"Dog ears" are fairly common with the Double Incision procedure. They are excess skin and fat that "pucker" out at the incision line, as it goes around the side of the chest, under the arm pits. There's a growing number of surgeons who are able to consistently avoid dog ears by doing additional liposuction. If one does get dog ears, they can be dealt with in a revision surgery, though that can be almost as pricey as Top Surgery itself unless it's covered under your surgeon's revision policy.