10 Things That Helped My Fat Body Get Through Top Surgery/Operation: #FreeTheBelly

Top Surgery aka

Chest masculinizing surgery

Aka

#FreeTheBelly surgery

For trans mascs and nonbinary and genderfluid folks– is major surgery. The shit is no joke. It’s a really stylish, gender-confirming double mastectomy, folks. Sorry not sorry– if you aren’t aware of that somehow already, maybe start with that step. If you have DI top surgery– you will have lots of scarring, and you will need time to recover. At least 2-3 weeks.

Oh, and surgical breast tissue removal is 100% permanent. They will never grow back. Estrogen regardless.

There are loads of different types of top surgeries. I had a DI double mastectomy, as would almost anyone who is born female with a high enough BMI to be looking for posts like mine. Those procedures don’t have the same recovery times as DI top surgery, more similar to Peri or keyhole. You’ve gotta make peace with the differences in the procedures. For whatever reason– I have found countless photos of high BMI cis guys having gynecomastia surgery with minimal scarring. There must be a difference, but I think it mostly has to do with where the nipple is positioned, and how much reconstruction of the chest the surgeon will have to do.

As a big guy I have incisions twice the size of most fellows, and with twice the incision comes twice the risk of complications, it’s not personal it’s just the truth– anyway–

I have about 14″ incisions on each side. Shit was not minimal, not superficial and it’s been more than two weeks and I am still very much recovering, as I type now–

It hurts to type, I am irritated and impatient.

I want to make an episode but playing guitar for 30/60/90 minutes was not as easy as I remember it being. Each day gets a lot better however so I’m not really worried, just frustrated, and a bit depressed from being in constant pain.

I had drains and tbh while having them removed was a breeze, there is still so much tenderness and bruising in that area.

I also may or may not have a sternum seroma? It’s going away slowly… TBH I got it when I started writing on a real keyboard again a few days ago. I’ve since mostly stuck to one-handed things like using my phone. I need to contact my surgeon, lmfao. I’ll take my own advice in a bit lmfaooooo — of course, once I’m done typing this up, hunched over on a keyboard…

Here are my tips for someone having top surgery with a fat body. Or honestly, any size body. These tips will work for anyone, but I adjusted it a bit to account for my experience. I assume other bodies with similar experiences will appreciate some extra tips.

Should go without saying– I’m still using all these tips. Still recovering. Still learning, still evolving.

Tips for Top Surgery for Folks That Don’t Look Like Elliot Page:

1. Adjust expectations appropriately. You’re about to have major surgery. Will it be an emotional and uplifting experience? It was for me, but it might not be at first– especially if you have never been this incapacitated before. No one enjoys feeling this helpless, trust me.
2. Prepare. Clean up BEFORE surgery. Do laundry BEFORE. Buy some food BEFORE. Ask your surgeon for post op instructions BEFORE.
3. Donate blood regularly for months before surgery. This brought my CBC levels down to normal, healthy target ranges. This was essential for my surgeon, and she was relieved that I was proactive about this and got my CBC levels down. Even just one donation can make a huge difference, but if you’re on HRT — donate blood in preparation for surgery!!!
4. Have at least one person available to help for minimum of 10 days. They’re gonna need time off. My girlfriend went back to work around the 10 day mark, and it was honestly really difficult to do anything by myself still. I assume because of the extensive wideness of my tits lmfao.
5. Sleep at an incline! Grab yourself a big wedge support, or a million pillows. I really needed a foam wedge, I can’t afford/don’t have access to an incline specialty bed. A hospital bed rental would have been a fantastic alternative.
6. Ice, ice, baby yourself. Forreal 24/7 round the clock ice. All the time. First few nights home from the hospital I had an alarm at 3 am for percocet and ice.
7. If you are travelling from out of town, like I had to do– stay at a hotel!! This is more recovering than you’ve had to do, unless you’ve been hit by a car or had back surgery. I’ve had major back surgery, and top surgery wasn’t as hard to deal with as that, IMO. Not really comparable. Not sure why I’m comparing them? But if you’ve had back sugery– top surgery is not as bad, but it is really messy and you will need a lot of clean towels and clean sheets. Looking back on it– staying at a hotel for recovery was an amazing decision and I’d recommend it to anyone– mostly due to the built-in assistance my care team AKA mom and girlfriend had with the hotel also taking care of their needs. (breakfast, laundry, space to leave and work in– the hotel we stayed at gave us a huge discount for being with the hospital, and honestly my mom just loved having people to talk to besides me)
8. Get some bulk extra-strength tylenol. I like the plain white ones without any red coloring, the red dye gives me issues. Also you can’t take NSAID’s (ibuprofen/advil, diclofenac, other mixes containing these drugs) for two weeks before OR afterwards, which kinda sucks. I’m not usually a tylenol person so this was a weird switch for me.
9. Follow your surgeon’s instructions, and if they aren’t working– follow your body’s instructions. 6” Ace wraps for after post-surgery binding removal. Buy 8 of them. Use two at a time, you’re gonna be wrapping for weeks. Pro-tip: ice packs in an extra wrap layer. *NOT RECOMMENDED for binding, just for healing after surgery.
10. No drinking, no smoking nicotine. I dry-herb vaped cannabis a few days after the anesthesia wore off. Can recommend– however tbh it mostly just cheered me up. Pain management wise it isn’t very strong. If you’re curious– my nipples are totally pink, healthy, and perfectly attached to my body. My oxygen saturation at the hospital was 99%. IMO– dry herb vaping cannabis is not bad for my lungs. If you’re allergic to it or haven’t done it before surgery– why the fuck are you going to introduce this now lmfao, poor plan.

*EXXTRA-BONUS ROUND: OPINION TIME*

Did I stop taking HRT before/after surgery? I see this a lot online– I didn’t. I decided not to because, well, in my experience being on t for almost 3 years now– I would have 1. been fine skipping a shot or two, but 2. I didn’t want to risk depression or mood imbalances with low hormones, so I didn’t. Seemed to have no impact IMO, didn’t slow my healing– just prevented me from feeling low-t hopelessness.

If your job has it– apply for short term disability insurance. My work offers a Metlif plan– and although it clearly stated in their fine print that they do not cover gender reassignment surgery, or plastic surgery, or elective surgery– they covered my surgery without any issues. To this –I thank past trans people who asked until it happened– thank you for that, because I asked– and it happened.

I had a sore throat from the breathing tube for at least a week. Got a cough as well. Not fun, fortunately as an asthmatic I always have an inhaler and that helped.

I ate like I was sick, even though I “wasn’t sick”, and I really think it helped a ton. I really benefit from eating a simple, plain, easy broth-based diet when I am sick and healing. It’s pretty much just liquids, broth, noodles, veggies. IMO meat broth is the fucking best, bones and stuff, you name it. I had pho the night before surgery, and at the leftovers after. It really made me nauseated and not want to eat being in pain all of the time, so don’t really plan to be hungry. I also get nauseated from anesthesia, and have had past experiences with that– so I planned for the soup, green beans, noodles and mashed potatoes– stuff I was going to be willing to nibble and put back in the fridge for later. I’m still mostly eating this way because it’s fucking delicious. Godbless mashed potatoes, brothy noodles and green beans.

Straight up each time I just ate some noodles and broth and veggies–I would nod off to sleep with a Percocet and wake up better than I was.

I think considering that I’m so big, and have had so many past health issues and surgeries– with my experience I found it easy to plan, prepare, and lessen the load on my caretakers, and also had an easy time staying positive, because I felt like I was in control and had a regular routine planned.

