Gender Confirmation (Top Surgery) is performed for MTF or FTM transsexual, transgender, or gender nonconforming people. Following the World Professional Association for Transgender Health Standards of Care (WPATH 7 guidelines), Boston Mass plastic surgeons Dr. Taylor and Dr. Sullivan work with other health care providers and counselors from the entire region and around the country as well as those locally such as at Mount Auburn Hospital and the Fenway Clinic to prepare for a safe surgery and smooth postoperative recovery. Their experience as board certified plastic surgeons as well as fellowship training in craniomaxillofacial surgery gives them a rare and high level of training and experience to provide comprehensive gender confirming top surgery of the breasts, body contouring, and also facial operations such as facial feminization; forehead, chin and jaw remodeling; cheek implants; nose surgery; tracheal shave (chondrolaryngoplasty), and fat grafting for lip and cheek augmentation. They meet with each patient to provide education and ensure comfort with customized operations such as breast construction with breast implants or breast reduction. Breast construction can be performed with breast implants or fat grafting. Breast reduction or mastectomy is usually by a double incision mastectomy with nipple construction using a free nipple graft or by a circumareolar (keyhole) approach.