Facial Feminization Surgery

Adam's apple reduction

This procedure feminizes the neck and is one of the most commonly performed procedure in facial feminizing surgery.

If there is a pronounced Adam's apple, it can be reduced through surgery. Adam's apple correction, also known as tracheal shave, is a simple surgery in which the protruding forward and prominent Adam's apple is corrected through a small incision across the Adam's apple. This harmonizes the proportions of the neck and creates a better neck contour. The scar is small and almost invisible because the neck skin generally heals beautifully. Adam's apple reduction can be combined and performed together with FFS. 

Procedure

The tracheal shave procedure aims to reduce the prominence of the Adam's apple by removing a portion of the tracheal cartilage. Prior to the surgery, it is essential to assess the amount of cartilage that can be safely removed without causing damage to the vocal cords, which are located just below the Adam's apple.

During the operation, a needle is carefully inserted from the outside into the thyroid cartilage until reaching the desired area for cartilage removal. An endoscope is then employed by the anesthesiologist to verify the positioning of the needle in relation to the vocal cords. This meticulous approach ensures that the necessary amount of cartilage can be safely removed without compromising vocal cord function.

Adam's apple reduction surgery is typically conducted under general anesthesia, often as part of a facial feminization procedure for transgender women. The entire technique usually lasts around 30 minutes. In cases where the tracheal shave is performed as a standalone procedure, local anesthesia can be used instead.

An incision is made approximately 2 cm below the chin, ideally concealed within a natural crease. This incision allows for the creation of a small tunnel to access the thyroid cartilage. The surgical scalpel is then utilized to reduce the prominence and the superior border of the Adam's apple, always adhering to anatomically safe parameters.

Recovery  

What to expect?

• Scar: At first, the scar is red and noticeable. A year later, only a fine line is visible because the incision is usually made in a natural fold of skin. 
• Swelling: swelling may occur 24-48 hours after the procedure. This is normal and may last up to six weeks.

Your voice

What happens to your voice and why?

After surgery, the quality of your voice may possibly decrease. This can be caused by two main factors:

1. Intubation tube: During surgery, a tube is placed between your vocal cords to keep the airways open. This tube can affect the mucus on your vocal cords, which can lead to changes in voice quality.
2. Swelling: For several months after surgery, swelling will occur around the larynx. This swelling can affect the external laryngeal muscles, which are responsible for your vocal range and the quality of your voice.

Therefore, it is normal to experience this after surgery and during the recovery period:

• A smaller vocal range;
• A fragile/shaky voice;
• Sore throat;
• Tension in the throat;
• Difficulty swallowing or talking.