For patients with severe gender dysphoria, or gender incongruence, surgery has been a mainstay of treatment for decades. Recently, Medicare lifted a 33 year ban on gender confirmation surgeries, as the benefits are clear in a well-screened patient population and the surgeries are no longer considered experimental. Facial feminizing surgery, breast augmentation, and vaginoplasty may be pursued by male-to-female patients. Likewise, for female-to-male patients, chest masculinizing surgery, hysterectomy and genital reconstruction are often pursued. Chest masculinizing surgery is a procedure whereby breast tissue and excess skin are removed from a female-to-male patient, and the chest and nipple areolar complex are reconstructed to appear masculinized. Depending on the size of the patient's chest, either the keyhole (subcutaneous mastectomy) or double incision (simple mastectomy) techniques are utilized. In most cases, the nipple areolar complex is also resized and reshaped. Either procedure is typically outpatient, and most patients return to work within two weeks. The surgery is well-tolerated by most and, in experienced hands, complications such as infection, wound healing difficulties and nipple areolar loss are rare. Read more at Plastic Surgery Post.