How to address early tethering of periareolar scar after implant replacement surgery? Thank you. (photos)

This is a very difficult problem and I have seen it in my practice on very rare occasion.  The most important thing you can do in revising this problem is to wait as long as possible.  Massage will help in the short term but more than likely this area is going to need to be revised again.  I've had some success with scar tissue release and fat grafting in this area.  It may actually take several small sessions of fat grafting to completely correct the problem.  This should never be undertaken too early in the healing process.  You need to wait at least 6 months for the dense scar tissue to soften as much as possible.  

In cases like this, the scar goes all the way from the surface down to the capsule, so it has to be released and something placed to prevent it from doing the same thing again. Fat grafting could help but I would prefer either a dermafat graft (made from a piece of your own skin) or Strattice ADM.

is all you can really do at this time and you should confirm this with your surgeon.  If it remains tethered after healing, I would suggest releasing the scar with a picklefork cannula and fat graft the space to prevent re-adherence before formal revisions that require the OR.

I am sorry you are having this problem.  The tethered scar can be released, but then subcutaneous tissue/breast tissue must be moved into the void to prevent the same thing from happening again.  In your case I do not think there will be enough available local tissue to transpose without creating a contour deformity.  Therefore I think your best option is fat grafting.  It will likely take a couple of go-arounds, but for someone with the proper experience it is pretty straightforward.  The key will be to make sure your PS has the experience.  As for timing, there is no rush to do this sooner rather than later.  Good luck.