By Dr. Swaroop Gambhir, Plastic Surgeon, Sir Ganga Ram Hospital
Dog ownership has surged in recent years, bringing companionship and emotional support to millions. However, a troubling trend is emerging—an increase in pet dogs biting their own owners, particularly on the face and hands. As a plastic surgeon at Sir Ganga Ram Hospital, I have personally operated on numerous patients suffering from devastating dog bite injuries. These wounds often require complex reconstructive procedures, leave lasting scars, and can have a profound psychological impact. This growing menace calls for greater awareness, prevention, and proper medical intervention.
Why Are Dogs Biting Their Owners?
From a medical and behavioral standpoint, dog bites to the face and hands often occur due to:
1. Proximity and Reflexive Defense
Owners tend to interact closely with their dogs, bringing their faces near them for kisses, play, or scolding. A startled or irritated dog may react instinctively by snapping, often targeting the closest body parts—the face or hands.
2. Pain-Induced Aggression
A dog experiencing pain from an injury, arthritis, or illness may bite when touched in a sensitive area. Many bite victims report that they were simply petting their dog when the attack occurred.
3. Protective and Territorial Instincts
Some dogs become possessive over food, toys, or even their owners. If an owner unknowingly encroaches on what the dog perceives as “its space,” the dog may bite in defense.
4. Poor Training and Lack of Boundaries
Dogs that have not been properly trained in bite inhibition may react aggressively to overstimulation, rough play, or frustration. This is especially common in puppies that were not taught to control their bite strength.
5. Fear and Startle Response
Sudden movements, loud noises, or being woken up abruptly can trigger a fear-based bite, often directed at the hands or face of the person closest to the dog.
Medical and Surgical Implications of Dog Bites
1. Facial Injuries: High-Risk and Complex Reconstruction
The face is particularly vulnerable due to its soft tissues, delicate structures, and high visibility. Common facial injuries from dog bites include:
- Deep Lacerations – Cuts that may damage nerves, blood vessels, or underlying muscles.
- Tissue Loss – Some bites result in avulsions, where pieces of skin or tissue are torn away, requiring grafts or flaps for reconstruction.
- Nerve Damage – Bites near the lips, cheeks, or forehead can sever facial nerves, leading to paralysis or asymmetry.
- Scarring and Disfigurement – Even after healing, scars on the face can be psychologically distressing and may require multiple corrective surgeries.
2. Hand Injuries: Functional Impairment and Infection Risks
The hands are frequently targeted in dog bites, leading to:
- Tendon and Ligament Damage – Bites can sever tendons, affecting hand function and requiring microsurgical repair.
- Bone Fractures – Strong-jawed dogs can cause crushing injuries, leading to broken fingers or metacarpals.
- Deep Infections – The bacteria in a dog’s mouth (such as Pasteurella, Staphylococcus, and Capnocytophaga) can cause severe infections like cellulitis or even sepsis if untreated.
- Loss of Dexterity – Severe injuries can result in permanent loss of movement or grip strength, impacting daily activities.
Plastic Surgery Solutions for Dog Bite Injuries
1. Immediate Wound Care
- Thorough Cleaning and Debridement – To remove bacteria and dead tissue, preventing infection.
- Antibiotics and Tetanus Protection – Given based on bite severity and patient history.
- Suturing Techniques – In some cases, wounds are left open initially to reduce infection risk before being surgically closed.
2. Advanced Reconstructive Procedures
- Skin Grafts – Used when significant tissue is lost. Skin from another part of the body is transplanted to cover the wound.
- Flap Surgery – Local tissue is moved to reconstruct areas with missing skin or muscle.
- Nerve and Tendon Repair – Microsurgery may be needed for functional restoration in hand injuries.
- Scar Revision and Laser Treatments – To minimize visible scarring and improve cosmetic outcomes.
3. Psychological Considerations
Dog bite victims, especially those with facial injuries, often experience anxiety, depression, or PTSD. Plastic surgeons frequently collaborate with psychologists to address these concerns alongside physical healing.
Preventing Dog Bites: The Surgeon’s Advice
1. Training and Behavior Management
- Teach bite inhibition from puppyhood.
- Avoid rough play that encourages mouthiness.
- Set clear boundaries—do not tolerate aggressive behavior.
2. Recognizing Warning Signs
- Growling, stiff posture, or avoiding eye contact can signal discomfort.
- Never force a dog into an interaction it seems reluctant about.
3. Handling with Caution
- Avoid placing your face too close to a dog’s muzzle, even if it seems friendly.
- Do not wake a sleeping dog suddenly or reach for food/toys in its mouth.
4. Seeking Veterinary Help
- If a dog exhibits uncharacteristic aggression, a vet checkup can rule out pain or medical issues.
Conclusion
Dog bites to the face and hands are not just minor injuries—they can lead to lifelong scars, functional impairment, and psychological distress. As a plastic surgeon at Sir Ganga Ram Hospital, I have treated numerous patients with severe dog bite injuries requiring advanced reconstructive procedures. While surgical advancements can repair the damage, the best solution remains prevention through responsible pet ownership, proper training, and awareness of canine behavior.