I’m a trans man in his early twenties and I have been on testosterone for around nine months now.
I had double incision top surgery with Mr Yelland in Brighton, UK, on 7th August 2017.
The following is a collection of tips that were helpful to me in the lead up to surgery as well as during the initial stages of my recovery:
Get a fresh hair cut. You won’t be able to shower for a while after surgery and shorter hair is generally easier to manage and maintain. The same goes for any other body/facial hair. This is especially important if you’re on T, as things get hairy very quickly and you may not be able to reach certain areas!
Trim your armpit hair! I know you’re proud of it, but getting it stuck to your post op bandages is not fun.
Clean your bedroom and bedding. There’s nothing better than getting into a bed with newly washed sheets, right? Imagine how good it will feel when you get into your own bed after surgery. Amazing.
Rearrange items you use regularly to waist height. It really is true, you’ll be like a T-Rex for a few weeks post op! Don’t be afraid to ask for help from others.
Stock up on plenty of pillows. So important. I couldn’t have been comfortable without them.
Travel style pillows are a good buy and help to prevent any neck pain while you are sleeping upright.
Investing in a ‘wedge’ pillow was a great idea, as sleeping in an upright position can put pressure on your lower back and cause pain. Trust me, you don’t want any added pain! Placing the wedge underneath your knees supports your body and is surprisingly comfortable.
Practise making a ‘pillow throne’ before surgery so your bed is set up the way you like it on your return home. I stacked up a mountain of pillows for my back and then placed pillows like armrests on either side of me to stop my bandages/incisions feeling like they were pulling.
Wear an eye mask - your sleep pattern will change and you will most likely sleep during the day. You will be more tired than usual and the pain medications you are prescribed may make you drowsy. As someone who has to sleep in complete darkness, this was a good idea.
I know this sucks, but it is in your best interest not to share a bed with your partner (or pets!) during the initial stages of your recovery. Believe me, you will need the whole bed to yourself. My cat has a habit of sitting on my chest and head butting me, so he wasn’t allowed on my bed and my partner has a habit of ‘star fishing’ and flailing her arms in her sleep, so sleeping alone was definitely the best option for the sake of my nipples! I felt safe allowing my partner to sleep beside me after about three weeks as my incisions and grafts felt a bit more robust.
It is also beneficial to plan your journey home from hospital beforehand. I had to travel by car for four hours, so took pillows, a travel pillow, and a blanket for the ride home. I used my seatbelt across my lap, but held it away from my chest to protect my precious nipples! You can also buy seatbelt covers and clips online. You may be dosed up on lots of medication like I was and sleep for most of the journey home anyway!
If you live alone or will have limited support during your recovery, make sure to buy foods that are easy to prepare and cook. Fruits and vegetables are your friend, as anaesthetic/medications can cause you to be constipated. I’m going to sound like your dad here, but remember to keep hydrated! Drink plenty of fluids and it will help you to feel much better. If you are not back to your, ahem, ‘regular’ self, there are always stool softeners to get things moving again.
Take arnica pills for one week before surgery and the week following to help with bruising and swelling. I used Nelsons arnica 30c pillules. You can also purchase arnica as a cream. Use this once your bandages have been removed but do not apply the cream to your incision lines or nipple grafts. They need to be kept clean.
In terms of prescription medication, it may be difficult to keep track of what meds you took and when. I would suggest writing down a list of meds and ticking it off as you go. In total, I had eight different types of medication to take daily and wouldn’t have been able to remember all of this in my medicated state! Pill organisers also help to determine what medication you need to take on which day.
Set alarms on your phone for four hour intervals to remind you to take your next lot of pain medication.
Some stronger meds, such as codeine, may make you feel sick if you take them on an empty stomach. Be sure to eat something substantial beforehand.
If you are staying in hospital for days after surgery, bring any prescription meds you have in their original boxes or containers otherwise you run the risk of not being allowed to take them.
Stock up with paracetamol/ibuprofen at home to keep on top of any pain. Antihistamines will help to calm any itchiness you may experience when your incisions/grafts begin to scab over and heal.
