I know this an old post but I thought my experience would help some others. I am a bit older (45) and generally do dumbbell type workouts. Last June started barbell bench pressing in a group of guys and I jumped up in weight too fast. Felt a gnarly tear. Very little bruising, just a small one on biceps. 2 mos. later went to an Ortho (hip and ankle) who gave me kind of conflicting info but said I’d have a dent, but it was partial. It turns out he is a dipS#$%, So, I rehabbed for 5 mos. like he suggested. It got stronger but still about 20% off in the affected arm and pushups felt awkward. The middle of the muscle got progressively worse looking - I mean it really bunched up when I flexed. Something was wrong. I couldn’t get a referral to touch it. Pretty depressing.
On my own I found 3 different doctors that had an expertise with pecs. The top guy was in another state, he told me MRIs are misleading and we wanted pics. Based on pics (and the the bunching), the next day his office called to say it completely ruptured and he could fix it. I told him my MRI just indicated a very small tear towards the sternum. He said - yes, you may have that small muscle tear but your muscle won’t bunch up unless you tore the tendon, he figured I tore the entire sternal portion but the clavicular portion may be mainly intact. Whether it is at the junction or the tendon off the bone, he said he can fix it. He has done about 200 repairs.
He said if I’d seen him in 2-4 mos. he could guarantee perfection. 4-6 mos. near perfection. After that (I am now at 8 mos.), he could get all my strength back but cosmetically I (no one else) would probably notice a permanent subtle difference due to the longterm muscle atrophy.
I guess the point of this is to say, a lot of these doctors phone it in. Trust your gut, if it doesn’t feel right get a 2nd and 3rd opinion. Also, it is never too late to fix it, but the sooner you do the less likely you’ll need an allograft tendon and the better chance you have at perfect cosmetics. I am getting the surgery in 2 weeks by the way. I will re-post in 5 or 6 mos. when the results start to take shape.