Surgery, Retainers, Self Advocacy, and a Piercers Privilige

As some of you may know, I recently got top surgery! This has been a process 3 years in the making, and something I’ve been dreaming about for far longer than that. I opted for one of the most popular forms of top surgery- double incision without nipple grafts. This is one of the largest and most invasive surgeries I’ve had done, if not the most invasive. It was also the first time I needed to wear retainers for surgery, and I wanted to share my experience. Specifically, I want to address my experience from the perspective of a professional piercer and and client. My hope is to share a lot of the thoughts and process of retainers and hopefully allow piercers, clients, and medical professionals to better collaborate in the future.

Advocacy First

To be fully transparent, I did not want to wear retainers for my surgery. I also do not believe it was medically necessary for me to do so. There tends to be a heated debate when it comes to body jewelry for medical procedures, with some validity on both sides. For me, I wear entirely implant-grade titanium jewelry, and when I go into surgery, I’ll typically switch all the decorative pieces to simple ends, remove any chains and charms that could possibly snag, and go with the simplest, most low-profile pieces I have. Now, if I have a piercing directly in an area that’s going to be affected by surgery (for example, if I had my navel pierced but was having a laparoscopic procedure that involved an incision in my navel- obviously, I would remove jewelry for that. If I had my nipple pierced, I would remove those for top surgery. etc.)  But pieces not directly impacted by the procedure, I will leave in. This is because many of my piercings would close in just the few hours they would be out for surgery, or would shrink dramatically enough that it would be an issue to reinsert them.

Medical professionals typically have a few concerns when it comes to jewelry. The first is catching or snagging it- during surgery, it's not uncommon for them to need to move you around on the table some, they are working around you with cords, tubes, etc, and something could get caught or jostled and rip or tear. I think this is a reasonable concern. That’s part of why I switch all my pieces to the least decorative styles possible. Taping is also a solution to this- for my tubal scalpendectomy we taped gauze squares over my ears and placed strips of tape over my nostrils, cheeks, and bridge, so the jewelry couldn’t snag while they were working. Further, I signed a consent form stating I understood the risks of snagging by leaving jewelry in, and I was ok with that.

Another concern is burns. In procedures where the surgeon may be using electrocautery devices, there is a real concern of the electricity arcing to metal in the body and causing a burn. In fact, there have been confirmed cases of this occurring, including once in my state. There are also studies (https://pubmed.ncbi.nlm.nih.gov/31009888/) that show the risk is minimal. As a piercer, my theory is that some clients are undergoing surgery wearing very low-quality mystery metal, which can be conductive, and this is causing issues during procedures. However, with proper implant-grade jewelry, these pieces are nonconductive, nonferromagnetic, and non-arcing- it’s the same material used in medical implants. So it is safe to have it during these surgical procedures. This is the metal I wear in all of my piercings. I have had multiple procedures in the past with electrocautery, and I left all my jewelry in, with no issues. So I also had letters from previous surgeons stating I had been fine for their procedures.

((I also want to note that upon digging, the single confirmed case in my state involved leaving a micro dermal in very, very close to an incision site, and the exact material of the anchor is unconfirmed, but my initial inquiries led me to believe it was not implant grade. This really makes me further suspicious of how many confirmed cases are obvious examples of unsafe practices. As I mentioned above, if it’s directly near an incision, it does need to be removed.))

At every meeting with my surgeon, I expressed this, and also offered documentation about the material quality of my piercings, and studies that backed up the statements I made (you can learn more about my process of self-advocacy with doctors here).  My surgeon and my anesthesiologist were actually both comfortable with me leaving my jewelry in during the procedure, as long as I signed documents of risk of both snags and burns. However, the surgical center was not comfortable with this, and ultimately, their legal team refused to allow an exception, even with the documentation I have, and the surgeon's agreement.

Sometimes, even with all the advocacy we do, all the documentation we have, and all the support, the medical system is simply not often the most forgiving or understanding. I may have had all the documentation for my jewelry, studies to back it up, letters from previous surgeons, and the approval of my surgeon, and still a legal team could decide it wasn’t ok. Honestly, the fact that it took me till 30 to have surgery, where I had to remove them, is still quite impressive, and goes to show how effective self-advocacy and education can often be.

Compromise Second

When advocacy doesn’t work out, compromise is the next step. When I realized there was no reality where I could keep my jewelry in, the next step was getting retainers. I expressed that many of my piercings would close without anything in them, and also stressed that my piercings are an integral part of my self-identity and gender expression as well. It would almost be pointless to get top surgery for gender affirmation, just to lose multiple piercings and get dysphoric over that. Fortunately, my surgeon was very understanding about that, and we proceeded with permission for retainers.

Now, I have some unusual piercings and some piercings in unusual sizes, like my 10g vertical philtrum or my heavy modification work- my coin slots. The more unusual the piercing or size, the more difficult it can be to get retainers. Now, anything can be custom-made, but custom pieces take time. I made the call for retainers with my surgeon about a month before surgery, and I immediately contacted Glassware Studios with the information about the pieces I would need, and understanding I would likely have to pay a rush fee- usually, 1-3 months is a turnaround time for custom pieces. This is something you should determine no later than 1 month out from surgery, but ideally further, if you have unique piercings or sizes. For standard piercings, it’s very likely your local studio will have retainers in stock, but it also doesn’t hurt to have them set some on hold or layaway for you, so you know for a fact you’ll have the pieces you need for surgery. There is nothing more stressful than coming in the day before surgery only to find that the studio is out of stock of the size or style you need. So please plan ahead!

