Recovering from surgery

Important

It is important to follow your surgeon’s instructions for aftercare. The information here does not replace the information you receive from your surgeon. If there are any differences, you should follow the advice provided by your surgeon.

What to expect while you heal

After surgery, you’ll likely be prescribed painkillers to make you comfortable and antibiotics to reduce the chance of infection.

Your surgeon may give you instructions about what type of vest to wear, when to remove the dressings and when it is okay to shower. You will need to wear the compression vest for up to one month following surgery. You may want to have a second one handy so you can rotate vests when one needs to be washed.

You will have surgical dressings for the first few days or longer, depending on the type of dressing. You may have Steri-strips along the incision lines. You should follow your surgeon’s instructions about how to care for them.

During the healing process your body will generate fluid around the surgical site. To prevent this fluid from building up in your chest, it may need to be drained. The surgeon may insert drains Thin tubes placed in the body during surgery to remove excess fluid or blood. for this purpose, and you will be taught how to monitor and empty them. The drains will be removed by the surgeon during a clinic visit 3–7 days following surgery.

As a normal part of the healing process, you should expect:

• Discomfort — You may experience general discomfort as you recover. Your upper body may feel stiff and sore for the first 2-5 days after surgery and your chest may feel tight and sensitive to the touch. Feelings of sharp shooting pain and burning sensations can also be expected. 
• Redness — The incision sites on your chest will be red. The redness should not extend more than one to two centimetres from the incision. If it extends beyond that, you should consult with your primary care provider A person’s main health care provider in non-emergency situations such as check-ups and referrals. Family doctors, general practitioners (GPs) and nurse practitioners (NPs) are all primary care providers. .
• Knots — You may  feel or see the knot from the stitches at the end of the incision. While the knots can be annoying, they’re nothing to worry about. Around three weeks after surgery, they usually work their way to the surface and can be clipped free by a health care provider.
• Bruising and swelling — It is normal to have bruising and swelling after surgery. You may have more swelling on one side than the other, and it can change throughout the day. It will go down gradually, taking from one to several months to resolve.
• Changes in sensation — It is common to have changes in sensation on your chest wall. You may be less sensitive to pressure, temperature, pain or sexual stimulation. Once in a while, you might even feel prickling, stinging or burning sensations as the nerves heal and grow. It can take 6–12 months for the nerve endings to heal or grow back into these areas. There can be permanent changes to sensation, including areas of complete numbness. 
• Itchiness –  Recovering from chest construction A gender-affirming, upper surgery that removes breast tissue and sculpts remaining tissue into a shape that is typically considered to be more masculine. surgery can involve some itchiness. Itchiness is caused by the reduction of swelling. It can also be caused by your compression garment A special piece of post-surgical clothing that aids in the recovery process by applying constant and uniform pressure over the treatment area. or an allergic reaction to the adhesive in your bandages. If itchiness is accompanied by swelling and redness, it can be a sign of infection. Ask your primary care provider how to manage this side effect.

When to get medical help

You should contact your primary care provider or surgeon if you experience any of the following:

• Excessive wound redness
• Excessive bruising or swelling
• Yellow or green pus-like drainage
• The area around the incision is hot or hard and painful to the touch
• Chills or a fever over 38.5 degrees Celsius (101.3 Fahrenheit) by mouth
• Pain that is not relieved by prescribed medications or gets worse a few days after surgery

If necessary, go to the emergency room.

Tips to help recovery

Your recovery is affected by the surgical technique your surgeon used, your body’s reaction to the surgery and other factors. In general, many people begin to feel better within two weeks and a full recovery will likely take 4–6 weeks. Proper rest helps speed this process.

We’ve provided some general information regarding how to recover well from surgery, but it’s important to follow your surgeon’s instructions. 

Get lots of rest

Plan to do less activity during the day and allow yourself to nap. Your body needs extra sleep while you are healing.

Relaxation techniques can help your body heal from surgery, too. They reduce the effects of stress on your body, letting your body’s systems focus on the healing process.

