5 Things to Know Before Getting Top Surgery

Top surgery is a surgical procedure that’s sometimes pursued as part of someone’s gender-affirming care. It involves surgically removing chest tissue to create a flatter appearance. Depending on your body, nipple size and position may also need to be adjusted. 

Top surgery isn’t exclusive to any particular gender. And it’s important to know that not everyone desires or has access to gender-affirming surgical procedures. But for many people, it can be a life-saving decision.

If you’ve decided to include top surgery as part of your gender-affirming care, there are a few things to know ahead of time. Keep reading to learn more to help you navigate this process.

1. It can take time to find the right surgeon for your procedure

Top surgery techniques and expertise have come a long way over the years. And with that, it has become more customizable with several different options. So, you’ll have some decisions to make. The first one is deciding who’s going to perform your procedure.

Surgeons may specialize in various approaches to top surgery. The best fit can depend on your body, desired outcome, and access to care. Keep in mind that it can take time to find the right one for your procedure. 

As you’re looking through your options for a surgeon, here are a few things to consider: 

• Make sure you want to work with them. After a consultation (virtual or in-person), do you feel comfortable with them, respected by them, and confident in them?

• Consider their level of experience. How many times have they done the procedure you’re pursuing? Have they been trained specifically in top surgery?

• Ask what documentation is required for surgery. Many surgeons follow the World Professional Association for Transgender Health (WPATH) standards of care. This includes a gender dysphoria diagnosis and a letter from a mental health professional. 

• See if they work with your insurance provider. Some surgeons will work directly with your plan to get the procedure covered. If insurance coverage is an important factor in your decision, know that additional requirements may need to be met as well.

• Check reviews and read about other people’s experiences with them. This can help give you an idea of what it might be like to be their patient. And things you read might prompt specific questions to ask during a consult, too. 

• Ask to see a full range of before-and-after photos. This can show you what “successful” and “unsuccessful” outcomes look like with a particular surgeon.

You may be familiar with surgeons in your area who perform top surgeries. But if you aren’t, TopSurgery.net and the WPATH Provider Directory are some resources that are available. 

2. Go into your surgery consultation with your goals in mind, but manage your expectations

It’s important to be open and direct about your goals during your surgery consultation. But it’s also important to manage your expectations. That’s because there may be limitations in achieving your ideal results. Your surgeon should cover the available options, and which ones they recommend for you. They should also cover what type of outcome you should expect with your body type. 

For example, there are several different top surgery techniques that are used. Some techniques result in less scarring but may be more likely to require revisions. Certain techniques may be preferred for smaller chests, while others are a better fit for larger chests.

Read more like this

Explore these related articles, suggested for readers like you.

What Do Different Types of Doctors and Medical Specialists Do?

How Much Does a Facelift Cost?

Can You Use an HSA to Pay for Cosmetic Surgery?

View more

Think about your goals. Do they involve things like scarring and nipple sensation? Your surgeon should discuss the pros and cons of each technique related to your goals and what’s possible with your body. Be prepared with questions. 

You may want to ask about their experience with your procedure. How many times have they performed it on bodies similar to yours? What’s gone right — and wrong? Have they been trained in that particular type of top surgery? 

It’s important to manage your expectations for your surgery and have clear communication with your surgeon.

3. You may need to travel and set up recovery accommodations

Top surgery is an extremely personal decision, and you’ll want to feel comfortable with the process. So, you may be willing to travel for the surgeon who you feel is the best fit. If this is the case, know that travel can add to the overall cost of top surgery. But for some people, it’s necessary and worth it. 

After surgery, your body will need a lot of rest. Keep this in mind as you’re preparing for the big day. Depending on your situation, you may not need to spend the night at the surgical facility after your procedure. But sometimes you may be advised to stay overnight for monitoring.

If you’re traveling, setting up proper accommodations is important since you’ll be away from home. In this case, you’ll want to have someone traveling and staying with you for assistance. Depending where you are, there may be community-based or low-cost options for lodging.

Keep in mind that it may take a few days before you’re in good enough shape to travel back after your procedure. And your surgeon may want you to stay in the area for a period of time to monitor progress and address any concerns that come up.

4. Plan to create an environment to heal

Healing is one of the most substantial parts of undergoing top surgery. As described above, the first few days or week might be away from home if you’ve traveled. But wherever you are, creating an environment to heal is important to your recovery. 

Below are a few things to consider or keep in mind:

• Have a support system in place. If possible, having someone there to help you can make the recovery process easier. That’s because you may need help doing things like using the restroom or getting into bed.

• Your movement and amount of weight you can carry may be restricted. You may have difficulty moving around the first couple of days. And your ability to reach for things may be limited for the first couple of weeks. Make sure you have what you’ll need set up nearby in advance.

• Create a comfortable space to rest. You may be advised to sleep upright for the first few days. Make sure you have a lot of pillow support to get comfortable. 

• Plan ahead for meals. If you don’t have someone who can help with meals, you can prepare them in advance. Consider that you may not be able to reach into the refrigerator, microwave, or oven.

5. Healing looks different for everyone

Healing looks different for everyone. Complications can sometimes arise and revisions may be necessary. And, even if everything goes as smoothly as planned, everyone heals at their own pace. Your chest can change as it heals, and it can take up to a year to see your final results. 

You may be wondering when you can return to your normal routine or become active again. Your surgeon can give you an idea of what to expect. But it’s important not to rush recovery. 

Below are a few tips to remember as you heal:

• Follow your surgeon’s aftercare instructions to set yourself up for the best outcome

• Stay hydrated and get enough rest

• Avoid smoking since this can affect the healing process

• Avoid alcohol since it may interact with medications you’re taking after surgery

• Slowly integrate back into your routine and listen to your body in the process

• Taking on too much physical activity right away can set back your recovery and may affect your results

Why trust our experts?

Written by:

Max Rigano

Max Rigano (he/they) is a diversity, equity, and inclusion advocate who educates through writing, public speaking, and social media (@kngmaxy). Max uses his training, personal, and professional experiences to promote transgender equity and health, both in and outside of the trans community.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Our editorial standards

Meet our experts