Top Surgery: Real Patient Shares What to Expect

For trans and nonbinary people, top surgery can be life-altering. Transgender male patients who were assigned female at birth often undergo this gender-affirming procedure to create a more masculine-looking chest. Techniques vary depending on each patient’s body and anatomy, but the surgery typically involves removing the breast tissue and excess skin. 

But what is the procedure actually like, and how should patients prepare for it? Here, an AW Plastic Surgery patient who’s undergone top surgery shares insight about the experience and what future patients need to know before making their decision – from consultation to recovery and everything in between.

What should patients expect during the consultation and before surgery?

“Expect to have pictures and measurements done. Meet Dr. Wilson and his staff, and discuss what top surgery options are best for you. Ask any questions that you may have, and get a good understanding of what to expect for prep, surgery day, and recovery. The office will handle paperwork regarding insurance, but you may need to assist with having additional paperwork filled out or letters written from therapists, physicians, etc. This step allows your insurance company to deem surgery medically necessary.”

What are the most important things to know before considering top surgery?

“The most important thing for me to know going into surgery was: Give yourself time to heal. Your vision of your chest may not match your results; expect months and months of scar-care after healing. You may want to push your boundaries, but don’t overexert yourself in any way. Take the time to heal, and allow your body to acclimate to changes. My chest does not necessarily look how I Imagined – but it looks great! The team at AW Plastic Surgery will make sure you love your results before sending you on your way. Also, expect to care for your scars for a long time after surgery to get the best long-term results. This involves morning and night care for up to a year; silicone gels and tape are your best friend!”

What are the most common misconceptions about top surgery?

“The most common misconception for me was that all the breast tissue would be removed. This is more of a cosmetic procedure to masculinize the chest, meaning you will still need annual breast screenings, and have a higher risk of breast cancer than a cisgender male. Another thing is that I never really expected to have drains or vacuum packs for nipples grafts. These were very annoying, but they were only needed for one week – and that week goes by very quickly! I would say the vacuum packs were better than the thought of a bolster.”

How should patients prepare before top surgery?

“I personally had many meetings with my support systems, including mental health professionals, in order to prepare myself for surgery and the recovery period. This is a good way to help yourself talk through any concerns and ultimately make the best decisions for yourself before going into surgery. Set up a caretaker for after surgery – someone who can take you to follow-up appointments, and in the first few days, lend a helping hand with anything that’s needed. (I was able to care for most of my own needs, but having someone there just in case was certainly necessary.)”

What should patients know about recovery?

“During the recovery phase, make sure you have help. That first day you will likely not be able to empty your own drains, and to be honest, be able to cleanse yourself very well. Stretching your arm in any direction will hurt. But this only lasts a few days. Keep the area covered well from water. During the first week or so, sponge baths, baby wipes and dry shampoo will become your best friend! Lastly, don’t be surprised with how long it takes for the nipple grafts to heal. They will look scary at first and then look better, and possibly scary again, but if you continue caring for them as advised, they will heal.”

When you’re ready to make a change in your life, let us guide you through your options at AW Plastic Surgery. Reach out to us here for a consultation on top surgery. We’re ready to help you achieve a happier, more confident life, and ease any discomfort regarding chest or breast size.