Buck Angel has had a double mastectomy (both of his breasts were removed) - this is considered a cosmetic procedure and is performed by a plastic surgeon. It looks like Buck has also had some facial recontouring to create a more angular, masculine face. It's not uncommon for transpeople to have facial recontouring surgeries, as well as implants to make their faces more masculine or feminine, so to match their choice of gender. Many FTM transpeople also have surgeries to refine their bodies: implants to mimic muscle, fat grafts to create wider hips (for MTF transsexuals) and liposculpture are popular - it does not, however, look like Angel has undergone any of these procedures. His defined musculature is most likely the result of hard work and hormone therapy.
Angel has become a porn star and is popular in many alternative gay porn circles. He performs with men, women and other transpeople. I've never been a pornography fan, myself, so I'm not familiar with Buck's "work" - I'm more cerebral than sexual... Still, to each their own. I wish Angel the best.
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