After Surgery

It is helpful to remind yourself that there will typically be ups and downs during the post top surgery period. This article provides a timeline of daily activities you can do to optimize your top surgery recovery and healing. Various restrictions depending on the type of surgery you pursued are also briefly discussed. It is important to review these recovery milestones to help you know what to expect and prepare for your gender affirming surgery.

VERY IMPORTANT: If you have excessive bleeding or pain, call your surgeon at (415) 780-1515. You can reach them day or night by calling the normal office line.

YOUR FIRST 24 HOURS: If you are going home, a family member or friend must drive you because you have been sedated. Someone should stay overnight with you. If you choose to go to a postoperative center, they will provide transportation. If you have any questions, please ask one of our nursing staff.

DRESSINGS: Keep your dressings as clean and dry as possible. Do not remove them until  instructed to do so.

ACTIVITY: Take it easy and pamper yourself. Try to avoid any straining. You may go to the bathroom, sit and watch TV, etc., but NO MATTER HOW GOOD YOU FEEL, DO NOT CLEAN THE HOUSE, REARRANGE THE ATTIC, ETC.! We do not want you to bleed and cause any more swelling and bruising than is unavoidable.

ICE PACKS: Cold or ice packs help to reduce swelling, bruising, and pain. Use frozen peas in the package or crush ice cubes and put them ice into a zip-lock bag. This should help, not hurt. If the ice feels uncomfortable, don’t use it as often. Before placing a cold pack against your skin, put a cloth between your skin and the ice. Also, check the temperature on the back of your hand before placing it on the area you were operated on; sometimes you can inadvertently hurt your skin if you don’t check the temperature before placing it on the affected area.

SHOWERING: Do not shower until after your first post-op visit with your surgeon. They will take down your dressing, inspect the surgical area, and give you the go ahead to begin showering. Until that time, you can have a sponge bath or use baby wipes  to keep clean. 

DIET: If you have any postoperative nausea, carbonated sodas and dry crackers may settle the stomach. If nausea is severe, use the post-op anti-nausea medications prescribed. If you feel good, start with liquids and bland foods, and if those are well tolerated, progress to a regular diet. It is important that you avoid salt (sodium) during your recovery. Salt will increase swelling and may prolong your recovery. Click here for a list of low-sodium meal choices.

SMOKING: Smoking reduces blood flow and can cause issues with healing, especially if you’ve had any sort of nipple graft done as part of your surgery. We advise you not to smoke marijuana or cigarettes or consume any form of nicotine (vape, gum, patch, etc) during the first 21 days after surgery.

ALCOHOL: Alcohol dilates the blood vessels and could increase postoperative bleeding. Don’t drink until you have stopped taking prescription pain pills. The combination of pain pills and alcohol can be dangerous. Wait at least one week to drink alcohol after surgery.

DRIVING: Don’t drive for at least 2 days after general anesthesia or intravenous sedation, and wait to drive until you have stopped taking prescription pain pills. It’s best to wait until you can drive comfortably and without any disruption to the area where you had surgery.

After Top Surgery; Practical Daily Milestones

7 days after top surgery

Maintain a low salt diet

  • Eat fresh fruits, veggies, and lean protein
  • If you’re eating boxed, canned or packaged food, ensure it has low sodium percentages

Take it easy

  • Rest up, take this time to reflect on all the moments that have led to this one!

Get some gentle movement 

  • As long as you’re not getting your heart rate up too much, moving around is good for your physical and emotional well being
  • Go for short, slow walks – avoid stairs, walking your dog, or any sort of vigorous activity

Emptying and recording your drain output (if you have surgical drains)

  • It’s important to keep a detailed record of your drain output with the log either Vista or St. Francis hospital has given you

Going to your post-op appointment on the 6th or 7th day after surgery

  • This day is particularly exciting, as you get to see your chest! Leave yourself plenty of time to get to your appointment to eliminate stress around such a special occasion. At this appointment, you’ll receive your post-op care instructions, see your chest, and get your photos taken

 8-14 days after surgery

You can take a shower

  • You’re able to shower now that all of your bandages have been removed and you’ve received the proper after care instructions
  • When you do shower, let the water and soap run over your nipples. Do not directly apply soap or scrub your nipples manually
  • Be sure to ‘pat dry’ once you’re out of the shower

Continue to follow the dressings instructions you have been given for your nipple areas

  • No other dressings instructions are needed on other incisions except for your nipples


  • You’re able to go on long walks as long as they are at a ‘strolling pace’

15-21 days after surgery

Nipple cleanliness

  • You can begin soaping the nipple areas gently with every shower to promote cleanliness and healing

Nipple dressings

  • Nipple dressings provided at your post-op appointment can be applied for the first 21 days after surgery.
  • After day 21, no bandages on the nipples at all.


  • You can go on long walks as long as they are at a slow strolling pace

22-42 days after surgery

Cardio begins

  • On  day 22 it’s acceptable to do cardio such as running, cycling, and elliptical.

We recommend that patients refrain from raising their elbows above their shoulders during the initial 3-6 weeks of the healing process if they’ve had:

Avoid stretching the chest

  • Moving and stretching excessively can cause widening of the scars
  • Avoid stretching your chest dramatically
  • Or twisting and turning in a way that may ‘pull’ on your incision lines

43 days-6 months after surgery

Back to normal life!

  • Regular workouts and normal activity is ok

You still can’t raise your elbows up to or over your shoulder until after 6 months. Please read our revised instructions regarding elbow mobility.

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