The Adam’s apple, medically known as the laryngeal prominence, can be successfully reduced through a specialized surgical procedure. This visible feature of the neck anatomy is often reduced for individuals seeking a smoother neck contour, frequently as part of gender-affirming care or due to personal aesthetic preference. Surgical reduction offers a reliable solution for this purpose.
Understanding the Laryngeal Prominence
The laryngeal prominence is formed by the anterior angle of the thyroid cartilage, the largest piece of cartilage making up the voice box (larynx). This cartilage acts as a protective shield for the delicate vocal cords housed directly behind it. Every person has this structure, but its size and visibility vary significantly between individuals.
The structure is more noticeable in males due to hormonal changes during puberty. Increased testosterone levels cause the larynx to grow, making the angle of the thyroid cartilage sharper and more forward-facing. This growth is also responsible for the characteristic deepening of the voice, as the vocal cords lengthen and thicken.
In contrast, laryngeal growth in females is less pronounced, resulting in a wider angle of the thyroid cartilage and a smoother neck profile. The size of the laryngeal prominence is considered a secondary sex characteristic, which is why its reduction is sought by those desiring a more feminine appearance. Reducing this cartilage does not typically alter the fundamental function of the voice box, provided the procedure is performed with precision.
The Tracheal Shave Procedure
The surgical technique used to reduce the laryngeal prominence is formally called chondrolaryngoplasty, but it is commonly known as a Tracheal Shave. This procedure focuses on carefully contouring the projecting cartilage without compromising the underlying vocal mechanisms. The surgery is often performed on an outpatient basis, utilizing either local anesthesia with sedation or general anesthesia.
The first step involves making a small, horizontal incision, typically one to two centimeters in length. The surgeon strategically places this cut in a natural skin crease, such as the cervicomental crease beneath the chin, to minimize scar visibility. Careful tissue dissection is then performed to expose the prominent thyroid cartilage and the precise area to be reduced.
Using specialized instruments, such as a scalpel or a rongeur, the surgeon meticulously shaves away the excess cartilage from the front surface. A primary element of the procedure involves avoiding the anterior commissure, the point where the vocal cords attach to the inside of the cartilage. To ensure safety and prevent voice changes, some surgeons use a small fiberoptic scope to visualize the vocal cords during the shaving process. The goal is to achieve significant aesthetic reduction while preserving the structural integrity necessary for proper vocal function.
Recovery and Potential Outcomes
Following chondrolaryngoplasty, patients can expect a relatively short recovery period, with results becoming apparent once initial swelling subsides. In the first few days, mild soreness, throat tightness, and temporary hoarseness are common as tissues adapt to the change. Most individuals return to non-strenuous work and social activities within one to two weeks after the operation.
Post-operative care is important for managing swelling and ensuring the best possible scar outcome. Patients are advised to rest their voice and consume soft foods immediately after surgery to avoid strain on the healing area. Scar care protocols, including massage and the use of silicone sheeting, are initiated after the incision has healed and can continue for several months to help the scar flatten and fade.
The reduction in the laryngeal prominence is considered permanent, as the removed cartilage does not regrow. Potential outcomes and risks must be discussed, including the small possibility of temporary or permanent voice changes if the reduction is too aggressive near the vocal cord attachments. The final appearance of the scar can take up to nine months to fully mature, but a well-placed incision is often discreetly hidden within a neck crease.