Female to male trans-gendered individuals routinely benefit from chest re-contouring to create a male appearance. The technique used is individualized according to the amount of excess breast tissue and excess skin present. Small breasts can usually be removed through an incision around the areola. Nipple areola reduction is accomplished at the same time. Commonly, larger breasts must be removed through transverse incisions and free nipple grafts. Nipple size can be modified at the same time. Every attempt is made to minimize the scars. Liposuction is utilized when necessary achieve optimal contouring. Secondary surgery may be necessary to obtain optimum results due to breast shape and healing.