Limit arm movement

Do your best to limit your arm movements. Some people find it helpful to imagine they are a Tyrannosaurus Rex (T-Rex). A T-Rex has short arms that cannot reach far forward or be raised above the shoulders. To be like a T-Rex, keep your elbows at your sides.

Avoid using your arms to stand up, sit down or get in and out of bed. You should also avoid lifting objects over 10 pounds. This will prevent pulling on sutures Sterile medical threads, also called stitches, used to close surgical incisions. and stretching your scars.

Wear your compression garment

You will come out of surgery wearing a compression garment to help reduce swelling. It may feel uncomfortable over time, but it is very important to continue to wear it as directed by your surgeon.

If you have problems or concerns related to the compression garment, contact your surgeon.

Manage nausea

Experiencing some nausea and vomiting after surgery is normal. You can try taking Gravol or ginger.

If it persists for several days, call your primary care provider.

Manage constipation

Constipation is a common side effect of pain medication. If you experience this, try increasing the number of walks you take, drinking more water, eating more fruits and vegetables, eating prunes or taking a stool softener. Get protein from food sources other than dairy. If constipation continues for several days, call your primary care provider.

Manage your pain

It is normal to experience a moderate amount of pain during the first few days after your surgery. Take your pain meds on time to keep your pain under control, manage stress, promote healing and decrease complications.

You may wish to use the pain medication tracking chart, featured in the Chest Construction Workbook.

Take care of your incisions & scars

You can take steps to prevent severe scarring by following your surgeon’s advice about getting rest, avoiding the sun, doing massage exercises and using silicone ointments. 

Surgeons will often recommend that you avoid getting direct sun on your scars and nipples for up to a year, to help prevent colour changes on the scar tissue. 

Talk to your surgeon if you have concerns about your scars. 

Empty your drains

It is common to have surgical drains inserted during chest construction. A surgical drain is a tube placed at the surgical site to allow fluids (like blood and fluid that surrounds your cells) to leave your body. The fluid will collect in a plastic pouch.

You will be taught to regularly empty your drains into a small measuring cup and record the amount of fluid each time.

A drainage record sheet is provided in the Chest Construction Workbook. This record will help your surgeon or primary care provider decide when the drains can come out.

Once the flow slows or stops, your surgeon or primary care provider will remove the drains. The amount of time drains are needed varies from person to person.

Wash hands frequently

Always wash your hands with soap before and after touching the parts of your body that are healing. This will help prevent infection.

Minimize the risk of infection 

Wear a high quality mask, ensure up-to-date influenza and COVID-19 vaccinations with boosters. You can also request COVID-19 testing and masking before visiting with others. Coughing after surgery can cause complications and infections can slow down postoperative healing. 

Move gently to promote healing

Go for little walks after your surgery. Walking increases your blood flow, which speeds up the healing process.

If walking is not an option for you, or if you are lying down for long periods of time, leg exercises and breathing exercises will also increase your blood flow and support your healing.

See the Chest Construction Workbook for exercise suggestions.

Enjoy foods that promote wound healing

Your body will need extra calories, proteins and nutrients to heal so look for foods that contain:

• Protein (meats, eggs and nuts)
• Zinc (whole grains, spinach, nuts)
• Vitamin A (carrots, broccoli, eggs)
• Vitamin C (strawberries, peppers). 

If you have questions, you may find it helpful to speak with a dietitian. You can contact a dietitian by calling 8-1-1 (HealthLink BC).

Attend your check-ups

Your surgeon will likely ask you to come in a few days after surgery to have your drains removed. You will likely be asked to see the surgeon again at 4–6 weeks after surgery. It is also fine to see your primary care provider about any concerns after surgery. 

When you visit your surgeon or primary care provider, they should check your surgical sites to make sure there is no infection or any wound healing problems. They will also ask you questions about pain, bleeding, fever, bowel movements, along with how you are feeling physically and emotionally.

