Is There Evidence Scar Tissue Can Be "Broken Up"

[David1991]

I had gyno surgery one year ago and at this point I'm pretty happy with it but under my right pec (no where near the nipple) there is this one ball of dense tissue, which I can only assume is scar tissue. Not very consistently, but here and there over the past year I have massaged that area very hard, pinching/rubbing it between my fingers, etc and it hasn't really done much.

Last Tuesday I had liposuction of my waist/low back and it's maybe too early to do much but I have a lot of very tight areas and I can feel hard lumps. It looks fine but my waistline is actually up almost an inch since directly after surgery (yea I measured at both times) so it seems like there is an accumulation of swelling and scar tissue so I'm wondering if massage would even help this or the gyno area mentioned above or if it's just psuedoscience.

I understand the theory behind why it could work, but it seems like a lot of plastic surgeons don't think it really helps much.

Thanks

[Dr. Elliot Jacobs]

Oftentimes, what we think of as "scar tissue" is a combination of swelling plus scar tissue.  That is why massage can sometimes help -- it milks out the swelling but the scar tissue remains.  Physical therapists know that joints that have scar tissue can be slowly stretched for a more normal range of motion -- but the scar tissue remains.

As regards to your very recent abdominal lipo, it is no surprise that your waist is actually larger -- that is to be expected.  Obviously only you and your surgeon know how much fat was removed -- but the remaining fat does in fact swell.  That is why most surgeons will recommend a firm compression garment for at least a few weeks after surgery -- it will help but not totally prevent all the swelling from occurring.

Be patient -- the results of your abdominal lipo will begin to appear in a few weeks.

Dr Jacobs

[David1991]

Oftentimes, what we think of as "scar tissue" is a combination of swelling plus scar tissue.  That is why massage can sometimes help -- it milks out the swelling but the scar tissue remains.  Physical therapists know that joints that have scar tissue can be slowly stretched for a more normal range of motion -- but the scar tissue remains.

As regards to your very recent abdominal lipo, it is no surprise that your waist is actually larger -- that is to be expected.  Obviously only you and your surgeon know how much fat was removed -- but the remaining fat does in fact swell.  That is why most surgeons will recommend a firm compression garment for at least a few weeks after surgery -- it will help but not totally prevent all the swelling from occurring.

Be patient -- the results of your abdominal lipo will begin to appear in a few weeks.

Dr Jacobs

Thanks Dr. Jacobs, very helpful reply as usual.

Interesting that your response and several others I have heard are indicating that scar tissue will remain. For such a long time I had been hearing from various sources that we can "break up" scar tissue. Even when it comes to fitness related issues often PTs and the like will recommend foam rolling / massage ball / deep tissue massage to break up the scar tissue that has formed in the muscle. I guess that was all pseudoscience though. I wonder why the idea is so prevalent.

Meaning I'm probably stuck with the lump under the right pec. It's not a huge deal, but does seem to make the right pec not look as lean as the left. My plastic surgeon thinks kenalog at this point would be a mistake though (I guess too risky in his opinion) so I'll probably just leave it alone.

[Dr. Elliot Jacobs]

Scar tissue can be stretched -- that is what is done with physical therapy -- but it does not disappear.  Therefore, massage, etc can be somewhat helpful to relieve tightness in some cases.  But one cannot "break up" scar tissue and make it disappear. 

I may, at times, recommend massage to my gyne patients -- but it is really meant to mobilize the swelling and try to get rid of it -- kind of like squeezing a sponge to get rid of the water. The sponge material (ie scar tissue) remains.

As for the small mass under your right pec, try not to concentrate on it.  Remember, gyne surgery is meant to improve the contour of the chest only.  If it bothers you, then perhaps a small injection of kenalog can help.

Dr Jacobs

[David1991]

Scar tissue can be stretched -- that is what is done with physical therapy -- but it does not disappear.  Therefore, massage, etc can be somewhat helpful to relieve tightness in some cases.  But one cannot "break up" scar tissue and make it disappear. 

I may, at times, recommend massage to my gyne patients -- but it is really meant to mobilize the swelling and try to get rid of it -- kind of like squeezing a sponge to get rid of the water. The sponge material (ie scar tissue) remains.

As for the small mass under your right pec, try not to concentrate on it.  Remember, gyne surgery is meant to improve the contour of the chest only.  If it bothers you, then perhaps a small injection of kenalog can help.

Dr Jacobs

OK interesting, thanks.

I will certainly bring this up with my doctor but since I feel you will be more objective I had one last question. Now that I'm 11 days out of the waist/lower back lipo surgery I think I'm seeing a pretty good representation of the end result. It's mostly good but I have a little fold on the right side that seems like a combo of poor contouring and scar tissue. Additionally, basically all around my lower back / sides I have what feels like a plate of scar tissue attached to my skin.  Like literally if you were to grab it it seems like the skin is very taut/hard around the entire area so I'm wondering

1.) Is the fold likely permanent / can anything be done about? It's not major but I of course notice

2.) is all of this "plate"-like scar tissue all around permanent, or will my body try to get rid of it / diminish it over time? It's very significant if you feel around. I feel like as I continue to lean out with diet (already fairly lean but want to get very lean for a photo shoot) it will become noticeable the leaner I get.

[Dr. Elliot Jacobs]

Obviously, I cannot comment on your personal situation.  However, in general, you are at the barest beginning of the healing from abdominal liposuction.  In my experience, it takes a minimum of six months to see the final results.  Until then, there will be firmness, swelling, folds, etc, which you will just have to put up with.  Just be patient!!

If you need further reassurance, then return back to your surgeon -- he knows what transpired during surgery and can best answer your questions.

Dr Jacobs

[David1991]

Obviously, I cannot comment on your personal situation.  However, in general, you are at the barest beginning of the healing from abdominal liposuction.  In my experience, it takes a minimum of six months to see the final results.  Until then, there will be firmness, swelling, folds, etc, which you will just have to put up with.  Just be patient!!

If you need further reassurance, then return back to your surgeon -- he knows what transpired during surgery and can best answer your questions.

Dr Jacobs

Great thank you again!

[DrPensler]

Your waist swelling is due to the procedure I typically tell patients with Lipo of the stomach and /or flank : remember I took tissue out I did not add any. The swelling resolves but it takes around 16 weeks.Swelling should not be confused with scar. While after surgery there is always scar that is not what you are noticing around your waist. Scar can be altered the easiest example of this to see is in the  case of a severe burn to the skin after which there is a resultant scar.The scar is treated in a number of ways including but not limited to pressure , range of motion and sometimes steroid injection.

[David1991]

Your waist swelling is due to the procedure I typically tell patients with Lipo of the stomach and /or flank : remember I took tissue out I did not add any. The swelling resolves but it takes around 16 weeks.Swelling should not be confused with scar. While after surgery there is always scar that is not what you are noticing around your waist. Scar can be altered the easiest example of this to see is in the  case of a severe burn to the skin after which there is a resultant scar.The scar is treated in a number of ways including but not limited to pressure , range of motion and sometimes steroid injection.

Well I certainly didn't think he put anything in lol I just think he might not have taken as much out of the lower right side, making the area appear to extrude a little there. I do think there is some swelling remaining as I am 2 weeks out as of today, but there is clearly a lot of hard scar tissues in a few areas as well which I am trying to improve with stretching/massaging it.

I have my follow up appointment with my doctor tomorrow so I'm sure he will give me his opinion. It's not terribly noticeable but in certain positions the right side does appear to have a bit of tissue/swelling/something there sticking out like a mini love handle whereas the left side does not.