Reflections on Top Surgery, Part 2: Surgery

Gender affirming chest masculinization “top surgery” is one of the major defining moments for trans men. But getting from your existing chest to the one you want to have can be overwhelming from both the information overload and emotional point of view. Having had surgery 3 years ago, I wanted to share my thoughts on surgery in case it may help someone else in the same position. I’ve created a 3 part series on surgery : Pre-surgery, surgery itself, and post- surgery.

This will be mainly from my personal experience as a mostly binary trans man, but could easily be applied to non-binary/GNC people.

If you haven’t read Part 1: Pre-surgery, start there. To recap: I had a phone consultation with a privately funded top surgeon in Ontario, who gave me a surgery date 6 weeks later. I booked my time off from work as well as flights for me and my spouse, Meaghan Ray.

Last Minute Researching

While I had been looking at post-op trans guys for a while, and reading their stories of heading into surgery, suddenly it was going to be me in that position! I refocused my searches on what other people had found useful after surgery.

While there weren’t a lot of medical sites with information regarding top surgery for trans people, there was loads of information for people recovering from breast cancer surgery. Some of it was not quite relevant (what to do while waiting for breast reconstruction), but a lot of the advice on recovering from a long incision across your chest was useful.

The things I found most useful were button down pyjamas and shirts, as well as a neck pillow. Other items that seemed like they would be helpful but then I didn’t use were dry shampoo, body/baby wipes, and stool softeners (though I REALLY wish I had).

Arriving In Toronto

Since we were staying with family, we arrived a few days before surgery for a visit. Similar to when I was travelling for archery competitions, arriving and settling into a new location a little early allowed me to start mentally progressing towards acceptance and excitement.

I did some journaling at the time to help get rid of all the bees buzzing around in my head. I knew that I was super excited for the surgery, but there was now also the return of the anxiety of wondering if I had made the right choice. Everything I did was the last time before having a flat chest, and it felt important to remember those things, mundane as a lot of them were. “This is the last time I’ll be flying with a round chest” “This is the last time going to a cafe with a round chest”. So journaling helped with clearing my head a bit and helping me feel less chaotic.

Pre-op Appointment

The day before surgery I attended the clinic to see where it was, meet the surgeon face to face, and ask any last questions. The staff were great with pronouns, and the clinic seemed modern and clean. However, my appointment time was more than 2 hours behind schedule, and no one bothered to let me know. The only good thing about that is my anxiety completely burned itself out, and was only left with mild annoyance.

Meeting the surgeon was good, he was very respectful but clearly he had his method of doing the surgery and didn’t seem to be interested in what my desires were (similar to the surgeon back home). Despite those nagging worries, I was happy with the pictures I had seen of his results, and I was far too excited for a flat chest to let that slow me down. We drove the 90 minutes back home and settled in for a long evening of no sleep.

Day Of Surgery

Due to my sleep apnea they moved by appointment up to first thing in the morning. Once we arrived I changed into a gown and had the two clinic surgeons as well as a visiting surgeon draw the anatomical lines that would make sure everything ended up straight and proportional. It was a little awkward but clinical (“this is the last time a stranger will see my female chest”).

Everything happened fast after that. They got an IV started and I was off to the surgery suite, and next thing I knew I was waking up crying inconsolably with a pressure on my chest. I don’t know why I was crying, just that I couldn’t stop.

The surgeon came by briefly, but otherwise I felt very alone and disoriented. I was discharged fairly soon afterwards, but with fumbles from the staff leaving me unattended to have a panic attack in the bathroom, and while discharging me out a back door with minimum instructions. This left the experience feeling less than excellent.

Eventually we got back into the car and Meaghan Ray drove us home. According to them, I was frighteningly pale and very nauseous the whole way home but I don’t remember much of that. I do remember the neck pillow came in handy to keep the seatbelt off my new incisions.

First Couple Post-op Days

I was firmly ensconced in the bedroom for several days. The pain was manageable with medications, though I was fairly drowsy so I slept lots and watched lots of movies in bed.

My main complaint was the post-op compression binder used to keep the bandages tight to the incisions. My surgery included liposuction along my armpits and sides to prevent the dog ears that the Edmonton surgeon had mentioned. While that would allow for a more masculine appearance, those areas were not as numb as the incisions and were very tender against the binder. Meaghan Ray helped to modify the binder so that it would be more comfortable. I was told I would need to wear it for 4 weeks! Guess I would need to continue to deal with a binder even though I no longer had breasts. Argh.

Post-op Reveal

The day before flying home, I had a post-op appointment at the clinic where they would remove all the bandages and tapes. There are many videos on YouTube of transmen seeing their new chest for the first time where they elatedly collapse in happy tears and emotion.

My appointment was not like that. I mostly felt relieved to be free of the bandages, continued tiredness from recovery and pain medication, and a touch of feeling surreal. Luckily Meaghan Ray was there to capture the moment and feel excited for me, even if I couldn’t stir up those feelings very well.

Again we fell through the cracks while waiting to be fully discharged. We waited a respectable amount of time, and another 15 minutes on top of that. We finally had to sneak out into the hall where someone finally went “oh, I didn’t know you guys were still here!”

Everyone else who had surgery with this surgeon had nothing but good things to say about their experiences with this clinic, so it appears my experience was an anomaly. I believe most of their private pay clients stay at the hotel adjacent to the clinic so perhaps they were thrown off by me staying 90 minutes away?

I was (and still am) very happy with my results, though the experience itself was far from ideal.

Up Next

Now I got to take my new flat chest back home! I couldn’t wait to finally experience that gender euphoria around my friends, family and colleagues, when they would stop misgendering me since I now had a flat chest! Right?


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