FtM Top Surgery: Preparation

Posted: September 20, 2015 in Uncategorized
Tags: ,

Yesterday was exactly two months to the day before my top surgery, so I figured it was good timing to talk about top surgery in a bit more detail.

FtM top surgery is similar to a mastectomy, with the exception that after removal of the breast tissue, there is a lot of contouring that goes on as well, and usually a fair amount of fiddling about with your nipples. (Yeah, real technical terminology going on here.) There’s various techniques depending on how big your breasts are and, basically, the bigger the boobs, the more your chest is going to feel like you got hit by a 4×4 afterwards.

I will be blogging and vlogging in real detail when the time comes as to exactly what the experience is like, but right now, I’m experiencing the preparation stage.

And that’s a pretty long-ass stage.

Very basically, top surgery is a cosmetic procedure. Physically speaking. I’m not saying it’s just like people who want a nose job; what I’m saying is that top surgery is not something that your medical team goes ‘oh fuck you need this now!’ and rush you into theatre. This shit takes ages.

In my case, I have a straightforward referral and I have no medical history that would be of any concern to a surgeon operating on my upper body. (If the poor bastard was operating on my right knee, that would be a whole other story, but thankfully boobs don’t grow out of your knees.) So I get ‘turn up on the tenth for your pre-operative assessment, then if all goes well for that, turn up on the nineteenth for surgery.’

Referral comes from your psychiatrist. Yes, despite transgenderism no longer being viewed in the West by the medical community as a mental illness, it’s a psychiatrist (or similar) who gets to yay or nay your medical transition. Some surgeons in the US use a waiver model, where you sign a waiver not to sue them if you change your mind later, but most don’t. No psychiatrist’s letter, no surgery.

Some surgeons need two referrals, some need one. In my case, only one was needed. The surgeon accepted the referral, I made arrangements with his staff, and got booked in for surgery on 19th November. Job done!


Sort of.

The #boobwar is over, in the sense that now the only thing that can betray me is my own body, and if it does that, I’ll be shut out of surgery anyway. But that doesn’t mean that I’m just sitting and waiting for surgery day.

Because the surgeon has to do a significant amount of contouring and sculpting work on your just-decimated chest in order to make it look masculine as opposed to just flat, his or her job is made easier if there’s a bit of muscle definition already there to work with. And looking as masculine as possible is my goal, so I’m working out a heckuva lot at the minute.

Then there’s the medical instructions. I’ve been sent a doorstep of a booklet asking all sorts of questions, and telling me to take various vitamin supplements and herbal whathaveyous prior to and after the surgery in order to help healing. Now I’m not the homeopathic remedy kind of guy, so that took a bit of shopping around to freakin’ find, but whatever. He’s the expert.

Then there’s the general improvement to diet and fitness so the surgery doesn’t knock me flat on my arse too badly. Because I work two jobs, I don’t eat as well as I should. No more — and boy, am I not enjoying it. Seriously, after this surgery, I am never eating oranges again.

And, of course, there’s post-surgery preparation. I’ll need to sleep sitting up for a few days after. I may have drains. I won’t be able to reach above my head easily, and anything on a high shelf becomes impossible. I will contort my face like I’ve had a medieval pike driven through my thigh if I try and lift anything heavier than a piece of cotton wool. Working out is out, pun not intended. And I’m going to have to pack a special hospital bag, including pillows for the car on the way home, and a shirt I can put on without moving my shoulders.

But all of that is nothing compared to the psychological preparation.

I am not a very feelsy person. What bothers other people doesn’t seem to bother me, whereas what other people can do without thinking twice, I’m freaking out about. I get stressed about having to drive between two offices at my day job, because what if my universal access card doesn’t work. Turn up as a key witness for a three-week trial? No problem, bring me a magazine so I’m not bored.

Surgery is the same. Actually getting a major surgical procedure isn’t bothering me in the slightest. It’s not even on my radar yet. But what if I get lost on my way to the pre-op assessment?! What if I can’t sleep in their hospital beds? Holy shit, what if they serve some fucking awful weird-ass breakfast and won’t let me go until I eat the damn stuff??

Seriously, that’s bothering me. And on other forums where I’ve discussed this with other FtM guys, the reaction has actually been ‘wtf are you for real?’

Well, yeah. Actually I am. What I feel is unusual, sure, but it’s fine to feel the way I do. Just like it’s fine for other trans guys to not want to get top surgery, or have hormones, or whatever else. As long as I understand the enormity of what I’m doing, and the fact there is no turning back after the anaesthetist turns up on the nineteenth, then whether or not it’s making me nervous is irrelevant.

And weirdly, that’s taken me longer to settle down with than any of the rest of it. That it’s fine to feel the way I do about this upcoming event.

And after surgery?






(If anyone wants to send me chocolate to tide me over with happiness and e-numbers after I’ve been chopped up, I will love you forever. Just saying.)

  1. Tanya Philp says:

    How long will you have to be in hospital? Is it a long recovery time? Will you need to be fully healed before starting the hormone therapy? Like, it won’t muck up your recovery or delay healing or anything right? How soon can you start working out again? Mainly you’re altering breast tissue so the underlying muscle doesn’t have to be altered in anyway, does it? I know… a lot of questions but I do find it interesting and well, I just wanted to know that you’d be okay afterward.


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