Mindfully return to activities

Many people feel comfortable within a week and begin returning to their daily activities gradually over the next 3–4 weeks. Some activities, such as driving, heavy lifting and exercise, will likely be restricted in the postoperative period. Your surgeon will give you advice about when it is okay to resume the following activities.

• Taking a bath or shower
• Going to work
• Driving a car
• Swimming
• Participating in a sweat
• Having a sauna
• Playing instruments
• Lifting more than 10 pounds
• Exercising
• Participating in rituals and ceremonies
• Dancing
• Sunbathing
• Sexual activity

You may find that your energy, stamina or tolerance for different activities and sensations are affected by your surgery or pain medications. This is a normal part of your healing journey.

First 10 days after surgery

Avoid activities that can disrupt your healing, cause pain or bleeding, or lead to elevated blood pressure. Increased blood pressure post surgery increases the risk of internal bleeding (hematoma). This include:

• Having any kind of sex (alone or with a partner)
• Having an orgasm
• Running 
• Biking
• Driving 
• Walking a dog 

First 4–6 weeks after surgery

• Keep in mind that any activities involving another person (or a pet) are less predictable than those done on your own.
• Avoid activities that can cause rubbing on the incisions or nipple-areola complex Area of the chest or breast that includes the nipple and the surrounding darker-colored area (the areola). . This can cause infection, graft A surgical procedure in which one section of healthy skin is removed from a part of the body and used in another location (or in the same location in the case of nipple grafts). failure and inflammation of incisions.
• Be careful about activities where a repetitive motion causes a garment to subtly rub over the healing tissue (such as running, walking and biking).
• Avoid activities that can lead to internal or external bleeding, compromised blood flow and injury to nerves and healing tissues. This includes:
  • Tiring and repetitive movements
  • Activities that could stretch or tear incisions (inner or outer) 
  • Reaching or extending arms
  • Sudden or vigorous movements
  • Lifting more than 10 pounds
  • Strenuous activity (including certain kinds of sexual activity)
  • Bondage, suspension, pinching, squeezing, vigorous massage
  • Giving or receiving percussive activities, including flogging, spanking and paddling 
  • Very hot and very cold temperatures

Returning to sexual activity

Lots of people have questions about returning to sexual activity after surgery. This includes masturbation and sex with other people. The above recommendations apply to sexual activity. As with all other activities, speak with your surgeon about when it is safe for you to be sexually active after surgery. 

It can be helpful to speak with your surgeons before starting any kink or BDSM activities in the months after surgery. Your surgeon will likely welcome these questions. If you are shy, you can be creative and ask about returning to full contact sports, swinging a tennis racket, receiving vigorous massage, riding a horse, using a heating pad or wearing restrictive or tight body-shaping clothing, etc.

More tips on returning to activity after surgery

• Follow your surgeon’s recommendation about how long you should avoid sleeping on your stomach or chest (usually about 3 months).
• Ease back into your regular activities (shorter and less intense).
• Pay attention to whether your swelling or tenderness increases after activity. If it does, you may want to wait a bit before trying that activity again.
• You may find that your energy and stamina are reduced. This is normal and will balance out over time.
• You may find that your tolerance for different activities and sensations is affected by your surgery or pain medications. This is also normal and will balance out over time.
• Stop or take a break if you feel pain, anxiety or fear. 

Dealing with post-surgery depression

Many people experience a wide range of emotions following surgery. Medications, limitations on activity, and your healing body can contribute to depression after surgery. This can include feelings of low mood, loss of appetite, difficulty concentrating and even self-doubt. This is a temporary and normal part of the healing period. 

Here are some suggestions for making it easier.

• Put your self-care plan into action.
• Make lists of things you enjoy and reflect on how you can experience these sources of joy. Examples of these include:
  • Eating foods you love
  • Surrounding yourself calming smells and inspiring sounds
  • Keeping a journal
  • Writing letters of thanks to those who have helped you
• Speak with a family member, friend, counsellor or other health care professional about the feelings you are having.