Transgender MTF Adam's Apple Surgery
(Tracheal Shave)

The Adam's apple is one of the most characteristically male features on the body. Therefore it is one of the most common and recommended procedures performed in facial feminization. The Adam's apple is the result of prominent thyroid cartilage that enlarges at puberty. The goal in Adam's apple reduction surgery is to reduce the prominence of the thyroid cartilage by shaving and removing the excess cartilage. Age, Adam's apple prominence and proximity to the vocal chords will be the major factors in determining the extent to which the Adam's apple may be reduced. In some individuals the Adam's apple may be too large to completely remove, but a tracheal shave can help angle the cartilage to a more feminine angle.

Before Adam's Apple Reduction Surgery

Prior to surgery a complete medical history and thorough examination is taken in order to evaluate your general health. Your surgeon will describe the type of anesthesia to be used, the procedure, what results might realistically be expected, and possible risks and complications.

Preoperative instructions are important and include avoiding certain drugs, like aspirin that can cause excess bleeding. Antibiotics will be prescribed to prevent infection. Photographs are taken before and after surgery in order to evaluate the final results.

The Adam's Apple Reduction Procedure

Adam's Apple Reduction surgery is usually performed under general anesthesia with the patient asleep. It can be performed in one of two ways:

1. The more traditional method is making a small incision (about 1 inch) along the natural crease of the neck. The thyroid cartilage is exposed, marked and reduced by shaving at the most prominent area and the upper rim. Once the shaving is complete, the incision is closed with sutures. Surgery lengths will vary depending on the hardness of cartilage, which is usually correlated with age.

2. If liposuction if performed at the same time, the incision can be placed more inconspicuously under the chin. After the fat is removed, the surgeon can more easily dissect the skin and expose the thyroid cartilage. While this procedure is a little more difficult, it avoids the stigma of a scar indicating a tracheal shave.

After Adam's Apple Reduction Surgery

The first 24-48 hours after the surgery you many experience some swelling. Some patients have mild voice weakness for the first few days following the surgery, but that usually subsides with time. Icing the throat for the first few days is recommended.

Antibiotics are prescribed to prevent infection. Pain is mild to moderate and is controlled with oral medication. Beware that pain medication can cause nausea and vomiting so do not take it unless needed.

Patients are usually able to return to normal activities within a week although vigorous physical activity is discouraged for several weeks.

Some swelling and discoloration can occur but usually disappear within a few weeks. Scars, which fade significantly with time, are, for the most part, inconspicuous because they are made within the natural creases of the body whenever possible.

Complications connected with this surgery are rare; however, changes in voice may occur in cases of over-dissection. Reducing the Adam's apple too much may cause injury to vocal cords and it is likely that your voice change will be permanent. This can be avoided by shaving less of the Adam's apple.