For most people, having good hygienic habits, like bathing or showering, is important for obvious reasons.
Of course, there are some individuals who may not agree and don’t have this on their list of priorities or things to do.
For those individuals seeking female to male (FTM) or female to non-binary (FTN) gender affirming top surgery and who want some semblance of cleanliness after surgery, you should find the following guidelines relating to showering and bathing quite helpful.
Guidelines Are Just That – Guidelines
The guidelines enumerated below are what we presently recommend for our patients. They are sensible and easy to follow yet do not and should not compromise your post-surgical healing nor the ultimate results.
Furthermore, your cleanliness will be appreciated by many!
If you are undergoing top surgery with another plastic surgeon, you should follow their recommendations.
Showering Guideline Variables
Because of the variables associated with the different procedures and each individual, there are some variations and specifics regarding showering and precautions. It is not as simple as: “You can shower now”.
- Procedure Type: The restrictions are more specific and longer and precautions more important for the double incision free nipple graft technique as compared to the double incision mastectomy without nipples, keyhole approach and the concentric circle (periareolar) approach. This is related to the need for the free nipple graft to regain a blood supply (revascularize) in order to heal properly.
- Postoperative Time: With the passage of time in the early postoperative period, the restrictions are decreased until there are none at all.
- Personal Variables: Some people take longer to heal than others so this must be accounted for.
Showering Guidelines by Procedure Type
From Surgery to First Postoperative Visit
From the time of your surgery until your first postoperative visit, which is usually in two to three days, the instructions are the same regardless of the type of top surgery that you had. You will have a surgical dressing on that you must not get wet (photo). Therefore, it may be easier to take a sponge bath.
If you do have a mobile shower head with a hose, this can be used though you must be very careful to keep your dressing dry (photo).
After First Postoperative Visit
- Double Incision Mastectomy with Free Nipple Grafts: You can shower but keep the water off your chest until the dressings on your nipples (bolus dressings) are removed – at around two weeks. From that time until 4 weeks after your surgery, water from the shower can run down your chest but not hit it directly. After four weeks, there are no showering restrictions except to not rub or press on your nipple-areola complexes for one more month
- Double Incision Mastectomy without Nipples: You can shower but try to keep water off your chest as best as possible until your Steri-Strips (“butterfly tapes”) are removed at around 10 days to 2 weeks. After that, there are no showering restrictions.
- Concentric Circle (Periareolar) and Keyhole Mastectomy Techniques: You can shower but try to keep water off your chest as best as possible until your Steri-Strips (“butterfly tapes”) are removed at around 10 days. After that, there are no showering restrictions.
- Gender Affirming Breast Reduction: You can shower but try to keep water off your chest as best as possible until your Steri-Strips (“butterfly tapes”) are removed at around 2 weeks. After that, there are no showering restrictions.
If you have any questions about the above, please feel free to ask. Additionally, if changes need to be made to the above due to individual factors, these will be discussed with you.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona
