Excellent question. In my practice, we understand that transgender patients are on a journey to aligning their physical body with their gender identity, and that the journey can be a long and sometimes difficult one. Some transgender men may consider a top surgery as a stand-alone procedure to help them feel more like their authentic selves. FTM top surgery (breast reduction) can provide you with the masculine looking chest that better represents your gender identity, reduce body dysmorphia, and result in better overall body confidence. But ultimately the decision will be yours. During your initial consultation, we determine based on your individual goals and desired body shape how to tailor your top surgery specifically to you. The excess breast tissue can be removed with a traditional breast reduction or by using liposuction to sculpt a more masculine looking chest. In addition, the areola complex can be resized and made smaller and more oval for a more masculine appearance. The two major methods I use for FTM top surgery are double incision mastectomy with nipple grafting and keyhole. Keyhole (also known as peri-areolar) is ideal for small chested transgender men, up to a b-sized chest, with good skin elasticity. Double incision mastectomy procedure is ideal for medium to large chested transgender men. During this procedure, the skin on the chest is opened along two horizontal incisions, at the top and bottom of the pectoral muscle. (The muscle itself is not touched.) The skin is pulled back and the breast tissue is then removed. In both techniques, additional liposuction may be performed to adjust the contour of the chest. Which method we choose for your top surgery will depend on the size of your breasts. But, rest assured, no matter how much breast tissue there is to remove, there is a surgery for you. Our goal is to help you feel comfortable, happy, and confident in your own skin. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. best of luck! Dr. Schwartz Board Certified Plastic Surgeon #RealSelf100Surgeon #RealSelfCORESurgeon