Gender-Affirming Top Surgery Guide
This guide explains the dressings, wound care materials, and scar management products commonly used after Double Incision or Anchor Gender-Affirming Top Surgery at Evita Clinic. Following these instructions can help support nipple graft healing, protect incisions, and improve long-term scar quality.
Most Important Notes
- Do not remove dressings yourself. Several dressings are designed to remain in place until your scheduled follow-up visit.
- Nipple graft healing takes time. Dark color changes, crusting, and uneven appearance are often normal during recovery.
- Protect your incisions. Avoid unnecessary stretching, pulling, or friction across the chest.
- Scar management begins early. Steri-Strips and scar therapy products can help improve long-term scar quality.
- Contact the clinic if something seems unusual. Increasing pain, spreading redness, foul odor, fever, or sudden swelling should be reported immediately.
Healing Timeline
Protecting the Incisions
Several different dressings are used after surgery because different parts of the chest heal differently.
- Dermabond Prineo protects the IMF incision.
- NPWT protects the nipple grafts.
- Povidone Iodine is used around the areolar incision.
Early Healing Phase
During the first weeks, the nipple graft develops new blood circulation while the chest incisions begin to seal and strengthen.
Scar Protection Phase
Steri-Strips are commonly used during this period to reduce tension across healing scars.
Scar Maturation Phase
Scarheal Gold Gel may be started after complete healing to support scar remodeling and improve scar quality.
Dermabond Prineo (IMF Incision)
Dermabond Prineo protects the lower chest incision during the early stages of healing.
Dermabond Prineo is applied to the lower chest incision, also known as the inframammary fold (IMF) incision.
- No daily dressing changes are required.
- Do not peel, scratch, rub, or remove the dressing.
- The dressing gradually loosens and detaches naturally over time.
- Showering is generally allowed according to your surgeon's instructions.
NPWT Dressing (Nipple Grafts)
A Negative Pressure Wound Therapy (NPWT) dressing is applied over both nipple graft sites after surgery.
- Protects the nipple graft during early healing.
- Provides gentle suction to improve graft support.
- Supports circulation and healing of the graft.
- Do not remove, lift, peel, or replace the dressing yourself.
- A flattened appearance is usually normal.
- The dressing will be removed during your postoperative visit.
Contact the Clinic Immediately If:
- The dressing loses suction.
- The dressing becomes detached.
- You develop increasing redness.
- You develop fever.
- You notice foul odor or significant drainage.
- You experience sudden swelling or bleeding.
Povidone Iodine Swabstick
Daily disinfection is performed only around the areolar incision.
Povidone Iodine Swabsticks are used for daily disinfection of the areolar incision during the early healing period.
- Shower first if instructed.
- Gently clean the areolar incision once daily.
- Start from the center and move outward using circular motions.
- Allow the area to dry completely.
- Continue for at least 7 days or as instructed.
If you have an iodine allergy, please inform Evita Clinic before using this product.
Waterproof Bandage
Waterproof bandages may be used to protect the areolar incision after cleaning.
- Use only if instructed by the clinic.
- Protects the areolar incision during early healing.
- Replace if it becomes wet, contaminated, or detached.
- If moisture becomes trapped underneath, remove it and contact the clinic.
Steri-Strip Scar Support
Apply Steri-Strips perpendicular to the incision line to support healing scars.
Steri-Strips provide external support to healing incisions and help reduce scar widening caused by tension.
- Begin after suture removal.
- Continue use for approximately 2 months.
- Replace only when loose or naturally detached.
- Do not stretch the strips during application.
- Leave small gaps between strips.
Scarheal Gold Gel
Scarheal Gold Gel may be used after complete healing to support scar remodeling.
Scarheal Gold Gel contains sodium heparin, allantoin, and dexpanthenol, ingredients commonly used to support scar remodeling and improve scar quality.
- Start only after the incision is completely healed.
- Complete Steri-Strip therapy first.
- Apply a thin layer 2–3 times daily.
- Massage gently until absorbed.
- Continue for at least 2–3 months.
General Recovery Guidelines
- Attend all scheduled follow-up visits.
- Avoid strenuous exercise and heavy lifting for at least 4 weeks.
- Wear your compression garment as instructed.
- Protect the chest from excessive stretching and friction.
- Contact the clinic if you develop fever, redness, swelling, discharge, or worsening pain.
Important Note
Recovery after gender-affirming chest surgery is a gradual process. Different dressings are used for different areas because nipple grafts, areolar incisions, and chest incisions heal in different ways. Following these instructions carefully can help support healing, reduce complications, and improve long-term scar quality.