Tips for Top Surgery

by Sam Brighton

Honorable Mention: Flash 405 June 2016, Judith Freeman’s “Metamorphosis”


  • Close your eyes when your partner photographs your naked breasts. The surgeon needs to inspect them to calculate a quote. When you prepare the email, cross your eyes—it’ll help obscure them. You’ll just have to trust the security of the computer server. Then quick, delete the images. Empty the trash.
  • Resist temptation beforehand to watch the surgery online. No comfort will come from watching a masked man sawing into a person, his elbow pumping as if carving a turkey. Wait until after your surgery to observe that internal breast tissue glistens under surgical lamps like butter pats.
  • Ignore your friends who question your decision, evoking terms like “cosmetic” or “mutilation.” Trust yourself—you owe nobody an explanation.
  • Don’t smoke six weeks before or after surgery. Your nipples could fall off.
  • Even though you don’t actually identify as male, the surgeon and his staff will call you “Sir.” Explaining the ambiguities of your gender might violate the surgeon’s policies around proper gender identity. After the assistant types your excuse for missing work, Photoshopping male pronouns back into your female pronouns before submitting the letter hurts nobody.
  • When you meet the surgeon the day before, relax, unclench your fists. He’s done this surgery three times weekly for the last eleven years. Expect vomiting. Nobody yet has required a blood transfusion. (You’ll be okay—you never win raffles or lotteries or other statistical anomalies.) WARNING: His manila folder stores full-page photographs of your breasts. These images will make you gasp. The assistant had the grace to print from the black-and-white LaserJet.
  • The pre-op room will make you shiver. The surgeon will draw lines on your chest with a magic marker. This will tickle. Your partner has rarely touched you in these places. Just wait.
  • It’s okay if you decline one last look to say goodbye. You’ll never miss them.
  • Your heart might pound when you wheel into the bright operating room. The nurse will shove pillows under your bones and wrap squeezing cushions around your legs. She’ll watch over you.
  • The anesthetic oxygen will hiss. A minute later, you’ll wake up puking and asking bizarre questions to the nurse who holds the emesis basin.
  • Your chest will burn at first. But that’s nothing. Even with post-surgical swelling and lumpy compression garments, your chest will appear flat underneath your clothes. You’ll stare into the mirror. You’ll heal.
  • At last, you’ll live inside your body. Welcome home.


Judge’s Comments:

Metamorphosis: not just the predictable sort of thing, like pupa to butterfly, but nature-driven nonetheless in the deepest sense, a leap across that spectacular (undivided) divide of gender. I found beautiful metaphors in this piece, which limns that ever-increasingly mushy border between fact and fiction. Interesting structure as well, to make such a fine package for a piece of flash out of a series of suggestions (yes, tips) that somehow make such a comely, and credible, whole.

Sam Brighton is currently working on a collection of personal essays. She is heavily caffeinated and chronically dehydrated, and she requires frequent bathroom breaks during road trips. She lives in Portland, Oregon with her wife and two children.

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