The Adam’s apple, medically known as the laryngeal prominence of the thyroid cartilage, is a visible feature on the front of the neck. Formed by the largest cartilage of the voice box (larynx), which protects the vocal cords, its size and visibility increase in individuals assigned male at birth during puberty. This growth is influenced by hormones like testosterone, causing the larynx and cartilage to enlarge and protrude. Surgical options are available for those seeking to reduce its prominence.
Understanding Tracheal Shave Surgery
The medical term for Adam’s apple reduction surgery is chondrolaryngoplasty, also known as thyroid cartilage reduction or tracheal shave. This procedure aims to reduce the size of the thyroid cartilage to create a smoother, more feminine neck contour. It is frequently sought by transgender women as a facial feminization surgery, helping to alleviate gender dysphoria by aligning physical appearance with gender identity. The procedure also appeals to cisgender individuals who feel their Adam’s apple is overly prominent for cosmetic reasons. This surgical intervention is the only way to reduce its size, as hormone therapy does not diminish the prominence of developed cartilage.
What to Expect During the Procedure
A tracheal shave is typically performed under general anesthesia, though local anesthesia with sedation may also be used. The surgery usually takes between 30 minutes to an hour, but can extend up to two hours depending on complexity. The surgeon makes a small horizontal incision, often placed in a natural neck crease or under the chin to minimize visible scarring.
Through this incision, the surgeon accesses the thyroid cartilage. Using specialized instruments, the protruding cartilage is precisely shaved down to achieve the desired smoother contour. Care is taken to avoid damaging the vocal cords, which are located directly behind the thyroid cartilage. A laryngoscope, a tiny camera, may be used to visualize the vocal cords and surrounding structures, enhancing precision. Once the cartilage is reshaped, the incision is closed with sutures.
Recovery and Post-Operative Care
Following a tracheal shave, patients generally return home the same day, though an overnight stay might be recommended if combined with other surgeries. Initial discomfort, swelling, and bruising around the throat are common for several days. A sore throat and temporary voice changes, such as hoarseness or weakness, can occur due to vocal cord swelling. These voice changes typically resolve within a few weeks as healing progresses.
Resting the voice and consuming soft foods or a liquid diet are recommended until swallowing becomes comfortable. Patients receive instructions for wound care, pain management with prescribed medication, and applying ice therapy to reduce swelling. Strenuous activities should be avoided for one to two weeks to prevent complications and promote healing. While an immediate improvement in neck contour is often visible once initial swelling subsides, final results may take several months, up to a year, to fully appear.
Important Considerations Before Undergoing Surgery
Before deciding on a tracheal shave, individuals should be aware of potential risks, including infection, bleeding, and scarring. While surgeons aim to place incisions discreetly, healing varies, and some patients may experience noticeable scarring. Nerve damage is a possibility, though uncommon. Voice alterations are a concern, with a rare risk of permanent changes if excessive cartilage is removed or vocal cords are inadvertently damaged. However, temporary hoarseness is a more common, short-lived side effect.
Another consideration is the potential for unsatisfactory cosmetic results, such as persistent prominence if a complete reduction is not anatomically feasible. Setting realistic expectations with the surgeon is important, as the final contour depends on individual anatomy. Choosing a board-certified and experienced surgeon, ideally one specializing in facial feminization or head and neck surgery, helps minimize risks and achieve the best outcome. For many, this surgery is a significant step in gender affirmation, offering psychological relief and improved self-confidence. Professional counseling can be beneficial for individuals considering this transformative procedure.