Fun fact: While top surgery is often described as a “mastectomy,” that’s actually usually inaccurate. Many surgeons perform a “subtotal mastectomy,” which involves removing most, but not all, of the breast tissue. This prevents a sunken or fallen appearance after surgery, and makes it look like you have a sweet set of pecs (if you aren’t already sporting them). It does mean, however, that enough breast tissue remains for you to think about breast cancer risks. You should make sure your health care provider knows that you had a subtotal mastectomy so you can determine which, if any, preventative and screening measures (like mammograms) you should undertake. If you have a family history of breast cancer and/or have genetic testing suggesting you’re at greater risk, that may affect your surgical planning, so be sure to discuss it with your surgeon.
Many top surgery procedures are performed on an outpatient basis. There are a number of options for approaching the surgery, primarily dictated by the size of your breasts. Those with larger breasts will likely need a double incision, while others may be able to have a t-anchor or periareolar surgery, which involves a much smaller incision. That means less scarring and less healing time. Surgical outcomes can also be better for patients who don’t carry a lot of fat in their upper bodies, though your surgeon may perform a little liposuction to tidy things up.
For those eagerly looking forward to taking off their binders, sorry: For about a month after surgery, you’ll need to wear a compression garment to help shape your healing chest. You may also be directed to wear surgical drains, tubes that allow fluid to drain from your chest and collect in a little bulb. They’re about as gross as they sound, but you’ll need to empty them regularly and report any problems to your surgeon.
Once your compression garment comes off, you may need to take special care of your nipples if they were removed and grafted, to ensure that they heal well. Your chest will likely be swollen, bruised, and uncomfortable, and it will take around two years for it to completely settle. If you’re not happy with your outcome, you can meet with your surgeon to discuss a revision.
This section is part of a larger piece, Trans Summer School: The Wide World of Surgical Transition. To read the whole piece or another section, click here!
