This 23 year old transman has been living full time as a male for the past two years, and has been on testosterone for that length of time as well. He came to Minneapolis Plastic surgery for top surgery (total skin-reducing mastectomies with chest masculinization), and underwent this outpatient operation in our accredited on-site surgical facility under total intravenous anesthesia. TIVA allows complete (general) anesthesia without the nausea, side effects, and slow wake-up associated with “standard” hospital inhalation (gas) anesthesia. After an hour in the recovery room, he was alert, sipping a cup of coffee, and ready for discharge home (to the care of an adult who can drive and stay with the patient the first evening after surgery). After photos are one year post-op.