A Post About Top Surgery From Someone Who’s Currently Recovering
Yo! I’m gonna make a Trans Survival Guide sometime soon but until then I’ve had some stuff on my mind I wanted to get out here for anyone thinking about/waiting for top surgery. I’ll try to keep it reader-friendly cause i totally understand how hard it can be to read large blocks of text
You’ll be asked to not drink or smoke for anywhere from a month to 2 weeks prior to surgery, depending on your surgeon’s preference.
They ask that you only use Tylenol if you need to take pain meds as ibuprofen is a blood thinner and can lead to surgical complications.
If you take vitamins or supplements of any kind, get it cleared with your surgeon or stop taking them as well.
You are absolutely allowed to ask a surgeon how many surgeries they’ve done, their success-to-revision rate, their style if they haven’t already told you, and anything else.
You won’t offend them, and even if you do, making sure you’re going with the surgery you want is waaaay more important. Put your health and your chest above their feelings.
You’re also allowed to meet up with other surgeons to make sure you’re making the best choice. Consider this “shopping”. Just because you met a surgeon, doesn’t mean you have to go with them.
The specific details may vary, but from my own experience, this is how it goes.
You’re given a time to check in, then you’re called in from the waiting room to go into Pre-Op.
For me, this meant chillin for a couple hours under a heated blanket, IV in my arm and heart monitor on my finger.
Until you’re taken into surgery, a lot of nothing happens, and the everything happens. You meet your surgeon so he can draw on you. You meet the anesthesiology team and presiding nurses etc.
You can absolutely ask them any question you have, express any anxiety, no judgement. The more vocal you are, the more they can help you and by extension themselves.
I told the anesthesiologist I’d never had surgery before so I was stressed about going under, and they put something in my IV to help me relax before I was wheeled into the OR. Then they put the mask thing over my mouth and I was out.
You’ll be chillin naked under a hospital gown for a while lol. After you wake up, if it’s an outpatient procedure, they’ll keep you until they’re sure you’re stable - oriented, no vomiting, etc - before wheeling you out to go home.
You’ll feel kind of slow, very tired, maybe loopy, and of course whatever you tend to feel from anesthesia. For anyone who’s never had surgery, affects range from nausea to coldness to sleepiness to Total Crap.
Incisions and Types of Surgery
There are of course the two main distinctions most people know: key-hole and double incision. What many don’t know is there are vast differences in surgeons’ styles when it comes to these. I’ve seen double incisions shaped like
a straight line across the chest
two slightly curved lines
incisions that meet in the middle (as mine did, but only to avoid “dog ears”)
incisions that follow the pectoral muscle
This doesn’t even include botched stitching
If you can, ask to see pictures. They may or may not be allowed to show you; if they have a prior patient’s permission, they can.
Just to cover my bases: key-hole is a small incision made near the nipple which can only really be done for those with small breasts (A cups or smaller ((apparently there are smaller ones???))).
I still recommend double incision, because you have better results and are less likely to have excess skin. The only drawback is the scarring but I believe it’s worth it.
Typically, from my understanding, top surgeries are outpatient surgeries if you have to travel to get to your surgeon.
This is cause they want you numb while you’re travelling back home.
Of course, I’m speaking as someone from Sacramento who had to travel to San Francisco to see a top surgeon so of course you should check with your surgeon about these specifics.
You’ll get prescription meds. If you stay within the guidelines set for you on the dosage label, you won’t get addicted, so don’t put yourself through pain just cause you’re scared of addiction, trust me.
It is completely possible and probable for you to swell if you don’t have drains.
Your chest will feel swollen, maybe spongey ((BUT STOP TOUCHING IT)) and that’s normal.
If the skin feels heated, you get a fever, you have a hard time breathing, it’s tender to the touch (more than it should be), or makes liquid sounds, CALL YOUR SURGEON/RN.
For me, it was like this:
The first day wasn’t too bad, neither was the second day. The third and fourth hurt the worst, but the pain you feel after the first check-up is different and worse.
You get the gauze taken off your nipples, whatever compression device they have you use is taken off for the first time and you’re moving skin for the first time in at least a week. It hurts.
It goes from “bad bruise” pain to “oh shit my chest was cut” pain. If you’ve got a little meat on your bones and your skin tends to fold a little, that can cause irritation too. It sucks.
After about Week 2, you can switch from prescription meds to Tylenol, but not Ibuprofen just to be safe.
They’ll tell you not to raise your hands above your head.
They’ll say no heavy lifting or working out.
You absolutely cannot use your arms to sit up.
You should not go your full reach without doctor approval.
Try to avoid reaching out to the side or behind you.
Bending over is also something you wanna avoid cause as your midsection bunches up it can rub/crease your incisions and that hurts.
Honestly if you can avoid wearing anything but underwear and the compression garment, go for it.
If you can’t, button-ups or tank tops with big arm holes are your best friend.
For the first few days at least have someone else help you dress.
I’d suggest loose, non-button/zipper pants such as sweats or gym shorts.
No shoes with laces/velcro since you can’t bend over - sandals/flipflops are best.
As mentioned earlier, you’ll be given prescription pain meds. Take them as prescribed and you’ll be fine.
If you feel any of the negative side effects like hives or fever or nausea, absolutely stop taking them and contact your doctor.
You’ll also likely be given antibiotics to prevent infection. Take ALL OF THEM, as prescribed.
Depending on how you react to anesthesia and who your surgeon is, you may also be given stool softener.
Bottom line: take ALL of your meds AS DIRECTED. These people know what they’re doing.
If you’re doing everything safe and nothing has set you back, typically you’re good to drive around 3 weeks after, workout lightly about 4 or 5 weeks after, and everything else about 6-8 weeks after.
*****This post was made from things I have learned and my own current experience. If I haven’t mentioned something it’s because I don’t know about it and I’d prefer you have to find information elsewhere than risk spreading false information******
