Transitioning Via Top Surgery: The Top 5 Things to Know

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For individuals whose sense of gender identity does not align with their sex assigned at birth, their gendered body parts can cause a lot of discomfort and pain. The chest, especially, is one of the first things we notice about other people and is often what we use to gender-identify. While top surgery is often times a very relieving procedure that helps physically affirm a patients’ gender identity, it can also be a scary decision for some patients to make.

However, many traditional non-surgical transition practices, such as chest binding and silicone breast injections can be even scarier. While these practices can help alleviate gender dysphoria temporarily and can even keep individuals from discrimination and/or violence, these procedures aren’t completely safe and can cause serious side effects. While silicone injections can cause breast deformities, infections and changes to the skin, chest binding can cause skin rashes, damage blood vessels, and cause back problems.

These risks are why many patients often turn to surgery. Top surgery can help trans-patients and non-binary patients feel more at home in their bodies and is a safe and permanent alternative to chest binding and silicone injections.

As a board-certified plastic surgeon who commonly performs top surgery for transmen, transwomen, and other non-binary people, Dr. Rednam has compiled the top five things to know before top surgery.

Discuss Your Goals Freely with Your Surgeon

Though you’ve likely done a lot of research, discussing your expectations and goals candidly with your surgeon can help the two of you come up with the treatment plan that is right for you. There are different approaches to both MTF and FTM top surgery that take into account the patient’s current body as well as their aesthetic goals. Your surgeon will also help you choose the best procedure based on risk and recovery time. Being honest with your surgeon will ensure she can best meet your desired aesthetic goals, while also keeping you safe.

Talk To Your Surgeons About Scar Reduction Techniques

Different procedures leave different types and degrees of scarring. However, if you’re using the right scar care post-surgery, you can greatly reduce the redness and overall appearance of your scars. Your surgeon will recommend silicone products (like Biocorneum), show you how to perform scar massage and may even talk to you about laser treatment for severe scarring. While scars definitely take time to heal, it’s important to follow your physician’s protocol to reduce the look and feel of your surgical scars.

No Matter Your Gender Identity, Perform Regular Breast Exams

While your physician will perform regular exams throughout your transition process, it’s important to take your health into your own hands and check yourself at least once a month for any lumps, pain or asymmetry in your breast or chest tissue.

Additionally, if you were born with breasts, be sure to continue to get regular breast cancer screenings. You may also need to get regular screenings if you are taking hormone injections as part of your transition as well. This will help you catch any cancer in its early stages.

Share an Exhaustive Health History with Your Surgeon

Including a History of Silicone Injections and Breast Cancer
Just as you would share your relevant health history with your physician, you should also tell your surgeon exactly what you’ve done in the past to alter or treat your body. A history of silicone injections may increase the risk of infection or internal scar tissue after augmentation. Any free lumps of silicone may be removed, but sometimes the silicone damage is severe and the only solution is mastectomy with reconstruction. It is important to tell your surgeon about any history of silicone injection so they can provide you with proper treatment. It is also important to discuss any personal or family history of breast cancer as this can impact your treatment.

Top Surgery is a Journey

It is important to understand that top surgery is a multi-step process that requires preparation and recovery on top of the surgery itself. Though dramatic results are apparent right after surgery, you will likely not see optimal results until six to nine months and all the way up to a year post-procedure, once the swelling and scarring have receded. Being patient with your results will ensure your long-term success.

If you’re interested in learning more about top surgery, contact Dr. Rednam for a consultation at (713) 791-0700 or email