This point is very well known, but it’s worth repeating - button.up.shirts. You will not be able to put a t-shirt over your head. Like I said … T-Rex. It is better to get a larger shirt than usual as it will sit gently on your skin. You will live in these for the first couple of weeks. Definitely an essential item.
Make sure you have comfortable clothing to travel home from the hospital in. I was advised to wear my compression socks for the journey home. Don’t worry what you look like … you’ve just had major surgery! Your comfort is the most important thing.
This specifically applies to people who use testosterone in the form of a gel - as you will have limited mobility, it may be easier to have someone else apply the gel onto your body. Important: do not let the gel touch the skin of females, children or animals. My partner wore latex gloves to do this for me and then disposed of them inside out to prevent any contamination.
It is advisable not to use aerosol deodorant as this may get into your incisions. Use a roll-on alternative instead. I needed someone to help with this in the first couple of weeks, as lifting my arms caused discomfort.
Antibacterial hand gel is good for everything. For you, those who are looking after you … keep those incisions infection free.
Use bendy straws or a tumbler with a straw to drink those fluids I told you about earlier. Even lifting a glass can be difficult to do. Bendy straws make drinking easier and they’re F U N. (You can tell the recovery boredom has set in, can’t you?)
Between napping in bed, you’ll probably be on your phone, let’s be honest. Make this easier with a long charger cable so you can be charging and comfortable at the same time. I kept my phone on my lap so it would be easier to contact people if I needed help.
A table tray that you place over your legs is helpful and has multiple uses. Use it for drinks, food, your laptop, whatever.
You should be given physiotherapy exercises when you are discharged from hospital. Make sure you follow these religiously as it will help you regain movement in your upper body. It can feel scary to move ‘too much’, but I promise it’s fine and will help you in the long term. Just go steady and listen to your body. Your body is tougher than you think.
Having a long piece of fabric or a dressing gown belt can help with some physiotherapy exercises.
Depending on your surgeon, you may or may not have to wear a post op binder. My surgeon uses a binder without drains. If this is the case for you, it might be a good idea to purchase an extra binder so you can rotate the use of them and keep things clean. This would be a particularly good plan in the summer months.
The binder I used was made of Neoprene - not a very breathable material. After a few days, things got very sweaty and the binder began to irritate my skin. If you have someone around, ask them if they could wash your back with warm soapy water until you are able to have a shower. Being *partially* clean makes you feel a million times better!
I will share my best binder trick - find an old t-shirt and cut around the bottom of it to create a band shape wide enough to cover the area you are binding. Having soft material underneath the post op binder helps to keep your skin dry and stops the binder from rubbing against your skin. I would suggest using a white t-shirt to do this so you can monitor any blood or pus that may be coming from your wounds.
Something I don’t see talked about is the issue of recovering from surgery and sex. Pre surgery, I enjoyed a healthy sex life and had a high libido (thanks, testosterone). Post surgery, you’re going to be craving sex and it’s going to suck. Your T-Rex arms won’t be of much use to you or your partner. Talk to your partner. Be inventive. You’ll figure something out!
Aside from sex, you might miss physical contact. Cuddles, hugs, spooning … all that good stuff. This is not limited to people. it was hard not to pick up my cat and give him a cuddle! Just remember it’s not forever and those things on your chest won’t be in the way the next time you give someone a hug. Woo hoo!
Having six weeks to recover, boredom is definitely a thing, especially in the early stages when you are so restricted on what you are able to do. These are some things that helped to keep me entertained: Netflix, music, audiobooks, colouring, bullet journaling, reading, ordering new clothing, short walks … and writing a ‘top surgery tips’ guide!
And don’t forget to donate your binders to your trans and non binary siblings!
I hope that this can help someone who is considering having top surgery. It will be one of the most life changing and liberating things you will ever experience. It’s hard to put the feeling into words. It may sound strange, but try and enjoy it. Make the most of every second on this part of your journey because your battle scars will fade and it will soon be a distant memory. It feels as though I have had this chest my entire life and I am over the moon with my results.
Aside from this guide, if you have any questions regarding top surgery, my inbox is always open. I think it’s important to be honest about things like this and get resources out there for our community.
Thank you for reading and have a great day.
