Although this article primarily focuses on transmasculine top surgery, much of this information also applies to transfeminine top surgery.

Massaging your scars and applying topicals to keep the skin hydrated — when your surgeon gives you the OK to do so — are key to healing after top surgery.

Your surgeon may advise you to use one or more of the following over-the-counter (OTC) treatments after 2 to 3 weeks:

It takes about 12 months, on average, to completely heal after top surgery. If your scars are not healing as desired with topical treatments alone, your surgeon may recommend:

If you smoke or vape, cutting back or stopping altogether for at least 4 to 6 weeks before and at least 4 weeks after surgery can have a big impact on your results and recovery.

A systemic review published in 2006 found that longer-term smoking cessation decreased the risk of complications after surgery.

Increasing your intake of key nutrients — like vitamin C, zinc, and other antioxidants — or adding a supplement to your routine may also be beneficial. Antioxidants can help reduce redness and swelling.

Talk with your clinician about your diet and any medications you’re currently taking. Some supplements can interfere with prescription medication, so it’s important to take your overall regimen into consideration.

Your clinician may also suggest that you reduce your sodium intake in the weeks leading up to and immediately after surgery. Sodium can cause the body to retain water, leading to unwanted swelling or bloating.

Your clinician may also advise you to avoid certain OTC medications that can thin the blood for at least 7 days before surgery, such as:

If you take a prescription anticoagulant, like warfarin (Coumadin) or heparin, consult with a healthcare professional before discontinuing use.

Your skin tone, genetics, age, and overall health affect the way your body heals after surgery.

Avoid exposing your scars to the sun for extended periods of time, if at all, for at least 1 to 2 weeks after surgery. Consider wearing sun-protective garments to keep the affected area out of direct sunlight.

Compression

Your surgeon may advise you to use compression bandages or wear a compressive garment (like a surgical bra or a binder) the first couple of weeks after surgery.

Compression can help minimize swelling around the surgical site. The type of surgery you have determines the type of compression needed.

Your clinic or hospital may send you home with a compression garment, but you may wish to stock up with a couple of options yourself.

Your clinician may advise you to sleep in your garment, so you’ll want to have a spare handy to change into when it’s time to throw it in the wash.

Topicals

It’s generally best to wait to apply creams, ointments, and other topicals for at least 3 to 4 weeks after surgery. Your surgeon will let you know when it’s safe to apply topical treatments to your incisions.

Silicone gel is considered a front-line therapy for scar management. Silicone strips or adhesives may also be beneficial. Bio-Oil can also reduce the appearance of certain scars.

Although topical vitamin E is often touted as a treatment for scar healing, the available research is inconclusive.

If you can’t avoid sun exposure, wear sunscreen with at least SPF 30 and reapply every hour until you’re indoors and out of the sun. Sun-protective garments can also keep the affected area out of direct sunlight.

Massage

Your surgeon may advise you to start self-massage at or around the same time as your topicals. Massaging the surgical site helps remove collagen buildup to flatten the scar against the skin.

Use gentle, circular motions. Aim for at least one 5-minute session per day. If your skin is warm or painful to touch, seek medical attention as soon as possible. This could be a sign of infection.

Itching is a natural part of the healing process, but try not to scratch at all if possible. Scratching can break the surface of the skin and introduce bacteria into the wound. OTC antihistamines, like diphenhydramine (Benadryl), can help alleviate itching.

Top surgery is usually an outpatient procedure, so you may be able to go home the same day as your surgery.

It’s important to rest for the first 2 weeks after surgery. Avoid reaching your arms overhead. Do not attempt to lift anything of substantial weight.

Your surgeon may ask you to come in for a follow-up appointment around 2 weeks postsurgery. During this appointment, your surgeon will likely:

  • remove any drains and lingering stitches
  • clean the skin and reapply your surgical dressing
  • discuss the protocol for full-body showering
  • demonstrate how to massage the area and apply topicals

If you’re feeling up to it, you may be able to return to school, work, or other daily activities after 2 to 3 weeks. You’ll likely be able to bathe or swim, lift heavy objects or weights, and resume vigorous activity after 6 to 8 weeks.

Continue to care for your scars as instructed by your surgeon for the next several months.

Is it possible to completely prevent scarring after top surgery?

Some degree of scarring is inevitable, but there are ways to encourage healing and reduce the appearance of scars over time.

Are different types of scars possible?

Yes, because there are many techniques for top surgery. The size, number, and location of your incisions will affect the overall shape and texture of scars.

Should you massage top surgery scars?

Although you don’t have to massage the area, it can be incredibly helpful. Occasional massage is better than no massage, so do what you can, when you can.

How long does it take to heal after top surgery?

You can usually return to low impact work and other activities after about 2 weeks. But wait at least 6 to 8 weeks before you resume strenuous or high impact activity.

Your scars will be completely healed in about 1 year.

There is no “correct” way to heal after top surgery. Although many people follow a similar timeline for recovery, everyone is different. Your body will heal on its own timeline, so be gentle with yourself.

If you have any questions or concerns, reach out to your surgeon or another healthcare professional.

Soren Hodshire (he/him/his) is a queer trans writer based in Chicago, Illinois. After getting his Bachelor of Arts in cultural studies and minoring in women, gender, and sexuality studies, Soren has been organizing, writing, fundraising, and facilitating for queer and trans organizations. He’s deeply committed to community building and solidarity across marginalized groups. When Soren isn’t writing or watching video essays, you’ll find him listening to a podcast. You can follow him on Twitter (as long as it still exists) and Instagram.