Top surgery, which can include breast augmentation or chest masculinization, is the most common procedure performed for transwomen, transmen, and gender nonbinary people. The breast and chest area can be distressing for transgender people, as it is a highly gendered and outward-facing feature of the body. Rachel Bluebond-Langner, MD, the Laura and Isaac Perlmutter Associate Professor of Reconstructive Plastic Surgery in NYU Langone’s Hansjörg Wyss Department of Plastic Surgery, is dedicated to performing gender-affirming procedures in her practice.

In an article in SELF, Dr. Bluebond-Langner shares the top six things patients should know before having top surgery. “While top surgery is a physically and emotionally liberating procedure for many, there are, as with any surgery, health implications you should be aware of when researching your options,” she writes.

Dr. Bluebond-Langner says all patients should discuss with their surgeon their expectations, ways to reduce scarring, their family breast cancer history, and any silicon injections they have in their chest area. Additionally, she recommends patients perform regular breast and chest self-exams before and after the procedure and get regular screenings for breast cancer.

Read more from SELF.