Yahoo Lifestyle Getting Top Surgery? Here’s Everything You Need to Prepare
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Getting ready to go under the knife can be scary—even when it’s for a procedure you’ve wanted for as long as you can remember. If you’re preparing for top surgery (a gender-affirming chest surgery to remove or augment breast tissue) right now, chances are you’re probably trying to ease your pre-op anxiety by googling every question you can possibly think of. And that’s normal! But it can also lead you down some deep, dark Reddit threads that’ll do nothing but amplify your nerves.
If you’re wondering how to prepare for top surgery without all the panic-inducing anecdotes, you’ve come to the right place. I chatted with three experts and got their best advice on how to get ready for the procedure while preserving your peace of mind.
Before we get into the tips, keep in mind that the most important part of preparing for top surgery is choosing the right surgeon for you. In addition to finding an experienced and gender-affirming doctor, you’ll want to pick someone who can give you the results you’re looking for. “The techniques your surgeon will use can vary quite a lot depending on your breast size and shape, the texture and quality of your skin, and your goals for the procedure,” explains Eric Plemons, PhD, an associate professor of anthropology and cochair of the Transgender Studies Research Cluster at the University of Arizona.
To make sure you’ll be happy with your results, he suggests watching YouTube videos showcasing before-and-afters and looking at post-surgery images online to help you get an idea of what you want. Then be sure to find a surgeon who understands your goals—if they seem like they’re not listening to you, ditch them. Once you’ve made an appointment with a surgeon you trust, here’s everything else the experts recommend doing to prepare for top surgery.
Read your doctor’s pre-op and post-op guidelines carefully.
This might seem like a no-brainer, but it’s worth mentioning. Before your surgery, your doctor’s office will normally provide you with instructions on what to do before and after the procedure. They typically include info on dietary guidelines, activity restrictions, wound care, and any medications you might need. Make sure that you read all of the information carefully, and keep it handy for the recovery process. “Following these instructions diligently significantly improves surgical outcomes and ensures a smoother recovery,” explains Scott Mosser, MD, FACS, a plastic surgeon who performs gender confirmation surgery and the founder of The Gender Confirmation Center of San Francisco.
Prep your space.
Top surgery is a major surgery, and you’ll likely spend the first one to two weeks at home resting after the procedure. So it’s a good idea to prep your space accordingly. Make sure you’ve got a cozy couch or bed setup ready, and consider getting a mastectomy pillow to make lounging and sleeping more comfortable. The Trans Health Program at Fenway Health also recommends getting other items like a long phone charger, a grabber tool, and a back scratcher to make recovery go a bit smoother.
Also, keep in mind that you’re not supposed to lift your arms above your head in the days following top surgery. To make that easier to navigate, consider moving food and essentials to lower, easy-to-reach spots, suggests Plemons.
Make sure you take enough time off from work.
The last thing you want to do is spend your recovery period stressing about going back to your job. Be sure you request enough time off to allow yourself to truly rest and heal. Exactly how much time you’ll need to spend OOO varies from person to person, so it’s a good idea to chat it through with your surgeon at one of your pre-op appointments.
One of the main factors that determines how long you’ll need to take off work is how physically demanding your job is. You’ll have restricted movement in the weeks after your surgery, and you won’t be able to lift heavy objects, which could impact your responsibilities, depending on your line of work. “I generally ask patients to identify the most physically strenuous aspect of their job, and together we determine an appropriate leave period,” explains Dr. Mosser.
Stock up on loose button-up and zip-up shirts.
For your post-op wardrobe, you’ll want a stack of loose-fitting shirts that are easy to put on and take off without raising your arms. (Yup, t-shirts might be off the table for a bit.) Button-up and zip-up options will be your best friends during the recovery period. The loose-fitting aspect is also important because you may need space for surgical drain tubes under your shirt. Tops with interior pockets can also be helpful if you do end up with drains, says Dr. Mosser. And heads-up: Your shirts might get stained during the healing process, so Plemons recommends grabbing some options from the thrift store so that you’re not worried about ruining them.
