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Why Consider a Tracheal Shave for Gender Affirmation?
Adam’s apple, medically called the laryngeal prominence of the thyroid cartilage, develops during testosterone-dominant puberty. As the voice box grows, the cartilage around it expands outward, creating a visible protrusion in the throat. While it is a natural part of male puberty, the Adam’s apple is often culturally associated with masculinity.
For many transfeminine people and women, a visible Adam’s apple can be a persistent and distressing source of misgendering. It serves as a constant visual cue that feels at odds with their true gender identity. It’s important to understand that while hormone replacement therapy (HRT) with estrogen induces profound physical and emotional changes, it does not reduce the size of the thyroid cartilage that has already developed. Therefore, surgical intervention is the only option to alter this feature.
The desire for a tracheal shave is often rooted in the profound emotional need to alleviate this dysphoria. The procedure aims to create a smoother, softer neck contour that is more conventionally feminine in appearance. For many, this change is not merely cosmetic, it is a vital step in aligning their physical appearance with their inner sense of self, reducing anxiety in social interactions, and allowing them to move through the world with greater confidence and comfort.
A gender affirming procedure known as a tracheal shave is the standard for reducing the appearance of the Adam’s apple. Dr. Javad Sajan performs the best tracheal surgery.
Overview:
What Is Tracheal Shave Surgery?
A tracheal shave, also known as chondrolaryngoplasty, is a gender-affirming procedure designed to reduce the prominence of the Adam’s apple. By carefully reshaping the thyroid cartilage, the surgery creates a smoother, more feminine neck contour without compromising vocal function.
Your Pre-Surgery Consultation
Your journey begins with a personal consultation, which is the first and most important step in creating a safe and effective surgical plan just for you. Dr. Sajan takes the time to listen and understand your specific health background and aesthetic goals to ensure you feel heard and confident.
- Health Review: We’ll discuss your medical and surgical history, including any current medications, to ensure your safety.
- Personalized Assessment: Dr. Sajan will evaluate your neck’s anatomy. This may include taking clinical photos to help carefully plan the contouring of your Adam’s apple.
- Your Custom Plan: Based on your anatomy, Dr. Sajan will design a surgical approach that prioritizes your safety, particularly protecting your voice—while working to achieve a smooth, natural-looking feminine contour.
- Open Conversation: We believe in transparency. We’ll have a detailed discussion about the potential benefits, the possible risks, and what you can realistically expect during your recovery and final results.
- Next Steps: We’ll outline the investment, explain financing options, and help you with scheduling, so you have a clear understanding of the entire process.
Benefits & Risks
A tracheal shave is generally considered to be a low risk procedure. Most patients find the minute risks of surgery worth it for the result. Dr. Sajan thoroughly and holistically evaluates each patient to determine their risk profile for an Adam’s apple reduction. He will also discuss the benefits to the patient to help them a fully informed decision.
Some of the benefits of a tracheal shave include:
- Reduced cartilage projection
- Neck contour appears more feminine
- Natural looking results
- Helps treat gender dysphoria
- Small incision
- Short surgery
- Permanent results
- Minimal downtime and recovery
- Easily combined with other feminizing procedures
- Overall high satisfaction rate
The risks associated with tracheal shave surgery include many of the standard surgical and anesthesia risks. Though, there are also risks specific to an Adam’s apple reduction surgery. Some of these risks include:
- Infection
- Visible scarring
- Removal of too much cartilage
- Fluid collection
- Bleeding
- Prolonged side effects
- Skin necrosis
Overall, the risk of major complications during or after a tracheal shave is low. Some individuals may be at increased risk due to medical conditions, medications, or aspects of lifestyle.
The Tracheal Shave Procedure at the Feminization Surgery
The surgery is usually performed under general anesthesia and is considered a safe, straightforward procedure. Dr. Javad Sajan uses advanced techniques to ensure natural results and minimize scarring.
Here’s what the process involves:
- Incision Placement: A small incision is made in the crease between the chin and neck, where it can be well-hidden.
- Accessing the Cartilage: Dr. Sajan creates a small tunnel through the incision to reach the thyroid cartilage.
- Cartilage Reduction: Using a specialized burr, he carefully shaves down only the portions of the cartilage that protrude. This approach maintains structural integrity while producing a smooth, natural contour.
- Checking Symmetry: Before closing, Dr. Sajan examines the neck’s new profile to ensure balance and the best possible outcome.
