When performing traditional mastectomy, the breast soft tissues are removed using a transverse incision but all breast skin is preserved. When performing gender confirmation breast surgery, a strategic wedge excision of the lower breast tissues is performed with the purpose of eliminating both soft tissues and the overlying redundant skin in an attempt to masculinize the breast by creating a flat chest. The excision of the breast skin and soft tissues is designed to create linear borders in a pentagonal shape.