Pick up skincare and scar-healing products.
In order to help your skin adjust post-surgery, you may want to get an emollient-infused moisturizer like Bio-Oil or Palmer’s Cocoa Butter Lotion. As long as it’s okay with your doctor, you can even start applying these one to two weeks before the procedure to start prepping your skin, if you’d like. After the surgery, Dr. Mosser recommends using one of these moisturizers on your chest every morning and evening—but be careful to avoid your incision sites. This will help with skin relaxation and reduce the appearance of stretch marks, if that’s something you’re concerned about, he explains.
Double-check with your surgeon, but after any scabs from the surgery have fallen off, you should also be able to start using silicone scar tape. Dr. Mosser suggests using it for three months to help optimize healing.
Stop smoking.
If you vape or smoke cigarettes or weed, you’ll need to quit ahead of your top surgery. The American College of Surgeons recommends quitting smoking four to six weeks before any major surgery and staying smoke-free for at least four weeks post-op to lower your risk of complications, and most doctors require a similar timeline for top surgery.
The stakes are high: According to the Gender Confirmation Center of San Francisco, smoking increases the risk of anesthesia complications and postoperative complications like losing a nipple graft, which can require additional surgery to fix. It also delays healing, which can prolong the recovery process and make it more uncomfortable. Dr. Mosser requires all of his patients to stop smoking for at least three weeks before and after top surgery—no exceptions.
Gather a logistical support system.
You’ll need some help taking care of yourself and your basic needs in the days following top surgery, so talk to your friends and/or family in advance to put together a plan. “We’ve consistently seen better outcomes in patients who have a positive, supportive presence in their lives. The best way to ensure this support is to communicate openly with loved ones in advance, set clear expectations about what assistance might be needed, and cultivate an environment of encouragement and care,” Dr. Mosser says.
Decide who’s going to drive you home after the procedure (you won’t be allowed to drive yourself), and think about who might be a good fit to help you with activities like getting dressed and showering the first few days, suggests Plemons. You’ll probably also need someone to help you with tasks like meal prep, medication reminders, carrying groceries, and caring for any pets for a bit.
…and also an emotional support system.
In addition to logistical support, you’ll likely need some emotional support during the top surgery process. The procedure is often something you’ve been anticipating for a long time, and it can be an emotional experience. “Such a big event comes with big feelings about your body, about yourself, and about your future,” says Plemons. So think about who you plan to lean on for support as you navigate your feelings both pre- and post-op. Staying connected to your community—whether that be friends, chosen family, or an online community—is really important. “Even small moments of support, like check-ins or affirming conversations, can make a huge difference in feeling cared for during recovery,” adds Jesse Kahn, LCSW-R, CST, director and sex therapist at the Gender & Sexuality Therapy Center in New York.
Be prepared to feel a range of emotions.
“Top surgery is a significant emotional and physical milestone, and a range of feelings—excitement, anxiety, or unexpected emotions—are completely normal,” explains Kahn. They recommend giving yourself permission to feel and process your emotions without judgment or criticism. Your emotional support network can help with this, but if you’re already seeing a therapist you may want to schedule a session early on in your recovery. “[A therapy session] can be a good opportunity to just check in, look inward, reflect on what you’re experiencing, and give space for your emotions,” says Kahn. Practicing self-care, managing expectations, and doing activities that bring you comfort are also very important during the top surgery process, they add.
Pick out a celebratory outfit.
Give yourself something you look forward to by thinking about what you want to wear once you’ve healed. Buy a shirt in a style you’ve always wanted to wear, or plan out an outfit that’ll showcase your post-op body. “Choose something that will fit you well and show off the body you’re excited to have," suggests Plemons. "After soreness and swelling, it is amazing how gratifying it is to slip into that special shirt (or strut around in no shirt at all).”
This article is not intended to be a substitute for medical advice. Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding surgery.
This image is of a professional model and used for illustrative purposes only.
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