- Closing the Incision: The incision is stitched with sutures, and patients gradually wake from anesthesia.
A tracheal shave is an outpatient procedure and most patients can return home the same day with the support of a friend or family member, though an overnight stay may be recommended if combined with other facial feminization surgeries or if medical history requires monitoring.
For our self-pay outpatient patients not secured by any insurance, we are pleased to cover the costs of your transportation and accommodation related to your surgery, ensuring your journey is as smooth and supported as possible.
Results and Expectations
Most patients notice a smoother neck profile immediately after surgery, although initial swelling can temporarily mask results. As swelling subsides within the first week, the improved contour becomes more apparent.
Post-Operative Care
- Ice Application: Apply ice packs for about 20 minutes every hour during the first couple of days to reduce swelling.
- Scar Care: Once the incision has healed, scar massage and silicone therapy may be recommended to support optimal healing.
- UV Protection: Protect the scar from direct sun exposure for at least one year to minimize darkening or visibility.
Possible Complications
As with any surgery, risks include scarring or, rarely, the formation of keloids. Should these occur, treatment options such as steroid injections, laser therapy, or revision procedures are available to help improve the scar’s appearance.
Combining Procedures
Many patients choose to combine a tracheal shave with other gender-affirming surgeries to save recovery time and achieve a more complete transformation in fewer steps. Whether it is performed as a standalone procedure or as part of a larger facial feminization surgery (FFS) plan, the decision depends on your personal goals, timeline, and overall health.
- Standalone: It can be performed on its own or alongside procedures like breast augmentation or body contouring. In rare cases, it may be combined with bottom surgery.
- Part of FFS: Most often, a tracheal shave is included in a facial feminization surgery (FFS) plan for balanced results. Common pairings include hairline advancement, brow bone reduction, eyebrow lift, cheek augmentation, rhinoplasty, lip lift, and jaw or chin contouring.
While combining surgeries can be convenient, multiple procedures at once may extend healing time. Dr. Sajan carefully evaluates each patient’s health and goals to ensure a safe, effective plan.
FAQ
Does A Tracheal Shave Change Your Voice?
In theory, no, a tracheal shave should not change a patient’s voice. However, this is one of the risks of the surgery. It is normal to experience some vocal impairment after surgery, but this should go away within two weeks. In rare cases where a tracheal surgery was performed by an inexperienced surgeon, it could lead to a permanent change.
A higher-pitched voice can surgically be achieved through gender affirming vocal cord surgery. Adam’s apple reduction surgery should be performed before altering the vocal cords. Also, it is recommended that you see a surgeon who specializes specifically in gender vocal cord surgery such as a laryngologist.
Is Tracheal Shave Covered By Insurance?
Yes, most of the time a tracheal shave surgery is covered by insurance. This will vary by plan, company, and location. Dr. Sajan’s office accepts all private insurance companies. Insurance coordinators also can help patients navigate their coverage and the process of working to get tracheal shave surgery covered.
Does Taking Estrogen Make Your Adam’s Apple Smaller?
No, while hormone therapy can affect fat distribution, muscle mass, and skin, it will not alter existing cartilage. Therefore, taking estrogen or other forms of hormone therapy will not affect the size of the Adam’s apple.
Is A Tracheal Shave Permanent?
Yes, removed cartilage cannot come back naturally. Therefore, the tracheal surgery changes to neck contour are permanent. Gender affirming procedures have low rates of regret. Patients are usually happy with the results of their Adam’s apple reduction surgery.
What is the cost of a tracheal shave?
The cost varies depending on the surgeon, facility, and whether it is performed alone or as part of facial feminization surgery. However, the price ranges on average from $4,000 to $10,000.
How long does recovery take?
Most patients return to normal activities within one to two weeks. Mild swelling or tenderness may persist for a longer period, but the majority of healing occurs within the first month.
The Best Adam’s Apple Reduction Surgery By Dr. Javad Sajan
Dr. Javad Sajan is a Seattle plastic surgeon who specializes in gender affirming procedures of the face and body. Along with traditional top surgery for trans men and trans women, Dr. Sajan specializes in facial feminization surgery. He attended a prestigious FFS fellowship and has helped many patients feel more confident in their appearance.
To learn more and schedule a consultation, call us at 206.990.0060. Patients can also reach out online via chat or contact form.