Dog ears (aka Burow’s
triangles or cones) are triangles of tissue that are removed from the sides of a
circular or elliptical wound before doing a closure. Their removal allows the skin to heal flat without puckering at the ends, but also lengthens the incision and resultant scar.
If the Mohs surgeon is fairly certain that the next level of tissue will be clear of cancer, they may decide to kill two birds with one stone by excising the dog ears and having them processed as a level.
You will need to show the epidermis from the two sides of the cone (marked purple in the picture) as well as the surgical margin that makes up the base of the piece. Bisect through the apex of the triangle to get the epi around the tip to lay down easily. From here, continue processing it like a regular Mohs level.
