It is certainly possible. If you have not had a breast reduction yet but are on the fence between chest reconstruction top surgery and a breast reduction, it can be good to consider whether or not you will ultimately want a completely flat chest in the future. It is not recommended to have both due to increased scarring. However, if you have previously had a breast reduction and now want chest reconstruction, you will likely have more scars than an initial chest reconstruction top surgery, but it is still absolutely possible to have this surgery. Also important to note is that, a breast reduction is effective at improving back and neck pain from large breasts, but is not necessarily an effective way of treating gender incongruence if the ultimate goal is a flat chest..