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At last, you have finally arrived at this major turning point in your life. You are completely READY and EXCITED to proceed with your gender affirming top surgery. Depending on your gender identity, this will either be a FTM or FTNB bilateral mastectomy.

You have had your consultation with a reputable board certified Plastic Surgeon. Based on your personal situation, the technique recommended for you was the double incision free nipple graft approachor no nipples, if that is your preference.

It is highly likely that many details about the procedure were discussed with you. However, with all this information being presented to you – added to your overall excitement, nervousness and anxiety – you probably missed a lot of what was being said or just forgot much of it.

No worries!

Just call your plastic surgeon’s office and ask your questions. You should get answers.

For our patients, anytime that they have questions about their procedure or anything remotely related to it, they are encouraged to contact our office for answers and appropriate information.

So call if you need answers!

Before your surgery, you are provided with thorough, but clearly understandable, instructions and guidelines as well as expectations related to your top surgery procedure. This includes before, immediately postoperatively and more long term.

We try not to make this rocket science for you.

Let’s explore what you can expect for the first few days following your FTM or FTNB top surgery…

The Day of Your Top Surgery

Your surgery will be done under general anesthesia as an outpatient using an anesthesiologist. Time for surgery can vary depending on a few factors but it typically ranges from less than two hours to around three hours. A snug but relatively comfortable dressing will be placed around your chest at the completion of your surgery. This will be removed within two to three days.

Surgical dressing 3 days after surgery

You will also have two drains in place, one on each side, which will empty any fluid that could otherwise accumulate deep to your skin as a consequence of the surgery. These are attached to compressible silicone drain “bulbs” which will collect the fluid so that it remains a closed system. You will need to measure and record 24 hour totals of drainage for each side. The recovery room nurse will show you and whoever is with you, exactly how to do this. Once you see how it is done, it is truly very easy.

Discomfort after surgery can be expected to be mild to moderate. You will have prescriptions for pain medication, a prophylactic antibiotic and one for nausea (if needed). If you don’t require the narcotic pain medication, take Tylenol or Extra-Strength Tylenol – you will recuperate and function better with fewer untoward issues.

Your Initial Follow-Up Appointment

Your first follow-up appointment is usually in two to three days after surgery. The surgical dressing will be removed during this visit and replaced by a compressive garment that you were instructed to get and bring with you to the office. This garment will be worn most of the time for the next three to four weeks.

Three days after double incision free nipple graft mastectomy. Dressing had just been removed. Drains can be seen exiting the skin on the sides.


Another patient two days after surgery following dressing removal.

The drains will NOT be removed at this visit.

Usually by this time, the discomfort that you may be experiencing is generally fairly mild and well controlled with just Tylenol or Extra-Strength Tylenol or nothing at all.

Your next post-surgical appointment is generally in several days to a week. At that time, your wound tapes (Steri-Strips) are changed. Depending on drainage amounts, one or both of your drains maybe removed.

Follow Instructions – Ask Questions

During your postoperative appointments, important instructions are repeated as a reminder to you. We want your recovery to go as best as possible. In addition, you are encouraged to ask questions if you have any.

And there you go…

Easy and straightforward.


Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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