What is Top Surgery for Gender-Affirmation? Medically reviewed by Jennifer Richman on Dec 8, 2025. Top surgery encompasses a variety of surgical techniques designed to treat a patient’s gender dysphoria by bringing their upper-chest in greater alignment with their internal sense of gender. Chest reconstruction top surgery––sometimes called chest masculinization surgery or non-binary top surgery––removes breast tissue and any excess skin to flatten the chest. Breast reduction surgery for gender-affirmation significantly reduces the volume of the breasts for non-binary and transmasculine patients. Breast augmentation surgery, sometimes called feminization top surgery, increases the volume of the breasts through implants (silicone or saline) and/or liposuction fat grafting. If you are interested in …