Trans men are those who have been attributed to female sex at birth. But when they mature, they self-identify one’s gender as men. Many trans men look for male breast surgery or as commonly called Top Surgery. With this, they attempt to reduce their feminine chest shape.

Although breast/chest appearance is an important secondary sex characteristic, breast presence or size is not involved in the legal definitions of sex and gender and is not necessary for reproduction. The performance of breast/chest operations for the treatment of gender dysphoria should be considered with the same care as beginning hormone therapy, as both produce relatively irreversible changes to the body.

This Top surgery is done in individuals who have begun taking testosterone and after they have been adjusting themselves socially as males. The World Professional Association for Transgender Health (WPATH) lays down standards of care that require

1. Letter assuring consent for surgery from a psychiatrist/mental health provider.
2. Though most individuals undergoing top surgery are 18 or older, younger individuals may be considered for the procedure if the patient, their legal guardians, and their mental health professional are in agreement that top surgery is appropriate.
3. The best candidates for top surgery are those who are mature enough to fully understand the procedure and have realistic expectations about the results.
4. Male chest reconstruction is not recommended for transmasculine persons who intend to breast-feed.
5. Persistent, well-documented gender dysphoria
6. Capacity to make a fully informed decision and to consent for treatment;
7. Age of majority in a given country
8. If significant medical or mental health concerns are present, they must be reasonably well controlled.

The approach to trans persons seeking for a mastectomy is illustrated by the Standards of Care of the World Professional Association of Transgender Health.

May protocols to choose the most appropriate surgical technique, and based on anatomical parameters. Generally, the smaller the breast the smaller the incisions required; on the other hand, the larger or more lose the breast tissue, the larger the incisions required.

The social stigma attached to such issues is very well researched. These individuals are strongly advised to seek regular counseling. Strong family support and social life are vital for a better outlook.

Doctors who perform surgical treatments for breasts in gender dysphoria should be plastic surgeons who are board-certified as such by the relevant national councils.

In many cases, these can be treated like any other gynecomastia. However, in some cases they may need a skin tightening surgery at a later date to fully achieve an aesthetic chest.