Wow do I hate dogs!    Actually I don’t really hate all dogs.  I have two wonderful pets that lounge around my house and sleep by my bed.  I wouldn’t trade them for anything, but I also protect them from being upset or annoyed by visitors and or strangers.

Years ago, my first surgical case in practice was a dog bite.  I didn’t think much of it then.  A dog had taken a bite out of a lady’s leg and the Emergency Room called asking if I could repair the complex injury.   I didn’t realize at the time that I would soon see literally hundreds of these injuries.

Many of the injuries are small.  Often they are little superficial injuries where it appears that the dog simply nipped the skin.  This is often the case, and even with these, there is often a resultant scar.

Some of them stand out in my mind.  The little boy with both of his cheeks opened up and his facial nerves ripped in half.  The little girl with the majority of her forehead torn from her face.  The cleaning lady who lost the majority of her chin when cleaning for a new client.  The hairdresser who lost half of her lip to her boyfriend’s bulldog.

Some of these injuries are life changing.  The worst part is that most of them can be prevented.  I write this entry after taking care of yet another dog bite in the Emergency Room.  The Emergency Rooms in Southern New Jersey have realized that I am a plastic surgeon willing to come in when called to take care of these injuries.  To me, plastic surgery is not simply nipping and tucking, but also a chance to reconstruct and give back to the community.   Not all plastic surgeons make themselves available for these types of injury, but given our unique reconstructive training, they should.  I truly can get two or three calls some weeks to take care of dog bites to the face.  In the Spring it is worse, but it happens all year long.  Times of the year like Christmas bring parties with large, loud crowds and homes filled with excited people with the resultant dog becoming scared and feeling that his territory is being invaded.

The saddest part of these injuries is that most of them could be prevented.  If an owner had kept his dog on a leash, it couldn’t have run off to bite a passerby.  If a parent had scolded his or her child not to pull the dog’s tail so hard, perhaps he wouldn’t strike back.   If the mother at a “play-date” had put the dog out back perhaps the new friend wouldn’t have scared the dog who had always been so loving to family.   If the screen door wasn’t broken, perhaps the mailman wouldn’t have been attacked as an intruder.  If the fence had been repaired, the dog couldn’t have jumped through the hole in the first place.   My dogs always stay in the basement even when visitors come over and while this is perhaps overkill, I have simply seen too much destruction.

Dogs likely became domesticated about 30000 years ago after genetically separating from wolves around 100,000 years ago.   When scared or surprised, their instincts often overtake them and they bite.  They have powerful, destructive jaws and the harm can be great.  It is interesting that in my practice I rarely see injuries of dogs that simply go attack out of the blue.   While I have certainly seen this, it is often a dog that was startled during a nap by a child, a dog scared by a noise, or a dog worried about a territorial intrusion.

The American Society of Plastic Surgery has a list of measures in their “Beware of the Bite” program which includes socialization of your dog so it feels at ease around strangers, not putting your dog in situations where it may be threatened, following leash laws, training every dog simple commands such as “sit” and “stay”, confining your dog by a fence when it is not in the house, and not playing aggressively with your dog.   It offers safety tips such as never approach an unfamiliar dog, never run and scream around a dog, children should not play around an unfamiliar dog without an adult around, if a dog knocks you over roll into a ball and cover your face, not staring a dog directly in the eye, and probably most importantly don’t disturb a dog that is eating, sleeping, or caring for puppies.   While many of these things may seem like common sense, it helps to repeat them.

I would love to say it is one breed but it is not.  Many breeds are stigmatized but I have seen bites from the smallest of lap dogs.  A plastic surgeon is uniquely qualified  to treat these destructive soft tissue injuries and while I suppose I could consider these injuries job security, they are one type of case I would rather not have ringing the phone….

As always,

Evan Sorokin MD, FACS