Adam's Apple Reduction: What You Need to Know About Tracheal Shave Surgery
How it works
How long recovery takes
Fast facts
Adam's apple reduction (also called a tracheal shave or chondrolaryngoplasty) is a surgical procedure that shaves down the laryngeal prominence of thyroid cartilage in the throat, making it protrude less. In most cases, the procedure is performed as a gender confirmation surgery, sometimes during facial feminization surgery or at the same time as MTF vocal feminization surgery. Other people just want to reduce an overly large Adam’s apple for aesthetic reasons.
You can’t technically remove your Adam’s apple—it’s part of the protective, structural cartilage around your esophagus and voice box—but this procedure can significantly reduce how much that cartilage sticks out.Â
When too much cartilage is removed, vocal cords can be damaged. “If that area is damaged, the voice can actually get deeper and raspier and is almost impossible to fix,” says Dr. Sarah Saxon, a facial plastic surgeon in Austin, Texas, in a RealSelf Q&A.Â
Especially for MTF transgender patients, it’s important that the surgeon have deep experience in operating around the vocal cords. A board-certified facial plastic surgeon with training in otolaryngology (pertaining to the ear, nose, and throat) should be able to minimize this risk.
Related:Â The Surgery That Finally Gave One Woman Her Identity
When performed alone, the tracheal shave procedure requires only local anesthesia and can be done in about an hour. If you’re having your laryngeal prominence reduced as part of facial feminization surgery with multiple procedures, you’ll be under general anesthesia with a longer surgery time that’s dependent on what else you’re having done.
Your surgeon will insert a tiny video camera, via an endoscope through your mouth and throat, to locate your vocal cords and monitor them throughout the procedure.
They’ll make a small (1–1.5 cm) horizontal incision in the crease where your chin meets your neck or in a wrinkle in the skin, for a well-hidden scar. They’ll then pull back the skin and muscle on the front of your throat to expose the thyroid cartilage and shave it down with a burr tool, refining the cartilage to a smooth, flat surface.
Finally, your surgeon will clean the incision, close it with sutures, and place a bandage over it.
You'll need up to two weeks of downtime after Adam's apple reduction surgery.
In the first couple of days after surgery, your throat will feel sore, and you’ll have some bruising and swelling. It may be difficult to talk and swallow. Rest your voice, apply ice packs, and take pain medication as needed. Soft foods will be easier to eat.
Because the area is constantly moving when you talk and swallow, swelling can persist for up to a month. The scar tissue may also feel knotty or ropey for several weeks.
Adam’s apple reduction surgery results are permanent. Unlike other tissues in the body, cartilage doesn’t heal itself and can’t grow back.
The Adam's apple reduction photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
Updated December 4, 2023