Creation of a Male Chest in Female Transsexuals

&NA; This paper describes the indications for operation, the choice of operation, and the results in 9 patients evaluated by a gender identity clinic and referred for breast removal and construction of a male chest. These patients have lived for an average of ten years in their cross‐gender identity and were found to be stable, nondemanding, cooperative, and responsible in their life as males. A different operation is recommended for each of three types of breasts. None of the patients was suitable for a simple gynecomastia‐type operation. Patients with excess skin should have a procedure that produces an inframammary crease scar not connected to the nipple. Patients with less skin require a procedure that results in a C‐shaped scar curving downward and laterally from the nipple.