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Post-Operative Rehabilitation

If you’ve recently had a phalloplasty, seeing a hand therapist can play an important role after your surgery. Hand therapy is essential treatment after surgery to maximize your recovery and functional use of your hand.

You should expect hand therapy after gender affirming bottom surgery.

What Is a Hand Therapist?

A hand therapist is an occupational therapist or physical therapist who specializes in treating individuals with conditions affecting the hands and upper extremity.

What Does a Hand Therapist Do?

A hand therapist evaluates and treats your hand muscles after surgery. This treatment can include the following:

  • Custom splints/bracing
  • Wound care and scar tissue management
  • Range of motion of the hand and wrist
  • Functional retraining

Benefits of Hand Therapy

By having a certified hand therapist, you get these benefits:

  • Accurate assessments, immediate care, and effective treatment to reduce treatment time
  • Ongoing treatment after your surgery so you won’t need multiple medical providers
  • Faster recovery results, which can result in decreased medical costs
  • Increased function so you have a faster return to work and productive lifestyle
  • The most comprehensive care

Hand Therapy Evaluation: What to Expect

At your first evaluation, your therapist will spend time discussing any issues or problems that you would like to go over. Your therapist will also answer any questions about how hand therapy will help maximize your functional outcomes post-surgery.

Your hand therapy evaluation may also include a:

  • pain assessment,
  • wound assessment and appropriate dressing,
  • assessment of the range of motion of your joints,
  • sensory evaluation (to see what feeling you have in your hand), and a
  • baseline functional outcome measure (to meet standard measures).

What Should I Expect During Hand Therapy?

Immediately After Surgery

After surgery you will be in a bulky post-operative dressing and orthoglass splint. The orthoglass sprint is a pre-padded material. It is added after your surgery and held in place with Ace bandages. While it can be heavy, it does allow you to move your fingers. You should continue to wear this for five days to protect the donor site.

Days 5–7

You will get a custom forearm-based splint to protect your healing skin graft. This will prevent shearing forces (or body movement affecting your graft) and hematoma formation (a buildup of blood or bruising). You will also receive education on how to manage swelling (edema). This will include changing the wound dressing daily, once your physician removes the wound vac (placed during surgery), using non-adherent gauze to keep your wound moist. It is essential to make sure that the site of transplant and donor skin graft areas heal properly.

You will start hand therapy with active range of motion exercises for your shoulder, elbow, fingers, and thumb.

Days 8–14

Once your graft is healed, start washing with soap and water. You can begin applying moisturizer and gentle massage to manage your scar. Scar tissue is very fibrous. It can limit your movement if we don’t manage it properly, scar tissue should be flexible and pliable.

You will also begin gentle active range of motion exercises for your wrist and forearm. Keep watch on the graft for any tearing or tension on the wound edge. Apply pressure garments to your hand and fingers to manage any swelling.

Weeks 2–5

You will gradually wean yourself from wearing a splint. You will continue range of motion exercises, advancing from passive range of motion, gentle strengthening to endurance training and functional retraining.

You will also keep working on scar management to your forearm with silicone pad and compression. You need to protect your skin graft with sunscreen for at least one year.

Week 6+

After week six you will wear a corrective splinting if you need it. You will continue using your forearm compression garment. Keep doing your strengthening exercises and use your hand for daily activities.

Need Assistance?

Hand therapy is an integral part of your post-operative recovery. You should expect to see a hand therapist within the first week after surgery to start your comprehensive care.

A collaborative approach with the surgeon, therapist and you the patient, is most successful for you to be able to return to the activities you love to do and experience a seamless recovery process. 

During your recovery period, you can contact us as any time.