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If you haven’t already, we recommend that you take our top surgery visual tour. This presentation walks you through a top surgery so that you know what to expect. Next, we are happy to set up a telehealth visit to answer any questions you may have and complete a simple exam. We suggest that you explore your insurance policy to see what is covered and the requirements for coverage, which often include a psychological review and letter, and sometimes hormone therapy. If you need guidance, don’t hesitate to reach out.
We recommend that you read our content on preparing for your child’s surgery at Stanford Children’s Health. This information outlines what to expect before, during, and after a surgical procedure. In a nutshell, once a teen is ready for surgery, we schedule a pre-op appointment where we review the surgery, ensure that all paperwork is in order, and answer any questions that you have. We also direct you to purchase a postsurgical garment that supports healing. The surgery itself takes approximately four hours and requires a stay of one or two nights in our hospital. Families are welcome to stay in the room. Prior to discharge, you’ll receive instructions on how to care for the incisions and steps to take to promote healing.
At first, a dressing is placed on the chest, and it stays there for one week. Then, dressings are changed and drains are removed. A special garment is worn for six weeks under clothing to keep the area clean and to prevent any chafing. Most teens are able to start back to light activity after a week. We recommend limiting heavy physical activity (such as weight lifting) for six weeks. After your child is fully healed, the chest can be further sculpted and enhanced with exercise.
The risks for top surgery include the standard risks of undergoing any surgery, including anesthesia risk. Typical risks for any top surgery also can include loss or reduction of sensation, failed nipple graft, and the possibility of corrective surgery, which is uncommon.
For optimal results, we recommend that teens keep their weight stable prior to surgery. Losing weight or gaining weight prior to surgery, and then returning to the body’s more natural weight after surgery, may affect the appearance of the chest. We also recommend eating well, exercising, getting enough sleep, and generally staying healthy before surgery.
Our surgeons are artists who carefully sculpt the chest, always with the aim to create the least amount of scarring. Depending on the type of top surgery, there can be minimal scarring and rarely extensive scarring. Scars are often partially hidden by the areola of the nipples and the shadow of the chest muscles. At first, scars are red and visible, but after some months, scars usually mature and turn white. Your care team will outline a scar management plan for you.
We do not recommend that people get top surgery unless they are fully committed to their gender transformation. While top surgeries can be reversed, the results will likely include scarring and the loss of sensation.