This 23 year old F-M transgender patient is 5’7″ tall, and weighs 135 lbs. He has been living full time as a male for 4 years, on Testosterone for 4 years, and has been binding his breasts for 3 years. He has undergone hysterectomy, and came to Minneapolis Plastic Surgery because of a transman’s referral, but also because of our over 3 decades of experience with non-genital transgender surgery. He underwent outpatient keyhole (periareolar incision only) total mastectomies (“top surgery”) in our nationally-accredited (AAAASF) on-site surgical facility. His TIVA anesthesia permitted rapid, no-nausea wake-up, and discharge from our recovery room in one hour. His after photos show his appearance at just over 3 weeks post-op. Secondary nipple (papilla only) reduction surgery is recommended under local anesthesia separate from mastectomies due to blood supply considerations.