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What You Can Expect During Top Surgery Recovery

Posted by Dr. Hugh McLean on 23 April 2020
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Identifying with the gender of your choice is a natural human right, however, one of the dangerous techniques transgender men use in order to conceal their female gender-identifying features is binding. Although this may help in creating a flatter appearance of the chest, it doesn’t come without consequences. The negative health effects of binding include skin irritation, back pain, and blood vessel damage.

Doctors performing a top surgery operation

For those who truly wish to take the big step into aligning their body with their gender, cosmetic surgery is a viable option.

Female-to-male (FTM) or female-to-non-binary (FTN) top surgery is a life-altering procedure that detaches an individual’s breast tissue in order to provide a flatter and more masculine appearance. This major operation usually takes 1.5 to 4 hours to complete and is performed by a cosmetic surgeon with specific knowledge in gender-affirming or transgender surgeries.

Evidently, making the decision to undergo this medical procedure is a significant aspect of a person’s emotional journey towards identity and self-discovery. In other words, it’s a big decision to make, and, in turn, it requires proper consideration, planning, and care. Like any other kind of serious surgery, top surgery can come with a painful recovery process. In this guide, we will walk you through the pre-operation tips, things you can expect during the initial days of recovery, the essential steps to take in order to handle the pain, and the potential risks.

Pre-Operation Tips

Top surgery ranges from 1.5 to 4 hours in duration. You’ll be glad to know that the aftermath of chest reconstruction is relatively bearable for the majority of patients. However, prior to the day of the actual procedure, patients are advised to adhere to a few important preparation points.

Steer Clear of Alcoholic Beverages

Doctors advise the avoidance of alcoholic substances one week before your surgery.

No Smoking

If you are a smoker, it is highly recommended that you refrain from smoking at least three weeks before the day of your surgery. The reason for this is that smoking can hinder or cause implications with the anesthesia and healing process.

Watch What You Eat

Watching your diet can speed up your recovery process faster than you think. To be specific, lower your sodium intake. Excess sodium in your body leads to water retention. An abundance of sodium in your system, could prolong swelling during your recovery period. Aim to follow a low sodium diet two weeks prior to and after your operation. The recommended sodium consumption per day is approximately 1500 mg.

Discuss Medication

If you are currently taking any kind of medication, it’s imperative to disclose the information to your surgeon. There are a number of medications that could possibly interfere with your surgery.

Doctors would be able to advise whether you should continue taking them before or after the operation. Additionally, make it a point to inform your doctor about any possible breast cancer history in your family, if there is any.

Plan Transportation

Make sure you have a comfortable vehicle to transport you back home after the surgery.

Dress Comfortably

It’s advisable to wear and pack clothing that has either a zipper or a set of buttons in front. Getting dressed after your surgery would be much easier this way, as it wouldn’t aggravate the surgical site.

What You Can Expect During Recovery

Recovery time varies from one person to another, but generally, two weeks should be enough for you to be able to return to work or school. The complete recovery time frame is approximately 6 months.

When you wake up from surgery, you may notice swelling, bruising, and discomfort. There is no need to be alarmed, as these are all common postoperative experiences. You can expect your chest to be wrapped in gauze and a compression vest for support. The first two days after the procedure will definitely be the most uncomfortable, as this will be the period of time that the anesthesia will be wearing off. It would be best to have a family member or friend accompany you during the first 48 hours, as you will still be feeling the effects of sedation.

In order to ensure that no pressure will be applied to the surgical site, medical professionals would advise you to sleep on your back for at least the first week after your surgery. In addition, you may be instructed to avoid showering for approximately six to seven days or until the date of your postoperative appointment. Until this time, using wet wipes or taking sponge baths would be a healthy alternative to taking a shower. It is vital that you keep the dressing clean and dry at all times.

Once your gauze comes off during your post operative appointment, you’ll get the first glimpse of your new chest. You may notice a certain amount of redness and swelling, but rest assured that this is completely normal at this point. The swelling will most likely begin to subside within a span of 2 weeks to 6 months, depending on the case.

Tips for Managing the Post-Operative Pain

With regard to pain, doctors will be able to prescribe you with specific medication to relieve the pain and reduce inflammation. To avoid scarring and excessive discomfort, resist from lifting your arms above your head for two to three weeks.

The best way to manage the pain caused by top surgery is simple: ice packs.
Compressing with an ice pack doesn’t only effectively reduce the level of pain, but it also diminishes the bruising and swelling. You can either use frozen peas or place a few ice cubes in a zip-lock bag. Take note that you need to place a piece of cloth between the ice pack and your skin.

Aside from compressing the surgical site with ice, limiting your strenuous movements contributes drastically to the management of pain. Lifting anything heavier than 1 gallon is not advisable within the first week of recovery. What’s most important to remember is that you stay away from activities that could significantly increase your heart rate or put strain on your body.

Recovery is a process and it takes time, but it’s definitely worth it. The first few days may be a struggle, but once you reach day 22 of post-op, you are encouraged to engage in some light cardiovascular exercises, such as running and cycling. It is still recommended that you avoid any strenuous activities that involve stretching your chest.

Once you hit the 6-month mark, you’ll be fully healed and ready to return to business as usual.

Potential Risks

Complications are highly unlikely, however, it is only natural that undergoing an operation of this magnitude comes without its risks to a certain degree. The risks associated with top surgery are similar to those of other types of surgery. Patients run the risk of developing blood clots, infection, or adverse reactions to anesthesia.

To give a more in-depth overview, FTM or FTN chest surgeries can be associated with the following complications:

  • The complete loss of or reduced nipple sensation
  • Failed nipple grafts
  • Visible scarring
  • The probability of a series of surgeries in order to achieve the desired results

It is only in extremely rare situations that people experience shortness of breath, dizziness, chest pain, or swelling of limbs. In such cases, it is vital to contact 911 for immediate medical attention.

Life after Top Surgery

Once you’ve braved this emotional and exigent cosmetic procedure, managed the pain, and recovered successfully, it’s time to adjust to your newfound freedom. Regardless of your gender identity, it is indispensable that you perform self-check chest exams on a regular basis. Even if most or all of the breast tissue has been surgically removed, doctors still recommend yearly clinical exams for cancer screenings. It is critical that you remain vigilant to your health and listen to your body.

Contact us for more information.

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