Preparing for Top Surgery

In this content, we’ll cover the very basics of getting prepared for surgery and speak a little more about each topic and why they’re important. There is also detailed content that is provided to you during your pre-operative appointment with Dr. Mosser or Dr. Facque that can also be found here.

Getting Physically Healthy Before Top Surgery

Being healthy and maintaining a balanced diet and consistent exercise are some of the keys to a healthy lifestyle.

The Gender Confirmation Center doesn’t have a weight or BMI cutoff for folks who are considering gender-affirming surgery, and it’s best to be at your healthiest prior to any surgery. Here are a couple ways our patients have been able to maintain a healthy lifestyle before and after surgery:

  • Avoid Fad Diets: A ‘fad diet’ is a term that promises quick weight loss (usually through an unbalanced or unhealthy diet). An unbalanced diet means you’re usually cutting out one food group (or multiple), which means you could be losing out on important vitamins. A lot of these fad diets claim that you’re losing fat, but most likely you’re really losing water weight. Losing weight quickly is really appealing but can be dangerous for a number of reasons.
  • A Balanced Diet: Focus on eating whole foods, vegetables, and fruit. Avoid sugar, fried food, and processed foods. If you’re currently using government assistance for food, look into your local farmers’ market. A lot of farmers’ markets have a service where you can use your EBT debit card in exchange for coins you can use at the vendors’ booths to buy food. An incentive for you would be that they double your money; if you withdraw $10, they’ll give you $20 worth of coins. Cutting out processed foods or excessive amounts of sugar are great ways to jump start your healthier lifestyle journey. A healthy diet that is balanced with vegetables, naturally occurring carbohydrates, and protein is the best place to start.
  • Personal Trainer: Finding a trans friendly or trans identified personal trainer can be a great motivator. If financing is a challenge, ask the personal trainer if they offer a sliding scale. Sometimes attending just one session is enough to gain some confidence in different exercises you can do on your own. If you don’t have these resources in your area, there are plenty of trans guys and gender expansive folks who offer the same services online instead of in person. If you’re local to the Bay Area, previous patients of ours have used a personal trainer named Ace Morgan, who owns ‘Ace Morgan Fitness’. He’s a trans guy who is passionate about combating gender dysphoria through a healthy lifestyle.
  • Workout Friend: Find a workout buddy! Transgender and gender expansive Facebook pages are a great place to start. If you feel to vulnerable posting first, try searching the group for keywords to see if anyone has made a similar post. Local trans meetups and support groups are a great way to connect with the community and can be mutually beneficial if someone is in the same boat as you. If you’re more of an introvert and all of this sounds overwhelming, sometimes a secluded walking path in nature is a great way to find some peace as well as exercise.
  • Chest Exercises: Did you know that working out your chest isn’t necessary for surgery? However, it doesn’t hurt! For those who want more defined pectoral muscles after surgery, chest exercises are the way to go.
  • Vitamins: As we all know, vitamins help your body heal which is especially useful when recovering after surgery. Although some folks load up on micronutrients or natural supplements that are supposed to help with healing before top surgery, this isn’t necessary if you’re currently eating a balanced diet. It’s important to note that you have to limit your Vitamin E intake 7-10 days before your top surgery.

Emotional Help & Support Post Top Surgery

We have a lot of information on our site regarding what to expect emotionally after surgery, which can be found here. Here we’ll go over briefly how to set yourself up for success before top surgery and the level of support that may be most beneficial to you post-op.

  • 24 Hour Assistance: With any surgery during which you are put under anesthesia, you need to have someone pick you up and stay with you for the first 24 hours. This can be really challenging financially or for other reasons.
  • 24> Hour Assistance: The reality of top surgery post-op is that you’ll want someone around for at least the first couple of days, if not the whole 7 days after surgery. This is not to say that you will need their assistance 24 hours a day (except for the first 24 hours after surgery), but company throughout the week can go a long way in a happy recovery. If you have a support network, reach out and let them know what you need. If you don’t have a support network, checkout some content on support groups here.

Quitting Recreational Drugs Before Top Surgery

The most commonly used recreational drugs are alcohol, cigarettes (nicotine), and marijuana. Other recreational substances vary, and we’ll go over them in this content. Nicotine use is a big no-no in general but especially in regards to top surgery.

Quitting Smoking Before Top Surgery

  • All nicotine use must be discontinued 3 weeks before and 3 weeks after top surgery
    • No smoking, no patches, no vaping
  • While different surgeons have different policies about the use of medical marijuana, we ask our patients to switch to edibles for the 3 weeks before and after surgery to eliminate any smoking during this time.
  • If you’re a nicotine user, please read this content

Quitting Alcohol Before Top Surgery

  • You must stop alcohol one week prior to surgery
  • You cannot drink alcohol until 7 days after your surgery

Quitting Other Drugs Before Top Surgery

The following drugs have to be stopped 3 weeks before and 3 weeks after your FTM/N top surgery. If you’re wanting to use some of these drugs for pain management, stick to the prescriptions your surgeon supplies you with. Some of the drugs listed below can be prescribed by your doctor but have been flagged as drugs that are often abused, which is why we are listing them.

If you’re being prescribed any of the drugs listed below by your doctor talk to your surgeon and primary care physician about how they will affect you before, during and after surgery. Additionally, always disclose the drugs you are currently using (whether prescribed or un-prescribed) to your surgeon or other medical healthcare professionals who ask for your drug use history.

  • LSD & Psychedelics
  • Meth
  • MDMA (ecstasy & molly)
  • Cocaine
  • Ketamine
  • Oxymorphone
  • DMT
  • Carisoprodol (Soma)
  • Lorazepam (Ativan)
  • Morphine
  • Buprenorphine
  • Heroin
  • Zolpidem (Ambien)
  • Diazepam (Valium)
  • Clonazepam (Klonopin)
  • Methylphenidate (Ritalin)
  • Methadone
  • Tramadol
  • Alprazolam (Xanax)
  • Oxycodone (OxyContin)
  • Amphetamine (Adderall)

If you’re struggling with substance abuse and need assistance, please contact the national help hotline SAMHSA (Substance Abuse and Mental Health Services Administration) at 1-800-662-HELP (4357). They are available 24/7 365.