I have a thought to add...as I asked many of these questions myself.

For most TOS'ers there are several "fibrous bands" and scar tissue that develop to help the compression along...both in the neck area and in the distal region closer to pec minor.

As a standard part of the 1st rib resection, at least as I was told by Dr Reil (Dr Ahn's junior partner), a surgeon will detach any obvious extra fibrous bands near the pec minor on their way to the first rib.

Some doctors approach it differently, and I think there is a fine line between too much disturbance and getting enough out. For instance, Dr Filler makes a huge production of "cleaning up the area" by freeing every nerve, surrounding it with his favorite brand of neurological saran wrap, and then putting everything back together. He even makes a second incision at the armpit when doing a supraclavicular scalenectomy w/o rib resection to clean up the area near Pec minor.

Dr Jordan told me that his opinion is that it is best to disturb as little as possible to avoid the production of extra scar tissue "get in and get out!", since most of us are prone to it anyhow *and* by disturbing things you can generate more scar tissue as the surgical areas heals. He often looks at post surgical scar tissue by ultrasound, so he has seen the results of many different surgeries. (and has told me very seriously that Dr Ahn's technique is "excellent!")

Dr Ahn's approach seems to be to get the obvious stuff, but not disturb any more than neccessary to get the job done. At least, that's what I got by talking to him...I guess it is difficult for any of us to really know. And time will tell if that was a good approach for me