Top Surgery FAQ

  • How do I know if top surgery is right for me?
  • Choosing to undergo top surgery is a complex process shaped by internal feelings and philosophies as well as by external circumstances such as your overall health, your ability to travel for surgery and your current financial status.  Sometimes the decision to have surgery is more of a process, which takes time and exploration.

    As with any major life decision, it’s normal to be have some doubt and anxiety. At Dr Mosser’s San Francisco practice, we provide you with in-depth information on surgical techniques, recovery, safety and results so that you can make an informed final decision.

    Start by learning about the typical top surgery journey.

  • What are the positive effects of top surgery?
  • The ultimate goal of surgery is to make you feel more comfortable with your body by better aligning your physical characteristics with your internal sense of self and the self you want to present to the world. The relief surgery provides can enhance both your feelings of self-esteem and body confidence.

    Here’s what some of our patients had to say about their experience.

  • What are the major safety risks and complications of surgery?
  • Individual risk for top surgery will depend on general health, age, weight, and other characteristics, but you can take steps to reduce chances of complications:

    • be honest with your surgeon about your medical history and desired outcome
    • tell your surgeon about any medications or supplements you are taking
    • follow pre- and post- op instructions carefully
    • stop smoking completely 3 weeks before surgery

    In general, plastic surgery risks are relatively small. Always choose a Board Certified Plastic Surgeon who operates at an accredited surgery center. Read more about safety and complications.

  • How should I prepare for top surgery?
  • Your surgeon will give you specific instructions for medications, vitamins, clothes, food, and any other particulars a few weeks before surgery. (Take a peek at Dr Mosser’s pre-surgery guidelines for FTM Top Surgery or MTF Top Surgery.)

    It is best to minimize any major changes in your life, and be in close contact with your surgeon’s office if anything comes up.

  • What should I do to prepare if I have a history of anxiety or depression?
  • Although everyone expects to be ecstatic after surgery, it is not uncommon to go through a period of post-operative depression following surgery. If you already know you are prone to anxiety or depression, it might be a good idea to establish a relationship with a therapist to help with emotional support before and after surgery.  We recommend scheduling a visit with your therapist 10-14 days after surgery, so that you are prepared with a support system in the event that you experience post-operative depression.

  • What happens when I wake up from top surgery?
  • Top surgeries generally take around 2 hours. Once completed, you will be taken to a recovery area to be monitored. As you gradually wake up from sedation, it’s likely that you will experience some grogginess, soreness and in some cases nausea.

    When you wake up from surgery, it’s normal to experience some discomfort, swelling and bruising. Your chest will be wrapped in gauze dressings and a compression vest for support.

    Once you are cleared for release (typically the same day as surgery), you will need a friend or relative to drive you home. Your body will be exhausted at this point, and you should avoid significant physical activity.

  • What does recovery look like?
  • Though the first few days of recovery should be spent resting, you are encouraged to walk around.  However, you should initially minimize many other physical activities, especially raising your arms or lifting over 5 lbs. Taking it easy will minimize pain, discomfort and other possible complications after surgery.

    Typically patients resume non-physical activities after 8-10 days.

    Regular (cardiovascular) physical activity should be avoided for at least 3 weeks, and strenuous exercise for at least 5 to 6 weeks.

  • How much pain can I expect after top surgery?
  • Pain can vary depending on your tolerance level.  Most patients report minimal to  no pain (usually a 3-4 on a scale of 1-10 for pain), and may take prescription painkillers the first day or two, afterwards Tylenol or no medication.

    The most uncomfortable period is the first few days after surgery. Along with regular post-surgery fatigue, you may experience swelling, tenderness, and tightness in your chest due to the dressings. Moreover, you cannot sleep on your side and may have limited mobility in your upper body.

  • Do I have to wear a compression vest after top surgery?
  • Yes, you will need to wear a compression vest for 1-2 few weeks after surgery to minimize swelling and to help the skin tighten. For FTM Top Surgery patients, this vest is not as uncomfortable or tight as a binder.

