Scalenectomy was suggested after a failed first rib resection for thoracic outlet syndrome. any advice?

An option : For TOS, many of "experts" have gone to scalenectomy instead of 1st rib resection. Also it depends on the type of TOS you have, true TOS, vs neurogenic, vs presumed. My advice is to get 2-3 opinions from surgeons who do a lot of these which means usually a large academic center. Many years ago a mentor told me, "Nothing is so bad that it can't be made worse with surgery."