Before and After FTM Top Surgery

Written by Dr. Jacobs

We always take time with each prospective plastic surgery patient to get a sense of their readiness for a procedure—with transgender individuals this step is even more important than usual.  We encourage you to come to your consultation with information to share and the willingness to be open about your transformation so far.  The better we understand your background and goals, the better we can advise and support you.

The good news is that when you prepare for top surgery ahead of time, both emotionally and physically, and you give some thought to what you’ll need during recovery, you can leave the rest to us.  Your breast reduction surgery will take between 90 minutes and two hours, and we will be with you at every step.  If you’re ready to get started, give us a call at 212-570-6080 and we’ll set up an appointment.

Readiness for Surgery

Woman to man surgery is a big step; obviously you know this!  We anticipate that the procedure will have an impact on your entire life, not just your body.  That’s why, as a team, we need to ensure you are prepared inside and out.

• Psychological readiness for most patients means they have identified as male for years.  We find most are undergoing hormone treatment and have changed their name and wardrobe.  In essence, to consider surgery as the next logical step your transformation process should be well underway.

  If you can bring materials to your consultation to show us a bit about where you are in your journey, it will be very helpful.  These may include prescriptions, letters and copies of notes and charts from doctors and/or counselors.  You are also welcome to bring a parent or close friend to help us understand how they see you as a person.  Please know that it is not our intent to invade your privacy at all.  Simply put, since FTM top surgery is virtually irreversible, we need to know that this is the right move for you.

• Physical readiness is a shared responsibility between you and our staff.  We will ensure you have all the information you need to prepare, and you will commit to following our instructions and considering our advice.  “Must do’s” include quitting the use of tobacco—permanently is best, but temporarily before and after surgery is critical for proper healing.  You may also need to suspend taking certain medications; we will discuss this well prior to your procedure.  And you will definitely need to fill your post-op prescriptions before the big day.

  We will advise you to give your body the support it needs to heal quickly after surgery, including good nutrition and plenty of rest.  Prepare your home by having easy-to-fix meals on hand and materials to help you relax such as books, movies and music.  You may want to give your house a good cleaning and change your sheets and towels.  Most important of all—have a friend on hand for a couple of days to assist you and on call should you need more help.

Recovering from Top Surgery

Initial recovery begins when we place you in soft bandages and move you to the recovery room.  Fortunately, Dr. Jacobs and his M.D. anesthesiologist prefer to use intravenous (IV) sedation, also known as twilight sedation, rather than general anesthesia.  This means you’ll be completely asleep during surgery but breathing on your own.  You’ll wake up quickly and easily, with none of the “hangover” associated with general anesthesia.  After a short period of rest and monitoring, you can have a friend take you home.

Most breast reduction patients feel moderate soreness for one to a few days after surgery.  You’ll have prescription medication to use at first, then you can switch to over-the-counter pain relievers.  You’ll also notice swelling and bruising that will take several days or a few weeks to subside completely.

You should plan about a week to a week and a half of rest at home after your procedure.  You can begin light activities in a few days, adding more to your schedule as your body and energy allow.  Be advised that doing too much too soon can cause unnecessary swelling and even set recovery back a few days.  Be sure to take it easy!  You’ll be seeing Dr. Jacobs during this period and he can give you feedback on how you’re doing and make suggestions.

Be aware that it may take some time to get used to your new, more masculine torso.  Even if you have been sure surgery is right for you for years, it can take a while to adjust.  Give yourself (and possibly your friends) extra understanding during this period.

Dr. Jacobs and his team have many decades of experience between them, and they enjoy working with all kinds of people.  They derive great satisfaction in helping patients make a change as impactful as the one you are planning.  If you’re ready to talk, send an email and we’ll schedule an appointment.