FTM Transition: Top Surgery Surprises

Things I wish I had known before my surgery

Grayson Bell
3 min readDec 20, 2019


Photo by Kelly Sikkema on Unsplash

I am now over five weeks in post-op recovery from my top surgery. Since the last article I wrote on having top surgery, I have come across some unexpected things that I wanted to share with the community.

Uneven healing

My incisions began to change in the last couple of weeks, and I wasn’t sure if it was something I needed to worry about or not. I had been diligently applying the scar care treatment and using silicone tape as prescribed by my surgeon, along with giving my incisions a daily massage or two. However, there were small sections where the color and texture began to change, along with small nubs that began to poke through the incisions.

In addition to that, the dark crust that had been covering my nipple grafts was sloughing off my left nipple more quickly, while it remained in place on my right nipple with hardly any change. I was slathering both in equal amounts of Aquaphor and keeping them covered in gauze.

Unexpected bleeding

The left nipple also surprised me by starting to bleed unexpectedly. That’s when I was sure I must have done something wrong in my care and called my surgeon’s office. Thankfully, the nurse I spoke with assured me that not only was the bleeding expected, it was a good sign that my nipples had healthy blood flow. I wish I had known to expect the bleeding beforehand, then I wouldn’t have panicked as much.

Along with that, she also informed me that incisions heal at different rates, which is why I was experiencing the changes in color and texture in some sections and not others. I had emailed in some photos of what was going on and the nurse did ask me to make some changes in my scar care routine, including putting Aquaphor on my nipple grafts more frequently (I had been doing it only morning and evening), and also to massage my incisions more frequently.

Spitting stitches

These days, most surgeries are completed with internal dissolving stitches and surgical glue to hold the skin together. However, occasionally those internal stitches don’t dissolve, and the incisions will begin spitting out the little bits of suture



Grayson Bell

An autistic, gay, transgender man writing queer fiction and about LGBTQ issues, focused on the transgender community. (He/Him) http://graysonbell.net/