FTM Surgery Recovery

By Nick Peplow·Gender-affirming surgery coordinator

Last reviewed 27 September 2026· How this site is researched

These pages cover the weeks and months after surgery, across top surgery, hysterectomy and the genital procedures. The recoveries are very different in length. After top surgery most people are back at a desk in two to three weeks and the scars take 12 to 18 months to finish fading. Phalloplasty means up to a week in hospital for the first stage and one to two years across all the stages. Each procedure page has its own recovery timeline; these pages cover the practical detail that applies across them.

Start with the recovery timeline. It puts every procedure side by side (hospital stay, when drains or catheters come out, desk work, full activity, final result), then walks through what's normal at each stage and which changes mean ringing your surgeon. For one route in depth, top surgery recovery and bottom surgery recovery go week by week.

The first weeks

The first fortnight is mostly logistics. Drains after double incision or inverted-T top surgery need emptying and logging two or three times a day and usually come out at around a week. The compression vest stays on day and night until somewhere between week four and six, and your old binder can't stand in for it. Pain management covers what you're likely to go home with and the kinds of pain that are a warning rather than just soreness.

In the Bangkok hospitals where I've coordinated patients, the questions in week one are nearly always about drains and the vest, and by week three they have turned into questions about work and the gym.

Getting back to normal

Time off work depends on your job as much as your surgery. A desk job after top surgery and a warehouse job after phalloplasty are months apart, and the page gives ranges for each. Returning to exercise happens in stages, from walking on day one to chest work somewhere in months two to three after double incision, later after keyhole or peri-areolar. Scar care starts once the incisions have closed and runs for about a year, and consistency matters more than which product you buy.

Mental health after surgery has its own page because a low patch a few weeks after something you wanted for years is common. The people I've walked through surgery who knew it might come handled it far better than the ones it ambushed.

Spotting complications early

The complications section covers the ones worth knowing by name: hematoma, which is the early top surgery emergency; infection; nipple graft loss; and the fistulas and strictures that come with lengthening the urethra in bottom surgery. Each page describes how you'd notice it and what usually happens next. Revisions covers what can be fixed later, when surgeons will consider it, and how it tends to be paid for.

This is information, not medical advice; your surgeon's discharge instructions come first, and if something worries you, ring them.