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Whether you are a transman, a transwoman, gender nonbinary or have another gender identity, you have been waiting a long time for this moment.

For some, it has been a really long time or at least it seems that way.

You have consulted with an experienced and reputable plastic surgeon who specializes in gender affirming top surgery and is board certified by the American Board of Plastic Surgery. Impressed, comfortable and informed, you have selected him/her to perform your top surgery.

Everything is in order for you to proceed with your surgery. In fact, a surgery date has already been selected.

You are so excited! The beginning of the next phase of your life is almost here.

You do want the surgery to go well because it will be truly life changing for you.

At some point in time, the following thought may cross your mind: “What should I do to prepare for my surgery.”

It is highly likely that your plastic surgeon and his/her staff have provided you with this information for your upcoming surgery. Nevertheless, let’s look into what you can do to best prepare for your top surgery.

Follow Your Plastic Surgeon’s Instructions

The most important advice for you in preparation for your top surgery is to listen to and follow your plastic surgeon’s instructions.

This is so important that I will repeat it: FOLLOW YOUR PLASTIC SURGEON’S INSTRUCTIONS

They know your situation best and they are your surgeon. You are their responsibility. Furthermore, they know what works well with their patients.

Not only does this apply for before your surgery but also in the postoperative period as well.

When patients don’t follow instructions, they increase their risk for complications and lesser results.

Don’t let that person be YOU!

If you are unsure about somethings or you want to know why you have to do something or avoid doing something – just ASK.

The following are some specific items that ideally you should follow. They may or may not be included in the instructions provided to you by your plastic surgeon. If there are any discrepancies or conflicts with what you were told, discuss them with your plastic surgeon and default to their recommendations.

No Smoking, Vaping or Using Marijuana

You should stop smoking tobacco and marijuana as well as vaping starting at least one month prior to surgery. It is also recommended that you not indulge yourself with any of these until at least one month after surgery. Their usage can substantially increase the complication rate and extent of problems for a procedure that is life changing.

Is that what you want?

Even just one cigarette before surgery can be detrimental to you and your results.

There can be skin necrosis (the skin dies), loss of the nipple-areola complex, wound separation, delayed healing, wide and thick scars and infection.

And more.

In addition, the irritation these agents cause to your lungs can increase your risks for anesthesia problems.

Avoid Blood Thinners

Bleeding and hematoma formation are among the most common complications occurring with top surgery and may result in the need to return to surgery in order to address. There can even be a long term residual effects on appearance from this issue. In order to reduce these risks, it is recommended that you avoid blood thinners like aspirin, ibuprofen, Aleve and many more starting at around ten to fourteen days prior to your surgery and continuing until around ten to fourteen days after surgery.

My office provides our patients with a list of medications and supplements to avoid. Your doctor’s office may do the same.


Ideal wound healing depends on several variables and one of those is proper nutrition. Having a well-balanced diet with appropriate nutrition is important for postsurgical healing, wound strength, the nature of the scar long term and even infection risk.

Protein that is comprised of a wide diversity of amino acids provides the essential building blocks for wound healing. That can only be found in animal based proteins – like beef and chicken – and not in plant based sources. Consequently, strict vegans and vegetarians who do not temporarily supplement their diet with animal proteins are more likely to have wound healing issues such as delayed healing, weak incisions, wide scars and even wound separation.

Though this will vary among plastic surgeons, I recommend that my patients are on a high protein diet starting one month prior to surgery and continuing until at least one month after surgery. During this same period it is also recommended to take high dose vitamin C and multivitamins. Zinc and vitamin D are also beneficial.


The closer you are to your ideal weight the better your results will be and the lower your anesthesia risks are. A lower body mass index (BMI) is preferable to a higher one. For many, unfortunately, being at a “reasonable” weight will never be in the cards. However, if you are significantly overweight, even losing several pounds prior to surgery can reduce your risks for healing and other untoward issues.

In summary…

There are several things that you can do to help create more ideal conditions for you to obtain the top surgery results that you desire. The above outlined information should assist you in this goal though you may need to inquire on some of the specifics.

Remember, though, that the most important thing for you to do is follow the instructions and recommendations of your plastic surgeon.

For more information on the above or to schedule your consultation with me for top surgery, please call my office at (480) 451-3000 or contact us by email.

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



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