Miss M’s Guide to Top Surgery

  1. Presurgery. 6 months or so BEGIN TO THINK about surgery and preparing body. Look at your alcohol consumption, quit or reduce smoking, do fewer or no recreational drugs.
  • Collect images of how you want your chest to look. Be realistic. Look at chests on bodies similar to your own. Bring the images to your Dr so s/he has a clear idea of the look and size you want for your new chest. **this is more important than you think!. It is especially important for breast reductions! Bring in images of how you want your chest to look. For AFAB folks wanting masculinization, bring in photos of successful top surgeries that appeal to you. For AMAB wanting feminization bring in realistic photos of the size you want your new breasts.  For femmes or folx who are changing cup sizes, Drs have NO IDEA what cup sizes are – you need a picture for them to get the idea of how you want your new chest to look. I learned this The Hard Way!
  • Start a detox diet 2 months before your surgery. Eliminate wheat, dairy, sugar, beef, pork, and fried foods for at least 10 days. Reduce coffee. This is best done with a Naturopathic Doctor  so it can be a learning process to identify foods that work and don’t work for your system. Introduce each group of foods back one at a time so you can see if you get some response after clearing it. ie: eat lots of cheese for dinner and lunch and then avoid it for 3 days and watch how you feel after.
  • Continue to eat a “clean-ish” diet after your detox to optimize your infection fighting and healing potentials. Practice the 70/30 rule – if you are eating whole grains 3 times a week minimum, 2-3 fresh vegetables daily, 1-2 fruits per day, vegetarian protein and good quality meats 70% of the time, the other 30% doesn’t matter as much.
  • Take a health food store brand multi vitamin (better quality), vitamin C and fish oil or flax seed oil daily if possible. Your local coop or natural food store should have good choices. Avoid pharmacy brands and supplements. Metagenics PhytoMulti is a high quality brand available online.
  1. Presurgery: 1 week ahead.
  • Drink less alcohol. Have several nights with nothing to drink.
  • Get lots of sleep. 8 hours per night if possible.
  • Go grocery shopping. Your fridge and cupboards need to be stocked with one weeks worth of food at least. Have clear broth and hearty soups ( ie vegetable, organic chicken noodle, butternut squash, split pea), apples, salad ingredients, applesauce, organic yogurt, toast, crackers, ginger tea. Cook a pot of brown rice.
  • Buy a few ginger-based drinks from your local health food store or whole foods. Ginger is good for nausea and helps the first few days after surgery. I like Ginger Soother by The Ginger People (filtered water, honey, ginger juice, lemon juice, natural flavour.)
  • Pick up a herbal laxative from health food store/whole foods and some fiber caps or powder. I like Genestra Herbolax (online) or Natural Factors Senna Capsules and the. Miralax is also readily available in all drug stores and may be available as a RX to get the cost covered.
  • Pick up your arnica 200ch homeopathic remedy and Traumeel gel (now called T Relief) – at your coop for shock and trauma to tissues
  • Pick out a gentle good quality soap for washing the wounds with. Commercial soaps can be too harsh. I like Avalon Organics lavender soap or Dr. Bronners unscented or lavender soaps. Nothing with a “moisturizing” base or scents other than pure essential oils.
  • Eat a healthy diet with as little wheat, sugar, and dairy as possible to have your system geared towards optimal wellness or, avoid foods you learned caused reactions on your detox diet
  • Follow hospitals advice. Stop all medications and vitamins as they request 3 days ahead of surgery.
  • If possible get prescriptions filled ahead of time for post-surgery so you can go straight home afterwards.


  • ask for anti-emetic (anti nausea) in with anesthesia to make coming out of the surgery easier on you.
  • Relax! Its out of your hands now.
  • Trust your doctor.

™ I had two chest surgeries. I tried to view my moment of surgery as a submission experience. This helped me to surrender my control and give my trust to the doctors in the operating room. And made it a much more enjoyable experience!

4. post surgery:

  • first day. Have apple sauce and organic sheep/vegan/cow yogurt in fridge plus some juice that you like. When you get home, have a small dish of applesauce with or without yogurt (can add maple syrup) to buffer the pain medications. Use this as a light snack to take with pain meds that require ‘with food.”
  • Arnica 200c homeopathic. 3 pellets three a day for first 3 days home. Can take up to every 2 hours for strong pain. Then reduce to once a day until pain is resolved.

