Though like breast cancer , the risk does not become zero, but is drastically decreased. The risk will probably never be known since the overall population of transgender men is very small;[ improper synthesis? By some doctors, the surgery is done in two steps, first the contents of the breast are removed through either a cut inside the areola or around it, and then let the skin retract for about a year, where in a second surgery the excess skin is removed. In addition, there is less denervation damage to the nerves supplying the skin of the chest wall with a peri-areolar mastectomy, and less time is required for sensation to return. Hysterectomy and bilateral salpingo-oophorectomy[ edit ] Hysterectomy is the removal of the uterus. 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. This is equivalent to post-menopausal bleeding in a woman and may herald the development of a gynecologic cancer. Some undergo this as their only gender-identity confirming 'bottom surgery'. If the cervix is removed, it is called a 'total hysterectomy. It is unknown whether the risk of ovarian cancer is increased, decreased, or unchanged in transgender men. Completely removing and grafting often results in a loss of sensation of that area that may take months to over a year to return, or may never return at all; and in rare cases in the complete loss of this tissue. While the rates of endometrial and cervical cancer are overall higher than ovarian cancer, and these malignancies occur in younger people, it is still highly unlikely that this question will ever be definitively answered.