Yes, it is possible to surgically reduce the prominence of the Adam’s apple. This elective procedure is formally known as chondrolaryngoplasty, though it is often called a tracheal shave. The surgery involves contouring the cartilage that forms the protrusion on the neck. People often seek this reduction for gender affirmation or cosmetic reasons. The goal is to create a smoother appearance without compromising the function of the underlying vocal structures.
Anatomical Structure of the Larynx
The structure identified as the Adam’s apple is the laryngeal prominence, the most noticeable part of the thyroid cartilage. This cartilage is the largest of the nine cartilages that make up the larynx, and it functions primarily as a protective shield for the vocal cords. The thyroid cartilage has two plates that meet at an angle in the front of the neck. The sharpness of this angle determines the degree of protrusion.
Both males and females possess a thyroid cartilage, but it becomes more prominent in males during puberty due to hormonal influence. This causes the cartilage to enlarge and the angle where the plates meet to become more acute. The vocal cords, which are attached to the inner surface, are also lengthened by this growth, resulting in a deeper voice pitch.
The Surgical Procedure
Chondrolaryngoplasty focuses on shaving down the projecting thyroid cartilage. The operation is performed under general anesthesia, though local anesthesia with sedation may be used. A small, horizontal incision is usually made directly over the prominence or hidden in a natural crease beneath the chin to minimize scar visibility.
Once the incision is made, the surgeon dissects through the soft tissues and muscles to expose the thyroid cartilage. Precision is important because the vocal cords are attached to the lower internal aspect of this cartilage. The surgeon must remove the maximum amount of cartilage for the desired aesthetic result while preserving the vocal cord attachment point.
The prominent cartilage is contoured and reduced using a scalpel or specialized shaving instruments. A common technique involves using a bronchoscope or needle localization to mark the internal position of the vocal cords, maintaining a safe distance from the vocal mechanism. After reduction, the incision is closed with sutures, and a small dressing is applied.
Post-Surgical Expectations and Healing
Chondrolaryngoplasty is often an outpatient procedure, though some patients may require an overnight stay for observation. Following surgery, patients should expect swelling, bruising, and discomfort around the incision site and neck area. This initial discomfort is managed with prescribed or over-the-counter pain medication.
Wound care involves keeping the incision clean and dry, and sutures are removed about one week after the operation. Patients are advised to limit talking or straining their voice for a few days to allow internal structures to heal. Most people can return to light daily activities within a few days, but heavy lifting and vigorous exercise should be avoided for several weeks.
While initial aesthetic improvement is noticeable right away, results become clearer as swelling subsides over the following weeks. Most visible swelling resolves within the first two to four weeks, but final contouring results may take several months to appear.
Potential Concerns and Vocal Impact
As with any surgical procedure, there are risks associated with altering this area. One concern is the potential for a visible scar, although surgeons often place the incision strategically in a natural skin fold or use a submental approach to minimize its appearance. Scarring may be noticeable initially, but it fades over several months to a year.
A more serious concern is the risk of damage to the vocal cords or their attachment structures. Because the thyroid cartilage serves as an anchor, removing too much cartilage can inadvertently affect vocal function. This damage could lead to temporary or permanent changes to the voice, such as hoarseness, difficulty projecting, or a change in pitch.
There is also the possibility of an unsatisfactory aesthetic outcome if the cartilage reduction is insufficient or if the prominence recurs. If the initial reduction is not enough, a revision surgery may be necessary to achieve the desired neck contour. Patients should discuss realistic expectations for the outcome with their surgeon beforehand.