Top Surgery Recovery Restropective (Double Inscision Masectomy w/ Free Nipple Grafts)

5/22/2022

Hi. I'm transgender. I was assigned female at birth, but much more heavily identify and present masculine. I don't consider myself a "man" so to say, and usually identify as either Nonbinary, Neutrois, or Agender. This is all a really long way to say that being born into a body that ended up having DD-Cup breasts was not ideal. I've always hated my chest even before I knew I was trans. (I often stated I would seek out breast reduction even when I identified as a butch lesbian.) In a pursuit of a body that I didn't despise, I first tried just getting used to binding. Anyone who has used a binder can tell you that they are kinda crappy for the most part the larger of a chest you have. I have heard a lot of people really like gc2b, but I never got amazing results that helped me to pass as male using them. I still used them, but I would often use my black underworks tank when I had to wear a binder for longer periods of time. I didn't have dysphoria strong enough to justify seeking out a doctor before 18, but I think looking back, knowing what I do now, I would have gone through the process of applying and receiving top surgery sooner. I am not an expert on the process of seeking top surgery at all and it's different for everyone. That said, in general it was simple. I have been taking T for about 6 years now, and it made it a lot easier to find doctors who would take me at my work that way. That combined with the fact I live in a pretty progressive city (and have my parents' insurance) made it straightforward. Instead, I want to document some of the thoughts I've had since the day of surgery (May 3rd, 2022) up until 20 or so days later now that I am mostly done with the hard part of recovery.

Surgery Day (And the days before)

For any surgery process these days you have to wash the night before and morning of with surgical soap. I had to actually lose the tongue piercing that I had because of this (they intubate you while in the OR for oxygen) since you can't have any piercings in your face. I had to take my lip rings out as well, but that was a little less of an issue since I've had them longer than I've been on T and they're pretty much a permanent part of me by now. So note: Once you have a surgery date, don't get any piercings for a few months leading up to it. Also, on that note, get any shaving, waxing, haircuts done a few days before. You're not allowed to shave I believe the day before and of surgery. They asked me to shave two days before at the latest if I wanted to shave. (I simply didn't cause I knew I wouldn't be able to reshave my face until I was more recovered.) For surgery, I had to be there at 6 a.m and I had to have a person there to stay the entire time. My mom came since she's my emergency contact and my fiance can't drive. She had to wait roughly 6 or so hours between getting there and us leaving. She was also given all of my care instructions whiel there and a list of my meds to pick up. Thankfully my doctor had already sent mine to a local pharmacy. Something you MIGHT not get told to get is stool softener. Pain meds (which. You WILL want to take some sort of pain management med) can make your digestive system really backed up. Anyways, another thing that I got before leaving was actually a motion sickness patch. I was given anti-naseau meds by my doctor, but they also gave me a patch that helped a lot. The pain meds I was given were opioids which can cause sickness, and anaesthesia makes you feel woozy sometimes. If they don't recommend them but you aren't good about staying on top of meds, they're pretty cheap online or at a pharmacy. (Roughly $0.50 per patch for a box of 16 I believe. Mine lasted me an entire day.)

The first week of recovery

Once you finally leave and get home, here's another good recommendation. If you have drains (which you probably will) and you don't have an armchair to sleep in, then invest in some sort of sitting up pillow. The kind you lean against with the arms. The LAST thing you want to do if you tend to sleep on your side is to roll. You will probably wake up before you do because it will hurt, but your drains also might get tangled. It sounds weird but it was more difficult sleeping than anything for me the whole first week I was recovering. On the topic of drains, unless you're lucky and go to a surgeon that somehow doesn't need them, you'll have to get use to checking on them regularly. I was lucky and my drains very quickly cleared up and slowed production. My schedule was basically to 1) Take my pain meds every 5.5 hours (that frequency worked for me) even if it meant waking up in the middle of the night. It was pretty slow for the first week for me; we had family in town visiting so I mostly stayed home. I had a follow-up the next Monday (six days later) to get my drains removed and to see my chest the first time.

The second week of recovery

Beginning the second week of recovery was my follow-up appointment. I went to my doctor's normal office to have a status check. He removed my vest and swapped it for a smaller one (the one he'd gotten for me originally was too large) and he checked my scars. Being happy with the state of my healing, he removed my drains. (Side note. Drain removal is the worst part of the entire process in my opinion. I would rather swallow glass than deal with that again.) He then gave me the run down for my care; he kept the foam pads that I had during my first week and had me begin to swap out my dressing daily. I had graduation the day before I was allowed to stop using the foam and switch to just using non-stick dressings. The foam was really obnoxious, ngl.

The third week of recovery

Right now I am in my third going on fourth week of recovery. I will have another follow-up this coming week, and I'll be able to give more insight into what my recovery is like after that. As far as what is going on now, I have had to try and track down boxes of non-stick/adhesive free dressings. CVS seems to have the biggest boxes of them and I've switched from anti-bacterial cream/topical med to aquaphor. Showering is MUCH easier now, but reaching up and down can still really hurt. Stretching is probably the worst. I can technically lift my arms above my head, but it hurts too much for me to actively try or want to do that. We have some high up cupboards that I still have my mom or fiance reach into for me.
Update: Today I had my followup appointment. I don't have to cover my scars and nipples with Aquaphor now; I've been told to use a scar cream on the incisions and to keep using non-stick pads on my nipples + Aquaphor. All said, I've been told I can return to normal activity as much as it is comfortable.

Final Update!

Final update as far as this stuff goes! I have stopped wearing the compression top since 1. It was too small and 2. it was getting irritating to wash it every day (since I am working some now) and it didn't seem to be having any effect. Thus, I have been using scar cream on all of my scars, and all of my stitches have dissolved or fallen out (in a "they were mostly gone way" so I am pretty much done! We'll call that a month and some change for recovery. :) I have almost all of my range of motion back, and the only thign that's really "difficult" to do is reach across my chest with my opposite arms. I'll probably begin actually being able to work out soon, and I plan on shopping for shirts that actually fit! (Sidenote: I went down an entire shirt size!)