Background: As traditional elliptical excisions for skin tumors are designed before surgery, they may waste normal tissue and result in poor outcome, both in terms of the wound length and direction. Objective: To compare the predicted results of elliptical excisions with scars resulting from round excisions with dog ear repairs. Methods: Forty-one patients with skin tumors were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. Only the lesion and the required margin of adjacent skin were excised and closed with dog ear repairs. Precise measurements were conducted at each step. Results: Although many of the lesions required 2 dog ear repairs (59%), the overall sutured wound length was 14% shorter, and the wound direction differed from that of the predicted ellipse in 22% of cases. The shortening effect was distinctive in areas of thick skin, such as the trunk and scalp. Only 3 lesions resulted in a longer final wound length. In total, 29% of the patients required 1 dog ear repair and 12% needed no dog ear repairs. Conclusion: Round excisions with dog ear repairs should be considered prior to traditional elliptical excision as a more beneficial method of skin tumor removal.

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