For a lot of trans men, top surgery is recognized as one of the major guide points toward a successful transition. During top surgery, the surgeon will remove the breasts, remove excess skin, if necessary, reposition the nipples. For most trans men, this is a generally positive, life changing experience and goes a long way toward enhancing gender identity by adjusting appearance to fit more in line with a masculine gender identity.
Since top surgery is a surgery of the chest, it is easy to assume that most exercise and training programs should reflect strengthening your chest muscles. According to Dr. Scott Mosser, a leading surgeon who specializes in health and surgery for transgender and non-binary people…
“Chest-focused weight lifting can enhance the contour of your chest and improve your final results over time.“
According to www.topsurgery.net/faq it is recommended that people who are preparing for top surgery exercise and increase the muscle mass/ density in their chest. This is important to help you recover quickly from the surgery, but the increased muscle mass will give the surgeon more "contour" to work with, allowing better aesthetic results.
Strengthening exercises to build strength and mass in your chest are important to improve the overall strength, mass, and appearance of the chest muscles while also helping with the post-surgery recovery process. However, it is important to incorporate chest work in part of a larger strength and conditioning program to maintain overall body posture and strength, while minimizing your risk of developing injuries and ensuring that you are training safely and with balance to the other muscle groups in the body.
The main anatomy of the chest consists primarily of the Pectoralis Major, which is the most common of all the chest muscles. The Pectoralis Major connects both at the Sternum (middle of the chest) and the Clavicle (collar bone) and consists of a large swatch of muscle tissue which can be recruited on the upper or lower ends depending on the exercise. The purpose of the Pectoralis Major is to assist in the movement of the upper arm in moving it toward the body and rotating the arm internally (downward and toward the midline). It is a very strong and powerful muscle capable of building great strength and size.
The Pectoralis Major is assisted by several smaller muscles, including the Pectoralis Minor which runs between the Pectoralis Major and the Serratus Anterior along the mid to side section of your torso along the rib cage. The Subclavius helps to stabilize the shoulder joint when the Pectoralis Major is contracting. The Anterior and Lateral Deltoids also assist the Pectoralis Major during chest press and pushing type exercises.
Remember, the Pectoralis Major isn’t the only muscle you need to train when preparing for top surgery or to help build a more masculine upper body. There are muscles throughout the shoulders, back and arms that require training as well to help balance the load, maintain your posture and work together with the chest muscles through a variety of movements and functions.
It is important to remember that top surgery is a major surgery, and thus there is a preparation and recovery phase of the surgery, including time to rest and recover. Prior to your schedule surgery, there are many ways to prepare yourself for the surgery that help improve recovery as well as help you achieve a more masculine appearance. Here are some tips…
Chest work is important, but in moderation
Don’t forget Leg Day!
Start off light, and build technique through repetition
Be careful of shoulder impingement
Incorporate Different Chest Exercises
Remember the Five Point Contact Position
Recovery Days Count Too
The earlier you start training prior to your scheduled surgery, the better of a head start you will have in anticipation for the big day. Following your surgery, doctors advise a minimum of 3 weeks of recovery before you’ll be cleared to start exercising again and depending on your doctor’s orders, it will vary. Following surgery, it’s important to ease back into training again. You definitely will not be at the same level that you were before, so be patient and allow yourself time to build it back up; following advice from your doctor.
If you’re looking for a bit more guidance, Coach Dirk has a 90 Day Training Program available through your smart phone specifically for transgender and non-binary people who are preparing for top surgery. It has been designed with the guidance we’ve shared above and includes videos on proper exercise technique and can be tailored to meet your specific goals and level of conditioning. Find more information at http://www.stonewallfitness.com/online-training.html and get started training within minutes at https://www.trainerize.me/profile/stonewallfitness/?planID=28060
By Dirk Smith
David "Dirk" Smith M.Sc, SDL, CSCS, (He/Him), is a sport psychology expert, performance coach, teacher, writer, journalist, and athlete. He brings over 10 years of experience as a coach, athlete, personal trainer, fitness instructor, and sports psychologist to drive athletes to build their own self efficacy and express themselves through sport. Learn more about Dirk here!