Pre-surgery

Before surgery, focus on maximizing mobility, physical support, and relaxation for the best recovery possible.

Supported range of motion exercises

Strengthening your upper body joints before surgery can facilitate smoother recovery. Exercises (without equipment) to consider: 

• Neck (Controlled Articular Rotation) CAR 
• Scapula CAR 
• Segmented Cat Camel 
• Thoracic CAR 
• Shoulder CAR 
• Swimmer Hover
• Wall Angel 
• Quadruped Scapula Push-Up 
• Dolphin Press

Core and lower body exercises

Prioritizing core and lower body exercises is beneficial during recovery to help you maintain overall strength and stability when upper body movement is limited. Recommended exercises include:

• Hip CAR
• Deadbug
• Bird Dog Row
• Shinbox Extension
• Seated Good Morning
• Reverse Nordic
• Lateral Lunge
• Single Leg Balance
• Single Leg Deadlift

Breathing exercises

Practicing breathing exercises can aid relaxation and activate your parasympathetic nervous system, promoting a faster healing rate. Consider techniques like:

• Box breathing
• 2:1 breathing
• 4-7-8 breathing

Post-Surgery

Getting comfy

Ensuring comfort and ease during the recovery period is essential. Here are some general tips to consider for maximizing your comfort level:

• Bidet use
  • Installing a bidet reduces the need for torso and arm movement during toilet use, minimizing discomfort, especially in the early stages of recovery.
• Clothing choices
  • Opt for oversized button-up shirts or zip-up hoodies for easy wear during the initial weeks post-surgery. These garments require a minimal range of motion and alleviate the need for overhead movements.
• Sleep support
  • Expect sleep disruptions in the first few weeks post-surgery. Inquire with your surgeon about suitable sleep aids to alleviate discomfort and promote restful sleep.
• Gut health
  • Anesthesia can contribute to gut issues like constipation post-surgery. Incorporating probiotics and prebiotics into your diet can help alleviate digestive discomfort and promote gut health.
• Personal hygiene 
  • Managing personal hygiene, especially when showering is restricted, is crucial. Consider using wipes to maintain freshness and cleanliness.
• Comfortable accessories
  • Invest in a light cup with a straw to ease hydration during the initial recovery period. Soft padding around the surgical binder can reduce irritation and discomfort.

Rest & recovery

Surgery impacts your body’s functionality and response mechanisms, especially the brain. The brain signals discomfort and challenges that discomfort through immobility, inflexibility, fatigue, nausea, pain, and headaches. You may experience these symptoms during the first six weeks of your post-surgery recovery.

Focus on gentle movements to support and energize your body to prevent stiffness. Consider which movements feel safe and reduce discomfort to improve your overall well-being. 

Recovery Timeline

Week 1

• The most movement restriction, especially in the upper body.
• Sleeping may be uncomfortable and reduced.
• Experience brain fog due to anesthesia and recovery process.

Week 2

• You can likely sleep on your back and/or sides.
• Movement restrictions begin to ease but are still limited.
• Recovering from the challenges of the first week.

Week 3

• Begin to feel more settled mentally and physically.
• May be cleared for scar massage to promote healing.
• Experience increased energy and movement capacity.

Week 4-6

• Notice scar tissue tightness and nerve sensation returning.
• May feel antsy as you start feeling better and closer to your baseline or “typical” self.
• Cleared for a gradual increase in movement and activities.

Movement & sensation

Congratulations! With your surgeon’s approval, you can return to all previous activities. As you gradually begin to resume previous activities, reflect on the following:

• Can you control your breathing? 
• Can you release tension that isn’t required?
• Is the scar tissue pulling?

Your body’s ability to adapt and change over time means undoing tension patterns can take time. Controlling your breathing and releasing unnecessary tension can significantly improve your well-being during recovery. Remember that your brain is catching up to your body, and you may experience load redistribution, phantom sensation, and pattern disruption.

Pattern disruption can refer to changes in the body’s normal processes or behaviors due to the surgical procedure. This might include altered sensations, movements, or responses that deviate from what one might typically experience.

Load redistribution means moving around the weight and tissue in the chest to create a flatter, more masculine or feminine appearance, depending on the individual’s gender identity.

Phantom sensation is the feeling of having a body part that is no longer there. In the context of top surgery, it often refers to the sensation of still having breasts or nipple sensations even after the breasts have been surgically removed.

Support networks and resources

The following are some valuable recovery resources and support networks to explore on your top surgery journey:

• Movement Genius – Movement Genius is a digital wellness platform that provides live and on-demand classes to help you improve your mental, emotional, and physical well-being. Use code PLUME50 at checkout for 50% off their top surgery recovery program or monthly/annual access to Movement Genius. 
• Queermvmt — Founded by MJ Jupitus, Queermvmt focuses on using movement as a tool to help LGBTQIA+ folks with pain management (from circumstantial to chronic), to feel more connected to their body and to prepare for/recover from gender-affirming surgeries.
• Nonnormative Body Club — Nonnormative Body Club offers personal training, group fitness, and wellness workshops by ACSM-certified personal trainer Asher Freeman.
• Imán Circus Arts – Founded by Alex Imán, Imán Circus Arts specializes in flexibility and contortion.
• Fuzz Culture Club – Founded by Lucinda Livingstone, Fuzz Culture Club offers personal training with specialized support for the trans and nonbinary community.
• Decolonizing Fitness – Founded by Ilya Parker, Decolonizing Fitness is an online educational resource for coaches, trainers, studio owners, and anyone interested in unlearning toxic fitness culture.
• Cirque Physio – Programs Dr. Jen Crane PT DPT OCS ATC created for injury prevention and performance optimization in circus arts.
• Train With Blake – Inclusive and progressive fitness training for the AFAB, FTM, and gender non-conforming community by Blake Knapp.
• Dibs Fitness – Inclusive, accessible fitness training empowers marginalized people to become strong, resourceful athletes. 
• DR DHT – Trans-owned, operated, and formulated hormone-safe beard, scar salves, and natural body products. 
• Cicalux – CicaLux® Scar Care Therapy is a wearable, combination therapy device designed to help improve scar healing following c-sections, hysterectomies, tummy tucks, breast augmentation, and similar incisional surgeries.

As you navigate the road ahead, remember to be patient with yourself and celebrate your progress, no matter how gradual it may seem. Remember that progress comes in many forms, and every step forward, no matter how small, brings you closer to healing and self-discovery.