The surgeon then contours the chest, altering the size and position of the areolae and nipples as needed or as indicated by the patient.

Some patients may also request specific shapes for the nipples that will be reattached, such as hearts or stars; some surgeons may have no qualms with providing this service, while others may feel less skilled or experienced in creating 'non binary' top surgery chests.

[1][2][3] In 1942,[4] British physician and author Michael Dillon underwent a chest masculinizing mastectomy as part of his transition to male.

In the mid-1970s, Chicago surgeon Dr. Michael Brownstein (having graduated from UCSF) opened a plastic surgery practise in San Francisco.

"[7] Brownstein continued to provide the plastic surgery until healthcare misconduct defense attorney Paul Walker contacted him, stating that he was violating the Standards of Care.

[13] Canadian actor Elliot Page underwent the surgery circa March 2021; he stated, "It has completely transformed my life... [It's] not only life-changing but lifesaving.

[16][17] Gynecomastia is a common breast deformity that can occur in cisgender men, which may require surgical intervention.

[citation needed] The areola is trimmed to a pre-agreed-upon diameter and the nipple sectioned with a pie-shaped excision and reconstituted.

Occasionally, the side limbs may be quite long, and the expression doctors use is "chasing a dog ear" into the axilla (or underarm).

A dog ear may occur when the skin at the edge or corner of an incision 'flows over,' when there is too much gathering, usually at an angle greater than 30 degrees.

This usually becomes more apparent after several months of healing, and can be caused by things like weight gain (excess skin or fat changing the shape in areas like torso, hips, stomach, or buttocks, may also occur along the incision line), or due to 'poor surgical planning and execution.'

Not uncommonly, a surgeon may revise the incision lines after 3 or more months of settling shows some residual problem areas.