Reduction of thyroid cartilage (adam’s apple)

A prominent Adam’s apple can be a permanent stigma in for a TG girl. Its surgical reduction is the single most common procedure in feminization…

Gender of the Trachea

The Adam’s apple is a defining characteristic of adult males.

The “apple” is a piece of cartilage located in front of the larynx, called the thyroid cartilage. The larynx acts as a resonance box for the vocal chords. During puberty, the larynx grows more in boys than in girls. This creates a greater resonance in the male voice, which is typically deeper.  It also causes the bump known as Adam´s apple to become more visible.

Feminization of the trachea

A surgical reduction of the thyroid cartilage is an efficient solution to the aesthetic problem.
The surgeon reduces the cartilage to obtain a female shape. Trachea reduction is another feminization procedure that is simple and quick, but should always be performed by a skilled surgeon since an aggressive reduction can weaken the structure of the larynx and permanently change the vocal quality. It not always possible to make a larger Adam’s Apple disappear with this procedure.

Procedure

It can be done as an ambulatory procedure under local anesthesia and sedation or under general anesthesia. Most women have it done in combination with other procedures. It takes approximately 1 hour. An incision is made around 2 cm under the chin, if possible, it is hidden inside a crease below the sub mental (chin) area.
From there, a small tunnel is created to reach the thyroid cartilage. With a surgical file and a special scalpel, the prominence and the superior border is reduced.
The muscles that are located alongside and over the cartilage are joined to cover the area that was surgically intervened.

Postoperative and possible complications in modification of thyroid cartilage

A piece of gauze will cover the incision during the first 2 – 3 days. For a period of 7 to 10 days it is possible to feel heat or some difficulties swallowing or speaking. Patients typically describe this as  having a sore throat. During the first 24 to 48 hours you can have swelling. It is possible to experience some weakness in your voice the first days after surgery; this will gradually disappear during the following postoperative days.