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Chest Reconstruction Surgery for Gender Affirmation: What to Expect at Home

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Your Recovery

Chest reconstruction surgery for gender affirmation reshapes your chest to align with your gender identity. This is also called "top surgery." The doctor most likely made incisions (cuts) across the breasts or below the nipples. Breast tissue and excess skin were removed to flatten your chest. Your nipples may have been reshaped and repositioned.

You may have soreness, swelling, and mild bruising. You may have a pulling or stretching feeling in your chest area. You will lose feeling in your nipples. You may get some feeling back. But it won't be the same as it was. You will have scars from the incisions, but they will fade.

You may need pain medicine for a week or two. You may get tired easily or have less energy than usual. This may last for several weeks after surgery. Most people can return to their usual activities in 4 to 6 weeks.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

 
  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better. Do not lift anything over your head for 2 to 3 weeks.
  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Your doctor will tell you when you can take a shower. Do not take a bath, swim, or use a hot tub until your doctor tells you it is okay.
  • Sleep on your back with your head and shoulders raised with a pillow.
  • Ask your doctor when it is okay for you to have sex.
  • Ask your doctor when you can drive again.
  • Your doctor will tell you when you can return to work. This will depend on the surgery you had and the type of work you do.
  • Be active. It can help prevent problems and help you recover. Walking is a good option for many.

Diet

 
  • You can eat your normal diet.
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

 
  • Your doctor will tell you if and when you can restart your medicines, including hormones. Your doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

 
  • Follow your doctor's instructions for how to care for your incisions.
  • You may be wearing a tight elastic bandage after the surgery. Your doctor will tell you when it can be removed.
  • If you have strips of tape on your incisions, leave the tape on for a week or until it falls off. Or follow your doctor's instructions for removing the tape.
  • Follow your doctor's instructions for keeping the surgical wounds clean and dry.
  • You may have one or more drains. Your doctor will tell you how to take care of them.

Other instructions

 
  • Follow your doctor's instructions for scar care. Protect scars from the sun when you are outdoors. If the area isn't covered by clothing, use sunscreen.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incisions come open.
  • You are bleeding from the surgery site, and it won't stop with pressure.
  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incisions.
    • Pus draining from the incisions.
    • A fever.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Swelling in the leg or groin.
    • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.