Chest Feminization and Masculinization Surgery: Part Two of the Plastic Surgeon’s Perspective of Gender-Affirming Surgery

Transgender individuals commonly feel significant distress and discomfort, termed gender dysphoria, as a result of the discrepancy between their gender assigned at birth and their gender identity. A major source of gender dysphoria stems from distinct anatomical differences between the male and female chest. Gender-affirming mastectomy of transmasculine patients and breast augmentation for chest feminization of transfeminine patients, also referred to as top surgery, are often the first surgical interventions and most commonly pursued physical modifications for the treatment of gender dysphoria among this patient population. Surgical modification of the chest improves psychological functioning, relieves distress from gender dysphoria symptoms, and has low rates of postoperative regret. This article aims to explicate the various top surgery options available to clinicians to aid their transgender patients' goal of achieving an outward appearance more closely aligning with their gender identity.