Transmen predominantly consider breast removal as a paramount body reconstruction and regard it as the leading surgery for genital reconstruction. This surgery is generally similar to breast reduction in patients with macromastia, but it should decrease the size of the breasts to the nearly flat appearance of male chests and sculpt the pectoral muscular shape or other customized results in light of the patient’s desire. It commonly adopts the method of breast lift via an areolar/inframammary incision (non-vertical scar breast reduction). Dr. Chuang first creates a circular incision at the periphery of the areola and another transverse incision along the inframamary fold to completely dissect the inferior half of the breast skin and mammary tissues, but this needs to preserve the blood circulation at the pedicle of the nipple and areola. Next, the nipple–areola complex is elevated upward to an appropriate horizontal level and fixated to the chest wall. Meanwhile, chest tissues are reconstructed and transferred to sculpt the bulky prominence similar to the pectoral muscle. Finally, the confirmation of the symmetry of both breasts is determined before suturing the wound. The advantages of this surgery are the effective removal of a majority of mammary tissues (at most, 90% of all breast tissues), no vertical scar like that from a traditional inverted T-shaped reduction, and concurrent elevation and reduction of the areola, thus rendering the results almost similar to those of a male chest appearance. The disadvantages are the relatively slow wound healing and atrophy or necrosis of the nipples due to poor blood circulation.