

I'm fine with having no boobs,i just don't like the pockets on the sides(dog ears).Dr told me i can see a plastic surgeon and get them taken care of,but i had hoped the bilateral would be my last surgery.I still have my drains in,and they are driving me crazy,so i'm hoping when they come out,some of thaat swelling will go down and they won't be as noticable.

I go back to the dr this friday,and hopefully the tubes will come out then,if not i'll probably lose it.I hate these things,they pinch,pull,and just plain hurt when i move.I didn't have stitches,instead they used glue,so maybe that's it,i don't know.

I do know that i'm on the verge of tears all the time,and that's soooooooo not me.

This has all been such an overwhelming process and it came right on the heels of a total knee replacement in May of this year.I never expected this at all,I hadn't given a thought to BC.

I still don't have my reports back either from the pathologist,hopefully this week..

Kathi

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Sep 4, 2008 03:40AM lisa-e wrote:

Kathi - I had a total hip replacement in April of this year, so I know what you mean about things being overwhelming.  Bad enough recovering from joint replacement and all that entails,  then having to deal with breast cancer.   I don't blame you for being on the verge of tears.

I appreciate hearing about everyone's experiences ... very helpful to me.  I've decided against reconstruction - mainly because I don't think it is a good idea to put a foreign body between my pecs.  I've told my surgeon not to leave any extra skin.  So we will see - if I need scar revision, so be it...

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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Sep 4, 2008 03:59AM Sher wrote:

Hi Kathi,

I can definitely understand you being on the verge of tears - you've been through a lot.  For the first couple of weeks after my surgery (July 21) I also had some very trying times, struggling to fight off the unexpected tears.  I was completely ready for the bilaterals, not being overly fond of my 60 year old droopy boobs, but I still afterwards had some awfully sad moments.  Maybe there is such a thing as pmd or even psd (post mastectomy/surgery depression).  Now I'm feeling much better and hopefully you will too, and very soon!  

The drains are awful!!!  My right side was the worst - had to stay in for 2 weeks and continued to hurt around the area after it was removed.  The pocket (largest dog ear) on my right side where the drain hole was located, seemed to start reducing in size just yesterday.  It's not as firm either, so maybe some of it was just lingering swelling even after almost 6 weeks.  Since it's only been 2 weeks for you, I would think it most likely that you have some post surgical swelling.  That and the fact that the drains are in place yet which your body doesn't like big time!  

I have bad knees too, and both need replacement, but I've been holding off cause I hate the thought of more surgery!   One thing at a time and one day at a time too, right?  

Prayers that your drains can come out soon and for a clean pathology report!

Blessings!

Dx 8/28/2000, IDC,

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