This 26 year-old patient came to Minneapolis Plastic Surgery for F to M transgender mastectomies (skin-reducing “top surgery”); he was referred by friends who know of our experience (over 2 decades) in providing caring and confidential transgender (non-genital) surgery. In this rare instance, we were able to obtain insurance reimbursement for his surgery, which covered operating room and anesthesia costs at West Health (a local hospital-operated outpatient surgical center), and a portion of our surgical fees. (Minneapolis Plastic Surgery no longer accepts any kind of insurance carrier reimbursement, but our American Board of Plastic Surgery certified plastic surgeons have full surgical privileges at several hospitals and West Health. Those patients who receive insurance coverage can pay surgical fees to us, and have our plastic surgeons provide surgery at a facility that accepts insurance for the remainder of the procedure costs.) We have found that many patients (of those who obtain coverage) have deductible or co-pays with their insurance provider that cost more than the entire cost of the identical procedure at Minneapolis Plastic Surgery’s accredited surgical facility. This patient had no pre-op photos as the surgery was not done at MPS.