It is possible to reduce the size of a prominent Adam’s apple through a surgical procedure. This procedure is sought by individuals who wish to achieve a smoother contour in the neck area for cosmetic reasons, often as part of gender-affirming care. The surgery focuses on modifying the underlying anatomical structure that creates the visible protrusion in the throat, providing a significant change to the profile of the neck.
Understanding the Laryngeal Prominence
The structure commonly known as the Adam’s apple is medically referred to as the laryngeal prominence. This bump is formed by the angle where the two plates of the thyroid cartilage meet in the front of the neck. The thyroid cartilage is the largest piece of cartilage in the larynx, or voice box, and it acts as a shield to protect the vocal cords and other soft tissues within the larynx.
The size of the laryngeal prominence is directly related to the growth of the larynx, which is influenced by hormonal changes during puberty. In individuals assigned male at birth, the surge of testosterone causes the larynx to grow larger, resulting in a more acute angle of the thyroid cartilage and a more noticeable projection. The primary functions of the larynx, including breathing, airway protection during swallowing, and voice production, are all maintained by this cartilaginous framework.
The Reduction Procedure
The surgical method used to reduce the laryngeal prominence is called chondrolaryngoplasty, though it is more commonly known as a tracheal shave. This procedure involves carefully shaving down the prominent part of the thyroid cartilage to create a less noticeable contour. It is typically performed under general anesthesia, though local anesthesia with sedation is sometimes used, and the operation generally takes between one to two hours to complete.
The surgeon makes a small, horizontal incision in the neck, often strategically placed within a natural skin crease to minimize the visibility of the resulting scar. Through this opening, the muscles are gently moved aside to expose the thyroid cartilage. The most projecting portion of the cartilage is then carefully excised or shaved down using specialized instruments.
Extreme precision is necessary during this shaving process to ensure that the deeper structures are not damaged. The surgeon must avoid the area where the vocal cords attach to the thyroid cartilage to prevent any permanent alteration to the voice. In some cases, pre-operative imaging like a CT scan is utilized to map the exact distance between the prominent cartilage and the vocal cords, enhancing safety. Once the desired contour is achieved, the incision is meticulously closed with sutures.
Navigating the Recovery Process
Following the chondrolaryngoplasty procedure, patients are usually monitored for a short time and often return home the same day, as it is frequently performed on an outpatient basis. The initial recovery phase involves managing mild to moderate discomfort, which can typically be controlled with prescribed pain medication for the first few days. Swelling and bruising around the neck area are common and expected side effects in the immediate post-operative period.
Patients are advised to keep their head elevated to help reduce swelling and to avoid any strenuous physical activity for at least the first week. A temporary change in the voice, such as hoarseness, may occur due to throat soreness or swelling, but this typically resolves as the area heals. Most individuals can return to work and resume light social activities within one to two weeks, though the final appearance takes longer to emerge.
The incision site must be kept clean and dry, following the surgeon’s specific instructions for aftercare. While the majority of the swelling subsides within the first month, the complete healing process and final result may take several months. Voice rest may be recommended initially to protect the vocal apparatus while the surrounding tissues recover.
Potential Outcomes and Considerations
The primary outcome of the procedure is a significantly reduced laryngeal prominence, resulting in a smoother neck contour. Patients can often see an immediate improvement, though the final aesthetic result becomes fully clear only after the post-operative swelling has completely resolved. The surgeon’s goal is to hide the surgical incision within a natural skin fold or crease, which helps the scar fade and become less noticeable over time.
However, as with any surgery, there are potential risks and considerations. A major concern is the possibility of permanent voice alteration, which can occur if the vocal cords are inadvertently damaged during the cartilage removal. This risk is minimized by the surgeon’s precision in avoiding the vocal cord attachment points, sometimes with the aid of intraoperative visualization.
Another consideration is the risk of an unsatisfactory aesthetic result, which may be either an under-resection, where the prominence is not reduced enough, or an over-resection. Removing too much cartilage is rare but could compromise the structural integrity of the larynx. The long-term appearance of the scar is also a factor. Selecting a qualified surgeon, such as a facial plastic surgeon or an otolaryngologist with experience in this specialized procedure, is a determining factor in achieving a safe and satisfactory outcome.