Chest Masculinizing Surgery for Gender Affirmation: Caring for yourself after surgery

Chest Masculinizing Surgery for Gender Affirmation: Caring for yourself after surgery

We are committed to helping you recover safely and quickly from your surgery. Use this information to take care of yourself at home. Your surgeon will have additional instructions for you after surgery. These instructions will be included in your after visit summary (AVS). Your care team will print your AVS and give it to you before you go home. If you have questions about your follow-up care, talk with your surgeon.

What can I expect after my surgery?

Take time to rest during your recovery. Have someone stay with you at least overnight after surgery to help with daily activities, such as making meals and other household tasks.

After surgery, you may have:

  • An upset stomach, nausea, vomiting and fatigue (feeling very tired). These effects can be caused by the anesthesia (medicine that puts you to sleep) you received during surgery and may last 1 or 2 days.
  • A low-grade fever (less than 101°F or 38°C) due to lung congestion. Usually, you can clear this congestion by coughing and breathing deeply. Your congestion may take a few hours to clear. 
  • A drowsy, dizzy or weak feeling for a few days after surgery.
  • Light drainage from your incisions for a few days after surgery.
  • Tenderness and bruising in your chest for 1 to 2 weeks.
  • Pain with arm movement for 1 to 2 weeks.
  • Temporary loss of chest sensation or numbness.

How do I manage my pain?

Pain medicine will help you feel more comfortable but won’t get rid of all your pain.

  • Your surgeon may prescribe pain medicine for you.
    • Take your pain medicine exactly as your surgeon prescribes.
    • Take your pain medicine with food to avoid an upset stomach. 
    • As your pain improves, you may take acetaminophen (Tylenol) instead of your prescription pain medicine, but do not take both at the same time. Some prescription pain medicines contain acetaminophen, so taking acetaminophen in addition to your prescription pain medicine could be harmful.
  • Check your AVS to see if it’s OK to take ibuprofen (Advil, Motrin) or naproxen (Aleve) starting 1 to 2 days after surgery.
  • Do not take aspirin, herbal supplements or vitamins for 1 week after surgery. These medicines can increase bleeding, bruising and drainage.

Other ways to manage your pain include the following:

  • Use ice packs or cool compresses on the sides of your chest.
    • Leave the packs on for 20 minutes every hour when you’re awake. 
    • Use as needed for pain for 1 to 2 days.

How do I care for my chest after surgery? 

  • We will protect your chest with an Ace bandage wrap. You will continue to wear the Ace bandage until your surgeon gives you other instructions.
    • The wrap will put gentle pressure on your chest to help reduce swelling and pain. You can adjust the wrap as needed for comfort.
    • Wear the binder or wrap 24 hours a day until your first follow-up visit. You can briefly remove the wrap to wash it or to take a sponge bath or shower.
    • You may find it more comfortable to sleep on your back or side for 3 weeks after surgery. Avoid sleeping on your stomach.
  • If you have nipple grafts:
    • As the nipple grafts heal, you may have drainage from the incisions and changes in skin color. Tissue may slough off for several weeks. Your surgeon will talk with you about what changes you can expect.
    • You will have a bolster (support dressing) placed over your nipple and areola (dark area around your nipple). The bolster protects your nipple graft and will be removed during your first follow-up visit. 
    • You will have a bandage over your bolster. The surgeon will give you instructions on how long to keep the bandage on and how often to change it.
    • Don’t shower or get your nipple dressing and bolster wet until your surgeon says you can. You may sponge bathe.
  • Take care of your incisions. 
    • Keep incisions clean and dry. 
    • Follow the instructions your surgeon has given you about caring for your incisions.
    • For 6 months after surgery, keep your incisions out of the sun. 
    • For 7 to 12 months after surgery, apply sunscreen if you’ll be exposing your chest to the sun. Use sunscreen with an SPF (sun protection factor) of 30 or higher. Using sunscreen will prevent your scars from getting dark. 

What about drinking and eating?

If you have an upset stomach, nausea or vomiting, you may not feel like eating.

  • Start by drinking small sips of fluids, such as clear carbonated beverages, tea or soup. Drink fluids often.
  • Gradually add bland foods to your diet, such as dry toast or crackers. 
  • Start with light meals. Go back to your regular diet as you feel able.
  • Talk to your surgeon if your nausea doesn’t improve. Your surgeon may prescribe medicine to help decrease nausea.

To prevent constipation from pain medicine:

  • Eat fiber (fruits, vegetables, and whole-grain cereals and breads).
  • Drink plenty of fluids.

How do I care for my drain tubes and drain site?

