An Adam’s apple is one of the most telling secondary sex characteristics of the male gender. It is not always present in every male or MTF, and can be present in some adult natal females. Nevertheless, when an Adam’s apple is noticeable in profile or with the neck is extended, it can give a more masculine appearance to the throat, creating a problem for an MTF trying to blend into the female world.

Facial feminization is an important part of transgender surgery. After all, the face is the first physical attribute people notice.

A tracheal shave (technically known as chondrolaryngoplasty) can play an important role in facial feminization and is probably the most commonly performed surgery on transgender women. A tracheal shave is a delicate surgery to reduce the prominence of the Adam’s apple. Dr. Alexander Sinclair of Beverly Hills Transgender Surgery is a general plastic surgeon who has been serving the greater Los Angeles area for more than 30 years.

His practice is focused on surgical excellence and a comfortable patient experience. You can rest assured that Dr. Sinclair has the skills and experience to correctly perform Adam’s apple reduction surgery.

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What is an Adam's apple?

An Adam’s apple is the prominent projection at the front of the neck formed by the thyroid cartilage of the larynx. It is a testosterone-induced structure, much more predominant among men than women. Everyone’s larynx grows larger during puberty, but it typically grows far more in males than in females. A larger larynx gives men deeper voices than women, although women’s voices also deepen as the larynx grows during puberty. Various factors may affect how prominent an Adam’s apple appears.

One factor is a person’s weight. An Adam’s apple tends to be more noticeable on a thin person than on those who carry more weight, and have a more substantial neck. The excess of cartilage on the larynx makes it more prominent and noticeable. In a tracheal shave, the surgeon reduces the amount of cartilage to shape of the throat to appear more feminine.

Tracheal shave procedure

The tracheal shave may be performed under general anesthesia or with local anesthesia and intravenous sedation. It can be combined with Facial Feminization Surgery (FFS) when it includes jaw work to avoid the appearance of appreciable scarring in the neck. In this procedure, the surgeon makes a horizontal incision in the throat, and then shaves down and trims the cartilage on the larynx to reduce its prominence through the incision.

Although simple and straightforward in design, the tracheal shave is a delicate procedure because the vocal cords are within the cartilage of the larynx, just below the Adam’s apple. The success of a tracheal shave is measured by a feminine neck profile (or the absence of prominent cartilage) with minimally visible scarring and no injury to the vocal cords.

What to expect with a tracheal shave

When you come to Dr. Sinclair for FFS, he will listen attentively to your treatment goals, analyze your facial proportions, and design a plan of procedure specifically for you, which may include a tracheal shave if your Adam’s apple is noticeably prominent. In the surgery, he will place the incision in a natural wrinkle or crease, so the small scar from the procedure will be less visible.

You can expect some swelling and bruising and you may have a sore throat after the surgery. These minor discomforts will usually dissipate within 24 to 48 hours. You may be encouraged to rest your voice and apply ice to the site of the surgery. Results will be visible almost immediately and will continue to evolve as you heal from the surgery and the swelling subsides.

Benefits of a tracheal shave

One of the most noticeable differences between men and women is a prominent Adam’s apple, particularly when it bobs up and down as a person drinks. As a facet of facial feminization, a tracheal shave surgical procedure can significantly reduce the Adam’s apple, for a smoother, more graceful appearing neck and throat.

As a step in your MTF journey, Adam’s apple reduction can help increase your confidence in presenting a natural-looking, feminine neck profile.

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We invite you to schedule a consultation with Dr. Sinclair to discuss how he can assist you with your transition. Consultations for elective cosmetic procedures are complimentary.

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