7 Factors That Affect Your Top Surgery Results

Dr. Mosser has identified 7 main factors that can affect your top surgery results. It’s important to note that this list isn’t exhaustive and other challenges or complications can arise that are not listed below.

Skin Elasticity Challenges

Some skin will stay exactly as tight as it is designed to be at the end of surgery, while some skin will re-loosen after surgery (in spite of everyone’s best efforts). While this is not entirely preventable, an experienced surgeon will make their best effort to place skin to the appropriate tightness based on your own tissue characteristics.

One common skin challenge patients express frustration with is stretch marks. Dr. Mosser has created the following regimen for all of his patients interested in reducing the impact of stretch marks on their surgery results. Please read our page on Minimizing Stretch Marks for a downloadable PDF version of Dr. Mosser’s instructions to be followed pre and post-surgery.

The Body’s Scarring Process

In spite of the most perfect incision closures, some patients will get thicker, ropy scars that are called ‘hypertrophic scars’ and may require steroid injections to get them to calm down. Very rarely, patients can develop keloid scars,  which are scars that invade the surrounding healthy tissue with scar tissue to some degree. For detailed information on chest reconstruction and scarring, click here.

Recovery Complications

Any time there is a return to the operating room for a bleeding problem (1-3% of cases) or infection issue (<1% of cases), the subsequent healing and scarring can be more problematic. To learn a little more about risk and safety, click here.

Anatomical Challenges

A person’s inherent symmetry of their chest contour, chest volume/shape, and the presence of excess fat in the trunk from obesity (or lots of excess skin from weight loss), can all affect top surgery results. This can make the process of planning incisions more challenging for the surgeon.

Medical Conditions and Smoking

Diabetes and other systemic conditions that affect major organ systems can also affect wound healing. Using nicotine as smoked tobacco (or in any other form) can be very problematic for the critical process of incision healing and skin graft take. Here is some content that addresses how smoking cigarettes can be detrimental to your top surgery results and healing.

Following Your Top Surgeon’s Instructions

Believe it or not, it’s absolutely possible for a patient to negatively impact their otherwise great result by ignoring their top surgeon’s instructions. This might mean limiting activity and exercise close to surgery, or limiting skin stretch by not having your elbows at or above your shoulders for 2-3 months after surgery for certain patients. For general post top surgery restrictions, click here.

Top Surgeon Skill

Of course, surgeon skill is one of the critical variables that determine a good result. Like any procedure, surgeons who have a high volume of consistent results will continue to be the most reliable. Some ways to assess a top surgeon’s skill would be to ask them how many transgender top surgeries they’ve performed, if they’re board certified, what their complication rate is, etc.

In conclusion, there will be factors that affect your surgical result that are out of your control as the patient. To limit the number of possible negative outcomes, focus on what you can control:

  • Follow post-op care instructions that your surgeon provides
  • Stop smoking at least 3 weeks before top surgery and don’t smoke (not even one puff) until 3 weeks after top surgery
  • Research different top surgeons so you can make an informed decision. Top surgery Facebook groups are a great place to get community feedback and see different types of top surgery results

For a printable/email-friendly PDF of this content, please see the following: 7 Factors That Affect Your Top Surgery Results