You may have drain tubes in place for a few days to 1 week after surgery. The tubes help prevent fluid from collecting near your incisions. Follow the instructions your surgeon gives you to care for your drains. In general:

  • Strip and empty your drain tubes 2 times a day. (We will give you a drain care instruction sheet and a sheet to record the amount of drainage.) 
  • Keep your drain site clean, dry and covered with a clean bandage. 

What about bathing?

Your surgeon will tell you when you can bathe or shower. In general:

  • If you do have a bolster dressing, sponge bathe until your surgeon says it is OK to shower or get your nipple graft wet.
  • If you do not have a bolster dressing, you may shower in 24 to 48 hours after surgery if your incisions are dry. 
  • Don’t soak in a bathtub, hot tub or pool until your incisions are fully healed (usually 3 weeks after surgery).
  • When you are able to shower:
    • Use mild soap and water to gently wash your chest—including your incisions—and armpit areas. 
    • Don’t scrub the incisions. Let water gently run over the incisions. 
    • Avoid direct water pressure to the chest for 1 to 2 weeks after surgery to reduce discomfort.
    • Pat incisions dry gently.
  • After showering, cover your incisions with fresh bandages to protect your incisions and avoid irritation. Wrap your chest with Ace bandage. 

What are my restrictions?

  • Don’t drive for 1 to 2 weeks after surgery.
  • While taking prescription pain medicine:
    • Don’t drive.
    • Don’t drink alcohol.
    • Don’t make any major decisions. Major decisions include activities such as signing important papers or managing legal issues.
  • Avoid traveling out of the area for 3 weeks after surgery.
  • You will need to have a friend or family member drive you to your first follow-up appointment.
  • Continue not smoking. Smoking can delay healing and increase risk of complications. 

What about activity?

Get up to walk around every 2 to 4 hours when you’re awake. This movement helps prevent blood clots from forming in your legs. These blood clots can be life threatening.

Other than light walking, you will need to significantly limit your activity while you recover from surgery. Too much activity produces fluid in your body and slows healing. 

For 2 to 3 weeks after surgery

  • Don’t lift anything heavier than 10 pounds (4.5 kilograms).
  • Avoid activities that involve repeatedly moving your arms, pushing with your arms or gripping with your hands. 
  • Don’t do strenuous activity, such as jogging, biking, swimming, weight lifting, vacuuming, shoveling, lawn mowing, gardening or sexual activity.
  • Light walking is OK, but don’t swing your arms too much or too fast.
  • After 2 to 3 weeks, your surgeon will tell you it is OK for you to lift 20 pounds (9 kilograms). You will likely have this 20-pound restriction for another 2 to 3 weeks. 

Returning to work

  • If you have a desk job, you may return to work in 10 days to 2 weeks. 
  • If you have a more active job, wait 3 to 4 weeks before returning to work. 
  • Don’t return to work until your drains are removed and your surgeon tells you it’s OK. 

When do I call my surgeon?

Call your surgeon’s office if you have:

  • A fever of 101°F (38°C) or higher.
  • Severe pain that doesn’t get better with pain medicine.
  • Increased redness, heat (feels warm to the touch), swelling or cloudy, foul-smelling drainage (pus) from your incisions or drain site.
  • Significant pain, bruising and sudden swelling in one side of your chest (as compared with the other side of your chest)—Your chest should look flat.
  • Bleeding from incisions or drain site that doesn’t stop after applying light pressure 
  • Fluid leaking around drain tube
  • A drain that falls out 
  • The drain tube gets plugged and you are unable to strip it open
  • An increase in the amount of discharge or a change in color of the drainage

Phone numbers

  • Park Nicollet Plastic Surgery
    5400 Excelsior Boulevard, Suite 150
    St. Louis Park, MN 55416 
    Monday through Friday, 8:30 a.m. to 5 p.m.
    952-993-3504
    If you call after office hours or on Saturday or Sunday, you will be transferred to the Methodist Hospital operator. Tell the operator you are a patient and ask to speak to the on-call plastic surgeon. A surgeon will call you back.
     
  • HealthPartners Plastic Surgery
    1875 Woodwinds Drive, Suite 120
    Woodbury, MN 55125
    Monday through Friday, 8:00 a.m. to 5 p.m.
    651-255-7777
    If you call after office hours or on Saturday or Sunday, call the HealthPartners Careline at 612-339-3663. 
     
  • HealthPartners Specialty Center
    401 Phalen Boulevard
    St. Paul, MN 55103
    Monday through Friday, 8:00 a.m. to 5 p.m.
    651-254-8290
    If you call after office hours or on Saturday or Sunday, call the HealthPartners Careline at 612-339-3663. 

 

23876 (8/2020) ©HealthPartners