Top Surgery is one of the most common female to male gender confirmation surgeries. Dr. Crane and Dr. Satterwhite perform both the double incision and keyhole surgical procedures. For double incision patients, Dr. Crane and Dr. Satterwhite do not use drains. This is safely accomplished by leaving an abundance of lymphatic tissue which allows your own body to reabsorb the fluid that the drains would remove. With the combination of not using drains and performing intercostal nerve blocks with Lidocaine before starting the procedure, Dr. Crane and Dr. Satterwhite’s patients have a dramatic decrease in their post-operative pain.