Lol speaking of routine, I got incredibly constipated from the anesthesia and the percocet. The soup, veggies, mashed potato diet was a godsend when it came to finally birthing that first post-surgery shit. Fucking horrendous. Always take your stool softener, and don’t eat anything that isn’t gonna squeeze out soft lmfao I apologize to whoever hates this part. 💩

Should go without saying– I was up and walking first day home from the hospital. I went on at least two short walks a day– short meaning– to the hotel lobby and back. Walking was significantly more painful than I thought it would be, especially with my weight and already limited thoracic mobility from back surgery. However– walking was really really really important. You can develop blood clots really easily, anybody can. Surgery is fucking nuts.

The easiest part of staying positive was how awesome the results looked, even just one week out. Also– none of my previous surgeries have ever been elective. I’ve only had emergency back surgery and a planned thyroid removal. Something about choosing this procedure made it much easier to deal with. While it has been difficult, it also has been wonderful.

Free yourself from picture reveals.

I sent a few photos to friends and family who asked. Most of them are still totally freaked out by it. I have twice the scarring than someone who is half my size, it’s not easy for everyone to look at– certainly only a few weeks out. That being said, it looks tremendously better every day. I ordered enough scar tape for a few months, so we will see how things age over time.

The moment I came out of surgery I felt incredible physical relief. I will always remember the first few steps I took when I got up and out of my post-surgery binding for the first time. I told my surgeon– “I’m still waiting for them to bounce–“

To be honest, I’m probably going to be waiting for them to bounce my whole life. Each time it doesn’t happen, I smile. Each time I don’t feel the tremendous weight of my ultra-sensitive chest, I smile.

I used to be deeply concerned about sensitivity after surgery, and while it is still numb in many areas– I am astounded by how much I can feel despite having a double incision mastectomy. I have sensation almost everywhere except for my right boob, which is hilarious because that used to be the smaller one. Now it’s kind of larger than my left side, which was significantly larger than my right.

It’s only been 17 days, I have tremendous sensation in my whole upper chest area. I think part of this has to do with the fact that I had top surgery with Dr. Haruka Okada in Columbus OH, who uses a technique that leaves about 10% of your breast tissue in place. This not only gives me a more realistic, natural looking chest, but it also seems to have spared me a bit of sensitivity. It’s dangerous and reckless for me to say things like “this method preserves more sensitivity” because it might not for others, it just seems to have in my case.

Another enormous benefit of Dr. Haruka Okada’s practice, Stratus Plastic Surgery-– is that she accepts insurance with her incredible nurse and assistant Kelly. This saved me thousands of dollars, while allowing me to get the most premium experience possible. They are quite literally changing lives over there, and I am forever grateful.

I don’t want to post a picture, not because I don’t look incredible– I look fucking amazing. I don’t post a picture, because how I feel matters more than how I look. I feel better than I’ve ever felt, and each step I take makes me feel as if I conquered my own fate.

I had top surgery to make myself feel better, not to make myself look a certain way. With that goal in mind– I succeeded and fully recovered in my very first moments post surgery.

All things considered, I can’t believe I’m saying this, but —

Paying some surgeon to cut my tits off was the nicest thing anyone has ever done for me.

To that I owe INSURANCE!!!! My surgeon took insurance!! From my hard work and perseverance getting a job that actually takes care of me. And I also owe my mother, who doesn’t know it– but she helped give birth to me twice. Once with an emergency c-section for my enormous head, and another time when she helped pay for the surgery that changed my whole perspective on my life, my body, and my esteem.

She also drained my drains, woke me up at 3am for ice and percocet, fed me noodles, listen to me bitch and complain, and somehow says “wow” every time I send her a picture of how my scars are doing.

She might never read this, but if she does– Mom– thank you for understanding and coming around. You might not have been able to get there before now, but 30 years in the making she now finally understands– she has a son.

Also–

MY BELLY HAS BEEN FREED

#FREETHEBELLY

Once this motherfucker’s hair grows back in

(they had to shave me, so sad. I look like a spayed cat)

Maybe I’ll post a pic of just him–

Nah.