Chest surgery for gender confirmation is usually the first surgical procedure performed in the process of allowing a transgender person to achieve an appearance congruent with the gender with which he or she identifies. In the female to male transition, this involves the targeted removal of a portion of the breast tissue and skin, often with a reduction in the diameter and projection of the nipple. in the male to female transition, this involves the placement of a breast implant similar to a breast augmentation procedure. The nuances of these procedures can be discussed during your consultation. This type of surgery is performed under anesthesia in the operating room, and most patients are able to go home after surgery without spending a night in the hospital. Surgical drains are rarely needed. Recovery takes roughly 3-6 weeks, depending on the magnitude of the change the patient desires. Complications are rare with this type of surgery, but can include infection, fluid collections, poor wound healing, scarring, numbness of the skin or nipple, and asymmetry. A more complete discussion of the risks and benefits of the surgery is always included at your visit.