Tracheal shave or Adam’s apple reduction

A tracheal shave, also called Adam’s apple reduction or chondrolaryngoplasty, aims at removing the Adam’s apple of trans women. A prominent Adam’s apple is a constant embarrassment for trans women. For this reason a tracheal shave is one of the most common surgical procedures for trans women. It is often performed stand-alone or in combination with other procedures of Facial Feminization Surgery.  The surgeon reduces your cartilage in the throat to make the shape more feminine.

Gender of the trachea

If you compare the profile of a man’s and a woman’s neck, you can clearly see there is a ‘bump’ in the male profile; the Adam’s apple. Because of the increase of testosterone levels in boys during adolescence, the cartilage of the masculine voice box will grow. The vocal folds (which are muscles) will also become thicker. This is why there is a voice change and why a man’s voice will deepen as they are going through puberty.

Difference between male and female tracheal area.

How to feminize the tracheal area?

You can have your Adam’s apple removed by undergoing a tracheal shave, also called Adam’s apple removal surgery.

 

Note: A tracheal shave is not meant to permanently change the pitch of your voice. If you want to alter the pitch of your voice, a speech therapist can help you with voice feminization speech therapy. In some cases, voice cord surgery will be necessary, also known as voice feminization surgery. Below you can read about how to take care of your voice after a tracheal shave.

Procedure

A tracheal shave is a simple procedure. The tracheal cartilage is removed so that your Adam’s apple no longer protrudes.

• First we need to check how much cartilage can be removed from the larynx without damaging the vocal cords. These lie just below the Adam’s apple.A tracheal shave will reduce the cartilage of the adam’s apple bone without damaging the vocal cords. The 2 red areas are the part of the Adam’s apple that is shaved and the vocal cords.
  

• During the operation

• During the operation, a needle is placed from the outside through the inside of the thyroid cartilage, right until where we want to remove the cartilage. The anesthesiologist then uses an endoscope to check whether or not the needle reaches the vocal cords. In other words, whether we can remove that much from the Adam’s apple without damaging the vocal cords. This method is extremely accurate.
  During the operation, a needle is placed from the outside through the inside of the thyroid cartilage, right until where we want to remove the cartilage.
• Adam’s apple reduction surgery is often performed under general anaesthesia,  in combination with other procedures. The technique takes approximately 30 minutes. If performed stand-alone local anaesthesia can be used.
• An incision is made around 2 cm under the chin, if possible, hidden inside a crease below the chin area.From there, a small tunnel is created to reach the thyroid cartilage. A year after the procedure the only thing you will be able to see is a narrow white line.
  Incision location for a tracheal shave: in a natural crease where the chin meets the neck.
• With a surgical scalpel, the prominence and the superior border is reduced, within anatomically safe parameters.
  The area that is shaved during tracheal shave surgery is indicated in red.

It is very important that a surgeon specialized in facial feminization surgery performs this procedure. A tracheal shave involves shaving off some of the cartilage which protects your vocal cords. Someone who has little or no experience with tracheal shaves can easily remove too much cartilage, which can lead to permanent damage to your voice. Or they might remove too little cartilage because they are overcautious, meaning that your Adam’s apple is still visible.