Top flattening surgery is one of the most sought-after and frequently done embodiment surgeries. Our surgery series provides in-depth information about this type of surgery. Doctors Ken McGee and Brianna Durand have previously contributed articles on exercise before and after top surgery and scar care for our blog. In this blog, we want to discuss getting ready for your hospital stay and immediate recovery time.
Flattening top surgery – also known as mastectomy, or chest reconstruction with bilateral mastectomy – is generally seen as a safer surgery. However, it is a major surgery, and your body will need significant healing time afterward. Dr. Scott Mosser’s Gender Confirmation Center is an excellent source of information on incision styles, options to consider when planning chest reconstruction surgery, the risks of this surgery, and physical and emotional prep for surgery. It also contains some information about the emotional and physical healing journey you might experience after surgery. We aim to help you plan your hospital stay and early recovery at home.
You will likely be discharged from the hospital on the same day as your surgery and will not need to stay overnight. This means that your list can be minimal:
- Your driver/support person – you will not be able to drive yourself
- They can hold on to your ID and any other personal belongings (phone, payment)
- Wear comfortable, loose clothes. Bring button or zip-up shirts, elastic, stretchy, or drawstring waist bottoms, and slip-on shoes.
- Pillow to place between your chest and seatbelt in the car.
- Emesis (barf) bags or basin for nausea in the car.
You likely won’t want to do much else than sleep on your first day home. Many patients swear by a recliner and wedge pillows: supports that allow you to sleep mostly upright. Your arm movements will be limited and you will likely be sore. Sleeping upright minimizes the effort needed to sit up and get out of bed when needed.
You should have a caregiver with you for at least the first twenty-four hours you are home. They can help you settle in, manage your pain meds, and help you optimize your early healing.
Plan for a few weeks of restricted movement and activities:
- Walking is encouraged, but no strenuous activities
- No lifting anything over ten pounds
- Limited arm movement: T-Rex Time!
- Many surgeons recommend not raising your elbows above your shoulders and minimizing arm movement for the first ten days to two weeks, then gradually adding in more range for the remainder of the first three weeks. These restrictions optimize your scar healing by minimizing tension on your incisions.
- Before surgery, consider a T-Rex challenge day or week to help prep your home. Spend some time going about your daily tasks, but don’t raise your elbows above your shoulders. What items in your home need moving before your surgery? You can also use this time to identify activities you may need help with during your recovery, such as lifting laundry baskets and bags of groceries.
- Showering after your care team removes your dressings and gives you the go-ahead (at about one week.)
- Refrain from submersion in water, including swimming, baths, or hot tubs, for about six weeks.
Supplies that may be helpful:
If you opted for nipple grafts:
- Medicated nonstick gauze (Dr. Mosser recommends Adaptic)
- Nonstick bandages
General supplies for after top surgery:
- Recliner or wedge and body pillows for sleep positioning
- Ice packs
- Antibiotic ointment if recommended by your surgeon
- Mild, hypoallergenic soap
- Wipes, flannels, washcloths, or sponges designed for sponge baths: you won’t be able to shower for a week. You can purchase pre-moistened, no-rinse body cloths intended for this use.
- Tips for sponge baths: have two water basins. One for soapy water, one for rinse water.
- Soft, fluffy bath towels may be a delight when you can shower: remember to pat your nipples (if you opted to have them) and incisions dry instead of wiping.
- A shower chair and detachable shower head may also be helpful – if you’re careful, you can bottom shower and keep your chest dry. A bath brush can also be helpful.
- Peri bottle or bidet for easier bottom cleaning while your arm movement is restricted.
- Roomy button-down shirts and comfortable bottoms
- An art bin or organizer for your bedside or chairside table.
- A chest buddy, armpit, or mastectomy pillow: designed to support your arms while protecting your chest
- Pillows that attach to your seatbelt are also available (or attach velcro to a pillow you already have!)
- A cart for moving items between rooms
- A stash of prepared meals for your first week or two
- Dr. Mosser recommends a low-salt diet to help manage inflammation. Protein supports healing.
- Both The Gender Doula and the Top Surgery Guide Book recommend squeezable applesauce, nutrition shakes, and plain crackers for maintaining nutrition and easier med-taking.
- Bendy straws! Disposable/compostable plates and glasses may also help with weight lifting and activity restrictions.
- A reacher/grabber tool
- Back scratcher
- Lotion stick for applying moisturizer to places you temporarily can’t reach
- A drain lanyard or shirts with interior pockets designed for drain management may be useful
- You can also safety pin drains to the inside of a shirt
- Scar tape
- Resource for BIPOC folks: Motivo Scar Care offers scar tape in a range of darker skin tones.
- Silicone scar gel
- Scar tape
Secondhand stores and community groups are great resources for obtaining reusable supplies such as wedge pillows, button-down shirts, and accessibility tools.
What to Watch Out For While You Are Recovering After Top Surgery
This is a partial list – your surgeon will review what to look out for.
- Sudden swelling or pain
- A fever or chills
- Heavy bleeding from incisions that does not stop
- New or sudden bruising near your incisions
- Wound discharge changes that smell bad or look different
- Significant tightness or pulling sensations on your incisions
Do you have darker skin? Read our blog about differences in surgical complications and hematoma risk for Black or darker-skinned patients.
Do you have sensory or chemical restrictions? Read our blog on preparing for hospital stays when you have allergies or sensitivities!
Download our Top Flattening Surgery Checklist!