The Adam’s apple, medically known as the laryngeal prominence, is a noticeable protrusion in the throat. Composed of cartilage, it can be surgically modified or reduced. The procedure, known as chondrolaryngoplasty, offers a way for individuals to achieve a smoother neck contour. This surgical option provides a permanent alteration for those seeking a change in their appearance.
Understanding the Laryngeal Prominence
The laryngeal prominence, or Adam’s apple, is formed by the thyroid cartilage, the largest of the nine cartilages making up the larynx, or voice box. This cartilage protects the vocal cords located directly behind it. While everyone possesses thyroid cartilage, its size and visibility typically increase during male puberty due to testosterone, causing it to grow larger and project more outwardly, creating the distinct bump. In contrast, females generally have a smaller larynx, and the angle of their thyroid cartilage is wider, resulting in a less noticeable or absent prominence. This anatomical difference is considered a secondary sex characteristic.
Why Individuals Seek Removal
Individuals pursue Adam’s apple reduction surgery for various personal reasons, often driven by a desire for a more harmonious appearance or alignment with their gender identity. For many transgender individuals transitioning from male to female, reducing the prominence of the Adam’s apple is a significant step in facial feminization surgery. This procedure helps to create a smoother, more feminine neck contour, which can improve self-confidence and alleviate gender dysphoria.
Cisgender individuals may also seek this surgery due to aesthetic concerns, feeling that their Adam’s apple is too prominent and detracts from their desired neck profile. A large laryngeal prominence can be a source of insecurity, regardless of gender identity. For these individuals, the surgery offers a way to achieve a physical appearance that better aligns with their self-perception and personal comfort.
The Surgical Procedure for Reduction
The surgical procedure to reduce the Adam’s apple is called chondrolaryngoplasty, also known as a tracheal shave or thyroid cartilage reduction. This outpatient procedure takes one to two hours to complete. Prior to surgery, imaging tests like a CT scan may be performed to precisely locate the vocal cords relative to the cartilage. The surgeon begins by administering either local anesthesia with sedation or general anesthesia, depending on whether it is a standalone procedure or part of other surgeries.
A small horizontal incision, 2 to 3 centimeters long, is made in a natural neck crease to minimize visible scarring. Through this incision, the throat muscles are held apart to expose the thyroid cartilage. The surgeon then shaves down or reshapes the excess thyroid cartilage to reduce its prominence, aiming for a smoother neck contour. Care is taken to avoid damaging the vocal cords. Once the desired reduction is achieved, the incision is closed with sutures.
Post-Operative Care and Considerations
Following chondrolaryngoplasty, patients can expect swelling, bruising, and mild discomfort in the neck area. This typically subsides within 7 to 10 days, with most patients feeling ready to return to work and light daily activities within one to two weeks. Keeping the head elevated and avoiding strenuous activities for at least the first week is recommended to aid in recovery and reduce swelling.
Patients may experience a sore throat and temporary difficulty with swallowing or speech for a few days post-surgery. Keeping the incision area clean and dry is important to prevent infection. While the goal is to preserve vocal cord function, subtle voice changes are rare but possible due to the proximity of the surgical site to the larynx. The final aesthetic results become more apparent as swelling resolves, within one to three months, and the incision scar will continue to lighten and soften over six months to a year.