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Many trans men considering the option do not opt for genital reassignment surgery; [ citation needed ] more frequent surgical options include bilateral mastectomy removal of the breasts and chest contouring providing a more typically male chest shape , and hysterectomy the removal of internal sex organs. Sex reassignment surgery is usually preceded by beginning hormone treatment with testosterone. Many trans men seek bilateral mastectomy , also called "top surgery", the removal of the breasts and the shaping of a male contoured chest. Trans men with moderate to large breasts usually require a formal bilateral mastectomy with grafting and reconstruction of the nipple-areola. This will result in two horizontal scars on the lower edge of the pectoralis muscle, but allows for easier resizing of the nipple and placement in a typically male position.

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