The visible protrusion commonly called the Adam’s apple can be surgically reduced. This modification is achieved through a specialized procedure that reshapes the cartilage in the throat, which is a structural component of the voice box. The goal of the operation is to create a smoother contour in the neck while preserving the functions of the underlying anatomy. This surgical option is available for individuals seeking to lessen the prominence of this feature for personal reasons.
Understanding Laryngeal Cartilage
The Adam’s apple is the layperson’s term for the laryngeal prominence. This cartilage is the largest of the nine cartilages that form the larynx, or voice box, and it is made of flexible connective tissue. Its primary function is to act as a protective shield for the vocal cords, guarding them against external trauma and supporting the airway.
The size difference between individuals is primarily a result of hormonal changes during puberty. Increased testosterone levels in males cause the thyroid cartilage to enlarge and the two plates of cartilage to meet at a sharper angle. This growth creates the more anteriorly focused and prominent bulge seen in many adult males, which is considered a secondary sex characteristic. The cartilage angle in females is typically wider, which results in a less visible laryngeal prominence.
The Surgical Process of Reduction
The surgical procedure to reduce the Adam’s apple is formally known as a chondrolaryngoplasty, though it is often referred to as a tracheal shave. The procedure aims to shave down the protruding thyroid cartilage. It is performed with precision to avoid damaging the underlying structures, particularly the vocal cords.
A small, horizontal incision is typically made in a discreet location, such as under the chin or within a natural crease of the neck, to minimize the visibility of the resulting scar. Through this opening, the surgeon carefully accesses the laryngeal prominence and uses specialized instruments to shave away the excess cartilage. The procedure usually takes between 30 minutes to one hour, and it is often performed on an outpatient basis.
The central challenge is ensuring the removal of enough cartilage to achieve the desired aesthetic result without destabilizing the laryngeal structure. Since the thyroid cartilage anchors the vocal cords, removing too much could affect the integrity of the voice box. The surgeon must maintain a safe margin to protect the vocal cords and prevent issues such as breathing difficulties. Once the cartilage is contoured, the incision is closed with sutures, completing the reduction.
Primary Reasons for Seeking Removal
The most common motivation for seeking a chondrolaryngoplasty is gender affirmation, particularly for transgender women. A prominent Adam’s apple is recognized as a masculine feature, and its reduction helps align the physical appearance of the neck with a feminine gender identity. This change can significantly reduce gender dysphoria and improve self-confidence in social settings.
The procedure is frequently included as part of broader facial feminization surgery, which aims to soften and refine other features influenced by male puberty. Some cisgender individuals also elect to have the surgery because they feel self-conscious about a naturally large or bothersome laryngeal prominence. In these cases, the rationale is purely cosmetic, seeking a smoother and less angular contour for the throat.
Expected Recovery and Vocal Impact
Following the procedure, patients can expect some discomfort, swelling, and bruising in the throat area, which typically lasts for two to six weeks. Soreness and tightness in the neck are common in the first few days. Most individuals feel comfortable resuming their normal daily activities within about a week, though strenuous activities and heavy lifting should be avoided for a longer period.
A common concern is the procedure’s effect on the voice, but a tracheal shave is not intended to change vocal pitch. The surgery focuses on the exterior cartilage and carefully avoids the vocal cords, which are responsible for voice production. Temporary hoarseness or a slight reduction in vocal range is common immediately post-surgery due to swelling around the voice box, but this usually resolves within a few weeks as the tissue heals.
In rare instances, persistent voice changes, such as breathiness or a weaker voice, can occur if the vocal cord attachments are inadvertently affected by excessive cartilage removal. For this reason, selecting a surgeon with expertise in the delicate anatomy of the larynx is highly recommended. The final aesthetic result, a smoother neck contour, becomes fully apparent as the swelling diminishes, which can take two to three months.