  • Are drains required? Do the drains hurt?
  • Most top surgery procedures do not require the use of drains to collect fluid buildup.  Dr. Mosser currently uses drains in less than 20% of his patients.  If used, they are removed within 5 to 7 days after surgery at your initial post-op visit with Dr Mosser.

    The way that Dr. Mosser places drains in his patients avoids any discomfort from the drains, or any additional scarring or healing issues that could be caused by drains.  Generally patients do not feel the drains that Dr. Mosser places (although they may be strange to look at).

  • When can I shower after top surgery?
  • Within 3 to 7 days after surgery at your initial post-op visit, Dr Mosser will remove your dressing, inspect the surgical area, and give you the go ahead to begin regular showers. Until that time, you can sponge bathe to keep clean.

  • How much time do I need to take off work?
  • You will need to take about a week off from work and other normal routines to rest and recuperate.  Patients walk around immediately after surgery, and most patients feel up to resuming sedentary work and light physical activity and a desk job within 8 to 10 days.  You can’t lift more than 5 lbs until three weeks after surgery.

  • When can I begin to exercise?
  • Any physical activity that may cause your heart rate to increase or for you break out in a sweat should be avoided for at least 3 weeks. Heavy lifting and chest exercises should be avoided for at least 5 to 6 weeks.

  • When can I suntan / swim after top surgery?
  • Keep your scars out of the sun (or wear strong sunscreen) for at least six months. Though you can splash around in the water as soon as 3 weeks after surgery, it is recommended to avoid swimming for exercise (because of the arms-over-shoulders requirement of most swimming strokes) for 6 months following surgery.

  • What can I do to minimize scarring?
  • Scar formation is a normal part of the healing process, but how your body responds to injury depends on several factors such as age, genetics, location on the body and skin color.

    There are several options to help minimize scarring: stop smoking 3 weeks before and after surgery; eat a nutritious diet; use silicon sheet or tape; as well as intensive treatments such as steroid injections or laser scar removal.  For many FTM top surgery patients, it is really important for you to avoid having your arms over your shoulders for as much as 6 months after surgery, in order to have the very thinnest, flattest scars you can have.

    Dr. Mosser will provide you with personalized recommendations following your surgery.

  • Will I need a revision or second procedure?
  • Most patients only require a single surgery to achieve desired results.  A small percentage (<5%) will choose to have a revision, which is typically a minor surgery with a much easier recovery than the original procedure.

  • Can I get other procedures done at the same time of my top surgery?
  • Choosing to combine top surgery with body contouring or other procedures (such as hysterectomy) in the same surgical session can reduce costs related to surgery and ultimately shorten your total recovery time. You are recommended to schedule a consultation with Dr Mosser to see if you are a candidate.

  • Do you provide a letter to change my legal name or gender marker?
  • Anytime after your surgery, our office can provide a letter for a legal gender change, stating you’ve had a surgical procedure for transition. We do it all the time.

  • How common is regret after surgery?
  • Satisfaction with surgical results is closely related to the surgeon’s skill, patient safety, and matching the procedure to the patient’s expectations. What is clear is that transgender visibility has risen dramatically in recent years, along with the number of requests for transition surgery.

    It is exceptionally rare for patients to regret transitioning genders.  Although rare, regret after surgery is often due to the patient’s unrealistic expectations, or due to the very rare complications from surgery, or (unfortunately) due to a poor result executed by an inexperienced surgeon. This is why Dr. Mosser specializes in transgender surgery, and emphasizes coordination with the patient’s support team, including physicians, family members, partners, or close friends assisting in the transition

  • Do I need to undergo top surgery for my transition?
  • The ultimate goal of surgery is to make you feel more comfortable with your body by better aligning your physical characteristics with your internal sense of self and the self you want to present to the world. Some transgender people are comfortable with their chest as-is and do not feel that surgery is necessary for them. Many others feel that altering (removing / augmenting) their breasts is the next step in becoming their authentic self.

    As with any major life decision, it’s normal to have some doubt and anxiety. We’ve helped many patients during their transition, and this website is designed to help you become comfortable with the idea of permanent change and answer important questions.