An Adam’s apple can appear more prominent in some MTF patients. When this visibility draws unwanted attention, it can become a source of gender dysphoria. Thyroid cartilage reduction, also known as Adam’s apple reduction or tracheal shave, is a surgical procedure that reduces this projection while protecting the voice.
Learn more about thyroid cartilage reduction, including the procedure, treatment approach, and ideal candidate criteria.
What Is Thyroid Cartilage Reduction?
Thyroid cartilage reduction, medically known as chondrolaryngoplasty, is a surgical procedure that reduces the prominence of the thyroid cartilage (Adam’s apple) to create a smoother, more traditionally feminine neck profile. The procedure is commonly performed as part of facial feminization surgery, but it can also be performed as a standalone surgery.
The Adam’s apple typically becomes more noticeable in males after puberty due to cartilage growth. For MTF patients, surgical reduction can help align the neck contour with their overall feminization goals.
Who Is a Good Candidate for Thyroid Cartilage Reduction in the USA?
Thyroid cartilage reduction may be appropriate for:
- MTF patients seeking a smoother neck contour
- Individuals in good overall physical health
- Patients with realistic expectations about surgical results
- Non-smokers or those willing to stop smoking before surgery
Additional evaluation may be required for:
- Patients who are pregnant or trying to conceive
- Those currently adjusting to hormone therapy
- Individuals with prior throat or transoral surgery
- Patients with certain blood disorders or uncontrolled medical conditions
- Individuals with existing voice or vocal cord disorders
Final candidacy is determined after a comprehensive medical review and consultation your FFS doctor.
What Are the Tracheal Shave Techniques Used in FFS?
Dr. Sajan offers two approaches for thyroid cartilage reduction as part of facial feminization surgery:
Cervicomental Incision (External Neck Approach)
In this method, the surgeon places a small incision higher on the neck, rather than directly over Adam’s apple. By positioning the incision closer to a natural crease, he can reduce the thyroid cartilage while making the scar less noticeable. This approach allows direct access to the cartilage and reliable contouring of the neck.
Transoral Tracheal Shave (Scarless Technique)
Dr. Sajan, the lead feminization surgeon at feminization surgeries performs a transoral tracheal shave to eliminate any visible neck scar. He makes a small incision inside the mouth and uses endoscopic guidance to carefully reduce the thyroid cartilage. This technique smooths the neck contour without creating an external mark, making it a preferred option for MTF patients who want a scarless result.
Voice Safety and Risk Considerations
Thyroid cartilage reduction is performed close to important voice structures, so understanding potential risks is essential. While complications are uncommon when performed correctly, possible risks may include:
- Temporary hoarseness or voice weakness
- Swelling that affects speaking or swallowing
- Over-reduction of cartilage
- Visible scarring with external approaches
- Infection or delayed healing
Dr. Sajan uses careful surgical planning and precise technique to minimize these risks. He evaluates each patient’s anatomy in detail before surgery and uses controlled cartilage reduction rather than aggressive removal. When performing the transoral approach, he works with endoscopic visualization to clearly identify structures and protect the vocal cords. His focus remains on preserving natural voice quality while achieving a smoother, balanced neck contour.
Thyroid Cartilage Reduction Cost in the USA
At Feminization Surgeries, thyroid cartilage reduction starts at $10,995. Final pricing for thyroid cartilage reduction in the USA varies based on:
- Whether it is performed alone or combined with facial feminization surgery
- Facility and anesthesia requirements
- Surgical complexity based on anatomy
- Postoperative care needs
A clear quote is typically provided after an evaluation so costs reflect the planned approach rather than a generic range.
Book Your Consultation with Dr. Sajan
If you are searching for thyroid cartilage reduction near you, a consultation with Dr. Sajan can help you understand what’s realistically possible. During the consultation, patients discuss their goals and whether the procedure will be performed as part of facial feminization surgery. Call us at (425) 380-5237 to schedule your thyroid cartilage reduction consultation.
FAQs
Can thyroid cartilage be removed?
Thyroid cartilage is not completely removed. Surgeons reduce its prominence by carefully shaving down the outer portion that creates the visible projection. Removing it entirely would risk damage to the vocal cords and airway structures. The goal is reduction, not full removal.
How risky is a tracheal shave?
A tracheal shave is generally considered low risk when performed by an experienced surgeon like Dr. Sajan. Possible risks include temporary hoarseness, swelling, infection, or visible scarring with external techniques. Permanent voice change is uncommon but can occur if cartilage is over-reduced. Careful surgical planning significantly lowers these risks.
How to reduce thyroid cartilage?
The only reliable way to reduce thyroid cartilage is through surgery. The procedure involves carefully shaving down the prominent portion of the cartilage. It can be performed through a small external neck incision or through a scarless transoral approach. Non-surgical methods cannot reduce cartilage size.
Does insurance cover tracheal shave?
Insurance coverage for tracheal shave varies by policy. Some plans may cover thyroid cartilage reduction as part of medically necessary gender affirming care. Other plans may consider it cosmetic. Patients should verify coverage directly with their insurance provider.