Prevention of dog-ear deformity

The patient with obesity or large breasts will often have redundant tissue, which can result in an unsightly and uncomfortable "dog-ear" deformity at the axillary end of the incision. A "Y"-shaped incision can be used to excise excess skin and avoid this deformity. Instead of suturing the full length of the wound, the medial one-half to two-thirds of the wound are first sutured using a subcuticular suturing technique. The lateral tip of the incision is then approximated to the midline of the closure, excess skin is removed, and the final wound will be "Y" or "fish-tail" shaped with two "arms" facing toward the lateral side of the wound.