5. Week after surgery:

  • Traumeel cream or gel (now called T Relief): locally around surgery site but not over bandages/exact site. Can also use Traumeel drops (T Relief) in water in addition to topical treatment f your are having a lot of pain and difficult healing. The gel is soothing and can be spread over the tape without worry. It does leave a weird glaze, so apply it to areas you can wipe off with a washcloth. Apply a thick coat an hour or two before bathing and let it soak in, then wash off.
  • The psyllium husk helps prevent constipation just by bulking stool. Take 1 tsbp in a mason jar of half juice half water, shake, and drink once per day. 1 tbsp = about 4 capsules. You must drink water with psyllium to follow with another pint of clear water right away and continue to have liquids ongoing in the day.
  • If using an opioid pain medication you will need a herbal or pharmaceutical laxative. After day 2 out of surgery use 1 or 2 caps  of herbal or one serving of Miralax on days when you use the pain meds. These are usually best taken before sleep. Most  health food store/coop herbal blend one is ok, or you can use Miralax powder from a pharmacy.
  • Begin taking your multivitamins and vitamin C again. Take vitamins with meals.
  • Eat lightly. You won’t be moving around much so your appetite may be low. Eat only when you are hungry. Eat until you are full, but don’t be surprised if its less than usual. Avoid chips, chocolate, ice cream, pop and coffee.
  • Drink as much water as you can. Keep a bottle of water next to your bed. Also have herbal teas and hot or cold lemon water.
  • Call your Dr right away if any infection or complications develop: redness, fever, excessive  pain, swelling, heat are signs of infection.
  1. The healing process:
  • As the tape comes off and the incisions are exposed, apply a mixed tocopherol vitamin E topically to incision site. Make sure your hands are clean!
  • St Johnswort tincture + Echinacea is an excellent anti microbial and pain killer combo. Use topically on incision sites with a clean cotton ball or q-tip once or twice daily after washing. Buy two small bottles and mix them together.
  • Continue to use arnica as needed whenever you do activities that seem to strain the incision sites or your chest hurts.
  • Continue to use Traumeel topically. Once the gel is gone you can switch to the cream as it absorbs much better. Only use the cream after the tape has fallen off. Apply to entire affected chest area to aid healing. Massage into incision sites as scars form to reduce ropy scar formations.
  • Use a small dab of tee tree oil on incision sites that get red or infected.
  • You may end up wanting or needing an antibiotic ointment as well – the single ones are more effective than the “triple therapy” ones.
  • If you know you heal slowly from wounds you may also want to support your immune system during this time. A good quality echinacia capsule or liquid once daily may be helpful to keep infections away.
  • Katie Emmitt Art

    Be gentle with yourself. Your “heart chakra” area has been radically stirred up. You may feel more emotional than usual. Surround yourself with people who love and support you. Ask for help. Give yourself lots of love. Note what issues come up and be prepared to go back to them with therapy or journaling as they may need to heal along with your chest.

  • Touch yourself. Let others touch you. Your nipples will heal best if they get regular gentle touch. Know where your own scars are, and which areas have more or less sensation. When you are massaging in the Traumeel or calendula or vitamin E be aware of the sensations you are feeling, or not feeling! Let your lovers touch the areas gently as part of your foreplay to reteach the nipples to respond sexually.

™ My body had a really hard time healing the internal stitches and would form yucky pus pockets as the stiches rose to the surface. Washing the sites once daily with a gentle soap and applying the St Johnswort/Echinacea topically helped but to some degree this just “happens” as my Dr said.  The second time I did not have the same degree of infection develop as the first. The only thing that was different was I DID NOT use a antibiotic ointment the second time and I used the Herbal liquid combo instead. My body may have just been less irritated by the stitches the second time as well

7. Down the line: 3-6 months.

  • When the incisions have become red scars, switch to calendula cream.  Alternate with a mixed tocopherol vitamin E. Calendula CANNOT be used on open wounds. Massage it into the ropy scar tissue. Use your intentions to break up the scar tissue and envision healed skin.
  • Thiosaminum 30c is a homeopathic remedy that can be used to break up scar tissue. Take 2 pellets per day for 2 weeks if you are developing thick scars. Do not take if your healing is going well. Order the smallest vial from https://www.hahnemannlabs.com/
  • Continue to take your multivitamin, essential fats (flax seed oil or better yet fish oil capsules) and vitamin C.
  • Follow up on emotional issues that may have come up in the first 2 or 3 weeks after surgery.
  • Acupuncture can also be helpful for reducing scar tissue or speeding along healing after difficult recoveries.

Congratulations on being your Beautiful self!