Key information:

How to prepare

There are a number of things you should do to prepare for top surgery. Some tips include:

• Avoid alcohol. Avoid alcohol for at least a minimum of a week leading up to your surgery.
• Stop smoking. If you’re a smoker (of any kind) it’s recommended you stop at least four weeks prior to surgery, as smoking can interfere and cause complications with healing.
• Discuss medications. You should always discuss any medications you’re taking with your surgeon and ask if it’s recommended you continue or discontinue their use before and after the surgery. Note: You will also have to stop taking aspirin, ibuprofen, vitamin E, and omega or fish oils temporarily for about 4 weeks before surgery and 2 weeks after.
• Set up transportation.*VERY IMPORTANT*to arrange your transportation from the hospital after your surgery is completed.
• Dress prepared. Bring comfortable, loose clothes that perhaps zip or button in the front to make getting dressed(and undressed) making it easier for you after your surgery.

Recovery

Recovery time for top surgery varies from person to person. After MTF or MTN top surgery, you can typically get back to work or school after one to one and a half weeks, if you are not doing anything too strenuous at work. You will have a restriction on activity of no strenuous activity or heavy lifting for about 3 weeks.

Recovery Timeline

• Days 1 thru 3 of recovery are often the most uncomfortable. This discomfort can be a result of the anesthesia wearing off as well as the surgical bra, which is holding the dressing over the incisions in place. Dr. Chandler uses long-acting numbing medication in a nerve block fashion to help with this initial discomfort.
• To ensure there’s no added pressure or weight on the surgery site, you will have to sleep on your back for at least the first week after surgery.
• About 7 days after surgery, you will likely have your postoperative appointment. This is often the first time the dressing comes off and many people get to see their breasts.
• The swelling generally decreases within 2 or 3 weeks, but for some, this can take up to 3-6 months.
• You should be careful not to lift your hands above your head for at least 2 to 3 weeks after surgery. Movements such as reaching for an object and/or lifting can increase scarring.
• After 4 weeks, you can typically resume physical exercise such as light sports, lifting, and running. You should progressively increase your activity level until you feel comfortable resuming all exercises and activities

Recovery Tips

• Don’t shower. Many surgeons instruct you not to shower until your postoperative appointment when the dressing is removed. Baby wipes and sponge baths are often two of the best and easiest ways to stay clean in the meantime.
• Don’t lift or do strenuous exercise. Lifting anything heavy isn’t recommended in the first week of recovery. You will be able to resume walking as soon as you are home from surgery, but be careful not to do anything that will result in an increased heart rate.
• Take care of yourself. The best things you can do to speed up the healing process is to rest, eat healthy, refrain from smoking and drinking, and listen to your body.
• Use scar treatments. Over-the-counter scar treatments can also expedite the healing process as well as decrease scar tissue and redness. Dr. Chandler will review with you the most recent and up-to-date recommendations for long-term scar care.
• Dr. Chandler will be sending you a wound care package to aid in your healing process.

Complications & Risks

The large majority of the complications and risks associated with all top surgeries are the same as those associated with any surgery, such as reactions to anesthesia, blood clots, and infection, in addition to risks specific to this surgery. These risks:

• Loss of nipple sensation
• Inconsistencies in the appearance of the implant
• Implant deflation or rupture, or implant infection
• Implant displacement, which is when the implant moves from the location where it was positioned during surgery
• Needing an additional surgery to obtain your desired result

Outlook

Research shows us that very few (if any) trans patients regret the decision to get top surgery, and the large majority report DECREASED gender dysphoria and an increased sense of self-confidence and comfort in their body after completing this step in their transition or alignment process.

For many trans and nonbinary people, this is more than just a surgery. It’s a necessary step in order to feel whole and better align with one’s gender and body. This can bean emotional and challenging process to go through, even if it’s something you know you want and need. Due to the personal nature of this surgery for many people, it’s critical you find a surgeon who you’re comfortable with and who has proper training in transgender and gender affirming surgeries.