FTM Transition: Top Surgery Surprises

Things I wish I had known before my surgery

I am now over five weeks in post-op recovery from my top surgery. Since the last article I wrote on having top surgery, I have come across some unexpected things that I wanted to share with the community.

Uneven healing

My incisions began to change in the last couple of weeks, and I wasn’t sure if it was something I needed to worry about or not. I had been diligently applying the scar care treatment and using silicone tape as prescribed by my surgeon, along with giving my incisions a daily massage or two. However, there were small sections where the color and texture began to change, along with small nubs that began to poke through the incisions.

In addition to that, the dark crust that had been covering my nipple grafts was sloughing off my left nipple more quickly, while it remained in place on my right nipple with hardly any change. I was slathering both in equal amounts of Aquaphor and keeping them covered in gauze.

Unexpected bleeding

The left nipple also surprised me by starting to bleed unexpectedly. That’s when I was sure I must have done something wrong in my care and called my surgeon’s office. Thankfully, the nurse I spoke with assured me that not only was the bleeding expected, it was a good sign that my nipples had healthy blood flow. I wish I had known to expect the bleeding beforehand, then I wouldn’t have panicked as much.

Along with that, she also informed me that incisions heal at different rates, which is why I was experiencing the changes in color and texture in some sections and not others. I had emailed in some photos of what was going on and the nurse did ask me to make some changes in my scar care routine, including putting Aquaphor on my nipple grafts more frequently (I had been doing it only morning and evening), and also to massage my incisions more frequently.

Spitting stitches

These days, most surgeries are completed with internal dissolving stitches and surgical glue to hold the skin together. However, occasionally those internal stitches don’t dissolve, and the incisions will begin spitting out the little bits of suture, that poke out under the healing skin. I have three or four of them right now that I feel every time I massage over the incisions.

I’ve read of ways to deal with these, but I will wait until my next post-op to see what my surgeon recommends. For now I’m going to leave them well enough alone.

Bad smell

One thing they definitely don’t tell you about is how smelly the black crust on the nipple grafts can get. It’s literally just dead tissue, and it begins to stink after a few weeks. I was warned not to pick it off. I need to let it naturally slough off with time, to make sure the skin underneath has the ability to heal properly.

This is why I need to keep applying Aquaphor and keep them covered in gauze, until all the crust can slough off slowly. I gently wash them two to three times each day before applying fresh Aquaphor and gauze. I don’t think I’ll ever forget the rank smell, even after it’s finally all gone and healed up. So far this is the worst part of my recovery and thankfully it’s temporary.

Are you a transgender guy who’s had top surgery? What were some of the things during your recovery that you didn’t expect or weren’t told about? Please let me know in the comments!

Transgender writer and author. I primarily write on LGBTQ issues, with a focus on the transgender community. http://glbalend.com/

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