Retainer Install

Since I am a piercer, I opted to install my retainers myself the morning of surgery. I actually don’t suggest this- it took me over an hour and was honestly very frustrating. I do this for a living, and I was still violently humbled trying to remove my own rook jewelry at 5am in my bathroom. If possible, see your piercer a day or two before surgery to have your retainers professionally installed. Some studios may offer to deep-clean your jewelry and hold it there for reinsertion, and that’s a great plan, I personally deep-cleaned mine and loved how sparkly and fresh it all looked when it was reinserted.

Retainers are not the most secure style of jewelry, more designed for temporary wear during surgery or a short-term event or occasion. This does mean it’s easier to lose retainers, so I suggest having them inserted as close as is reasonable to your surgery, and having jewelry reinserted as soon as you feel up to it.

An Unexpected Side Effect

As a professional, I have plenty of experience educating clients about the safety and purpose of retainers. I can walk people through how they work, when to use what style, and easily get them in and out for clients. Often, I’ll make a little joke that there's no grand reveal this time since retainers are basically invisible, but they’ll do the job of keeping our piercings safe and healthy for now. But I’ve personally been fortunate to be able to leave most of my pieces in for my procedures. This was the first time in my entire adult life that I would see myself with all my piercings either empty or with retainers.

And it was so much harder than I could have expected. I wasn’t exaggerating when I stated earlier that my piercings are a part of my gender presentation; they are an integral part of who I am. So looking in the mirror and seeing myself sans any jewelry…..it was very hard. I felt very disconnected from the person in the mirror, and it was all extremely dysphoric. Add to that the fact I was getting a major surgery and.…it was rough. I recall coming home from surgery and going to the bathroom and seeing myself in the mirror. Wrapped up in layers and layers of foams, swollen, exhausted, with tired eyes and a unique anesthesia pallor to my skin. Without any of my piercings, I barely recognized the person in the mirror as me. And this was an incredibly emotionally uncomfortable moment. It genuinely made it hard for me to be excited about getting top surgery, because I felt so disconnected from the person in the mirror. I was also very stressed about irritating my piercings with the retainers or losing them. This stress genuinely made it hard for me to relax after major surgery, which is not ideal.

Now I’m very privileged here, I work as a piercer, and I have really cool coworkers. Colin made a house call for me a few hours after I was home from surgery and very kindly put me back together. ((All my piercings are currently fully healed, and there was full informed consent about doing this in my home.)) Most people aren’t going to have this option, though. They are simply going to have to leave retainers in for a few days or even weeks till they can safely get to a studio and get things back in. In that moment, I was struck by the immense amount of privilege I had as someone in this industry with easy access to the documentation and knowledge that allowed me to avoid this situation through many surgeries, and the privilege of having a colleague able to come reinsert my pieces so quickly after.

I think as piercers, we are often a bit disconnected from the privilege we have when it comes to being able to always have our pieces in, or having the skills and ability to remove and reinsert pieces on our own, or having access to coworkers to help with this. I know I was. It took me experiencing how much not seeing my piercings in the mirror after surgery impacted my mental health and headspace after surgery to realize how difficult this must be for our clients. Again, logically, I have always understood it would be very uncomfortable to not see your piercings in the mirror when you need retainers. But to live it was very different. It’s given me a new appreciation for clients who endure this. Especially when you add in surgery, which often can cause depression and dissociation as part of the mental element of recovery and side effects of anesthesia. I was fairly distraught looking in the mirror, and I only had to deal with this for less than 24 hours. I removed my jewelry in the morning, and Colin put them back the same afternoon.

I am not sure how I want to incorporate this experience into my practice, but I have a few ideas. I want to write up something about dysphoria without your jewelry to have as a resource for clients who have similar experiences. Maybe this blog will suffice as that, but I may also make a separate piece or graphic. I also want to start addressing this with clients more directly in the piercing room when I’m installing retainers and make an effort to hold more space for the difficult emotions of seeing yourself without jewelry. I want to ensure clients feel seen and understand it's normal to have some disconnect with yourself without jewelry, and to know that it will be ok. This is also where having modular furniture and spaces in your studio comes in handy- I have a setup where I can work with clients in a large range of body positions, making it easier for clients to come see me sooner after medical procedures to have pieces reinstalled. Not every client may be able to lay/sit/stand after a procedure, so being able to work around their needs and limitations is helpful! I also want to start making post op plans for clients, so they feel more secure knowing the plan for their piercings, and supported in that part of their process.

Overall, I wanted to share my experience, especially one where, despite all the prep and advocacy, it still didn’t go exactly as I would have wanted it to. I wanted to show the lengths I go to advocate for myself (since they are usually successful!) and how I compromised in response. And I wanted to be really honest about how emotionally difficult I found it to have retainers in, both for clients who might have the same feelings and feel alone in them, but also for fellow piercers to be more mindful of how impactful this can be on our clients.

Knock on wood, all my piercings were fine, I did have an allergic reaction to the tape they used around some of my piercings for my intubation, which caused some irritation on my cheeks and labrets, but I’m currently four days post-op op and everything is recovering nicely. I am so thrilled with my results, even if the process of getting here was a stressful one, I would still do it all over again for the amount of gender affirmation this surgery has given me.

<3

Lynn