The Adam’s apple, technically known as the laryngeal prominence, is the visible protrusion formed by the thyroid cartilage surrounding the voice box. This feature becomes more pronounced during puberty, particularly in individuals with higher testosterone levels. For cosmetic reasons or as part of gender-affirming care, the reduction of this prominence is a surgical possibility that minimizes the appearance of the Adam’s apple, creating a smoother neck contour.
Understanding the Surgical Procedure
The procedure to reduce the Adam’s apple is medically termed Chondrolaryngoplasty, commonly referred to as a tracheal shave. This surgery focuses on carefully shaving down the projecting thyroid cartilage to reduce its size and visibility. The goal is a significant reduction in prominence, not complete removal, because the cartilage protects the vocal cords.
The surgeon often administers general anesthesia, though local anesthesia with sedation may be an option. A small, horizontal incision is typically made in a natural crease of the neck or underneath the chin to help conceal the resulting scar. Through this incision, the soft tissues and muscles are carefully separated to expose the thyroid cartilage.
Using specialized surgical tools, the surgeon meticulously shaves the cartilage down to an acceptable level. Avoiding the area where the vocal cords are anchored to the inside of the cartilage is primary. Some surgeons use a laryngoscope (a small camera inserted through the mouth) to visualize the vocal cord attachments and ensure a safe margin of resection. The cartilage is reduced until a smoother, less prominent neck profile is achieved, and the incision is then closed with sutures.
Potential Impact on Vocal Function
The primary concern regarding this surgery is its proximity to the vocal apparatus, specifically the vocal cords which attach inside the thyroid cartilage. The point of attachment is known as the anterior commissure, representing a danger zone for the surgeon. If too much cartilage is removed or the attachment point is inadvertently disrupted, it can destabilize the vocal cords.
The most common vocal side effect immediately following the procedure is temporary hoarseness or a slightly weakened voice. This is usually due to swelling around the voice box or irritation from the breathing tube used during general anesthesia, and it resolves within a few days or weeks. Permanent changes in voice pitch or quality are a serious, though rare, risk if the anterior commissure is compromised.
Damage to the vocal cord attachments can cause a permanent change in voice, often manifesting as chronic hoarseness or a loss of upper vocal range. Surgeons must exercise caution, prioritizing the preservation of vocal function over maximum aesthetic reduction. In some cases, a small amount of residual prominence may be left to ensure the structural integrity of the larynx and the safety of the vocal cords.
Recovery Process and Expected Outcomes
The recovery period for a tracheal shave is typically straightforward, with most patients returning home on the same day. Immediately after surgery, patients can expect soreness, swelling, and bruising in the neck area, often described as feeling like a sore throat. Keeping the head elevated and applying ice packs can help minimize this initial swelling.
Most patients resume light daily activities within one week, though strenuous activity and heavy lifting should be avoided for several weeks. Sutures are usually removed within five to seven days. Temporary hoarseness or difficulty swallowing subsides as the initial swelling decreases, and resting the voice for the first few days is recommended to aid healing.
Scar management is important for long-term recovery, as the neck incision is visible. Surgeons advise patients to begin scar massaging and using silicone sheets or gel after the initial wound healing period. While aesthetic improvement is noticeable immediately, the final contour of the neck may take up to a year to fully materialize as internal swelling resolves and the scar matures.