Creasing and Suspected Scar Tethering 6 Weeks Post-Op

[RichSnake]

Hello, I'm 6 week post-op and I'm suspecting that both my scar and portions of my chest skin has become tethered to the underlying muscle, which has caused both sides (more severely on the right side) of my chest to have become oddly shaped.

I understand that it will take a much longer time to see the final results of my surgery and my surgeon suggests that I continue waiting to see if the situation improves. However, I want to minimise the chances of me having to perform another surgery to release the scar and in the worse case scenario, having to perform a fat grafting procedure. 

I am therefore looking into ways I can help break up the underlying scar tissue with the use of massage therapy, and how specifically I should be massaging the area around the scar in order to improve my current situation, so any information regarding this issue would be extremely helpful. In addition to this, will bulking up also help with the contour of my chest? Thanks! 

*I included both a pre-op photo and photos of my chest 6 weeks post-op
*I had to undergo a second operation to treat a large hematoma the day after my initial surgery on the right side of my chest

[Dr. Elliot Jacobs]

There is definitely some deformity present -- and likely swelling as well.  I am not a fan of massage at six weeks -- some of my colleagues may differ with me.

My best suggestion is to be patient, return to your surgeon periodically to discuss and give it lots of time to heal.  A decision for revision surgery should be deferred until six months have elapsed.

Dr Jacobs

[Dr. Schuster]

Yes, you definitely have some extreme scar tissue going on. I also wonder whether a laser was used. The skin texture has a rather "woody" appearance. I start my patients on massage starting three weeks after surgery though I respect Dr. Jacobs different treatment recommendations. Depending upon your resources, both financial and time, you might also consider ultrasound treatments. I do not think the tethered appearance will soften on its own.

[DrPensler]

I reviewed your photos. Where were the incisions made? I do not see incisions under your areolas. I see tethering on the top portion of your areolas?

[RichSnake]

Yes, you definitely have some extreme scar tissue going on. I also wonder whether a laser was used. The skin texture has a rather "woody" appearance. I start my patients on massage starting three weeks after surgery though I respect Dr. Jacobs different treatment recommendations. Depending upon your resources, both financial and time, you might also consider ultrasound treatments. I do not think the tethered appearance will soften on its own.

Thanks for the reply Dr Schuster. A laser was not used during the operation and I'm not too sure what you mean by the "woody" texture on my skin. I have started to perform some massaging on the tethered area, but there does not seem to be a difference in the tethered area as you had predicted. My surgeon insists that I continue to wait a few more months before I look into performing any follow-up operations, but I still want to know more about the options I may be able to take if the situation does not improve. So other than ultrasound treatments, what other treatments could help with the tethered appearance and the buildup of scar tissue if necessary? Thanks in advance

[RichSnake]

I reviewed your photos. Where were the incisions made? I do not see incisions under your areolas. I see tethering on the top portion of your areolas?

The incisions were made on the top half of both of my areolas as my surgeon believed that using a superior crescent lift to treat my case would have been more beneficial. I suspect that the tethering on the top portion of my areolas may have been caused by too much glandular tissue being removed. I am however not entirely sure if this is the case. Thanks

[Dr. Elliot Jacobs]

Best advice is to allow alll healing to occur for a minimu of six months.  Massage according to your preference but I doubt whether it will help that much.

After six months, return to your surgeon to discuss the results of the procedure.  You may also want to visit a gyne expert in your area for a second opinion -- or travel for such expertise if possible.

Good luck!

Dr Jacobs

[Dr. Schuster]

I agree with your surgeon that revision, if necessary, should not be done till at least 6 months after the original surgery. Again, depending upon your resources, deep tissue massage may help to break up tight bands and break down hard lumps. It will not restore volume to areas which have been over resected. Ultrasound and heat (mild) can also help. I realize this is an area where different surgeons can have different opinions. I just think that it helps speed up the healing process, if not actually modifying it.

[RichSnake]

Just an update on the situation
It has been 3 months since my surgery was done and I am surprised by how much the massaging has helped with softening the scar tissue, so thank you Dr. Dr. Schuster for the advice. The tethering has improved significantly and I am very optimistic about how my chest will look after 3 more months of healing.
6 Weeks Post Op - http://imgur.com/llyF9K4
3 Months Post Op - http://imgur.com/wvw5Vbc http://imgur.com/ydnDAOu

[Dr. Schuster]

Excellent. I'm glad things have worked out so well for you. Lesson for anyone else reading these is that healing takes time and patience. Follow your surgeon's instructions and things will generally go well.