Chondrolaryngoplasty (commonly called tracheal shave) is a surgical procedure in which the thyroid cartilage is reduced in size by shaving down the cartilage through an incision in the throat, generally to aid trans women in achieving a passable female appearance, and occasionally on cisgender men and women who are uncomfortable with the girth of their Adam's apple.
After an anesthetic (local or general, depending on whether or not it is the only surgery to be performed) is administered to the patient, a small, horizontal incision is made on the bottom of the Adam's apple. The muscles in the throat are then held apart with forceps, and the protruding cartilage is shaved down with a scalpel, thus making the throat appear smoother and less angular. The incision is then closed with sutures, and a red line will mark the incision for about six weeks. Little scarring occurs in most cases because the surgeon will usually make the incision in one of the minuscule folds of skin that cover the Adam's apple.
The surgery is usually outpatient, unless it's combined with other surgeries that require hospital stays. Particular care must be taken by the surgeon to not remove too much cartilage, as doing so can reduce the structure of the trachea and cause breathing difficulties.
In younger patients, the cartilage has a consistency somewhat like a bar of soap, and in older patients (late 20s onward) it may become harder and in some cases almost bone-like.
Most surgeons who specialize in transsexual surgeries will perform it, and some general plastic surgeons will as well. It is likely the most common surgery performed on transsexual women, other than gender reassignment surgery.
Due to the proximity to the vocal folds, there is the small possibility that they may be damaged during this type of surgery. While the effects of a trachea shave on voice are minimal, some patients will choose to undergo vocal surgery at the same time.
Most surgeons will tell the patient to frequently rub the site of the incision to prevent noticeable scar tissue from forming. By and large, the surgery does not change the pitch of the patient's voice, though some report slight changes. Swelling and bruising around the site of the incision is the most common phase of recovery. Difficulty swallowing and speaking is also a common effect, to a greater or lesser degree depending on the individual.
The average time for complete recovery is about two weeks, though sometimes it takes longer than that depending on pre-existing medical conditions the patient has, for instance, anemia.
- Chondrolaryngoplasty Under General Anesthesia Using a Flexible Fiberoptic Laryngoscope and Laryngeal Mask Airway by Jeffrey H. Spiegel and Gerardo Rodriguez (Arch Otolaryngol Head Neck Surg. 2008;134(7):704-708)
- Reduction of Adamâ€™s apple for appearance by A. H. H. Al-Jassim and T. H. J. Lesser (Indian Journal of Otolaryngology and Head & Neck Surgery, Volume 58 Number 2, April 2006)
- Operative voice pitch raising in male-to-female transsexuals by K. Neumann, C. Welzel and A. Berghaus (European Journal of Plastic Surgery, Volume 25 Number 4, September 2002)
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