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FTM Top Surgery is a gender confirmation surgery procedure that creates a masculine chest. Top Surgery involves breast removal and male chest contouring, and may also include free nipple grafts, or nipple/areola resizing and repositioning. The different types of Top Surgery include Buttonhole Technique, Double Incision (DI), Inverted-T, Keyhole and Peri Areolar. Top Surgery is the most commonly performed surgery for trans masculine people, and may be the only surgical step taken in a FTM/FTN transition.