Chondrolaryngoplasty (commonly called tracheal shave, but this is a misnomer as the trachea is not involved) is a

surgical Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

procedure in which the thyroid cartilage is reduced in size by shaving down the

cartilage Cartilage is a resilient and smooth type of connective tissue. Semi-transparent and non-porous, it is usually covered by a tough and fibrous membrane called perichondrium. In tetrapods, it covers and protects the ends of long bones at the joints ...

through an incision in the throat, generally to aid those who are uncomfortable with the girth of their

Adam's apple The Adam's apple is the protrusion in the neck formed by the angle of the thyroid cartilage surrounding the larynx, typically visible in men, less frequently in women. The prominence of the Adam's apple increases in some men as a secondary mal ...

. An alternative to this procedure is feminization laryngoplasty, albeit this procedure involves additional risks and has an effect on the voice that the patient may not desire. __TOC__

Surgery

The technique was originally described by Francis G. Wolfort and Richard G. Parry and has been developed since. After an

anesthetic An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into t ...

(

local Local may refer to: Geography and transportation * Local (train), a train serving local traffic demand * Local, Missouri, a community in the United States Arts, entertainment, and media * ''Local'' (comics), a limited series comic book by Bria ...

general A general officer is an Officer (armed forces), officer of high rank in the army, armies, and in some nations' air force, air and space forces, marines or naval infantry. In some usages, the term "general officer" refers to a rank above colone ...

, depending on whether or not it is the only surgery to be performed) is administered to the patient, a small, horizontal incision is made on the bottom of the Adam's apple. The muscles in the throat are then held apart with

forceps Forceps (: forceps or considered a plural noun without a singular, often a pair of forceps; the Latin plural ''forcipes'' is no longer recorded in most dictionaries) are a handheld, hinged instrument used for grasping and holding objects. Forcep ...

, and the protruding cartilage is shaved down with a

scalpel A scalpel or bistoury is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, podiatry and various handicrafts. A lancet is a double-edged scalpel. Scalpel blades are usually made of hardened and tempered ...

, thus making the throat appear smoother and less angular. The incision is then closed with sutures, and a red line will mark the incision for about six weeks. Little scarring occurs in most cases because the surgeon will usually make the incision in one of the minuscule folds of skin that cover the Adam's apple. Newer versions of this surgery also exist wherein the incision is hidden beneath the chin, or alternatively inside the mouth. In these cases, the tracheal shave is then typically performed endoscopically. The surgery is usually

outpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other healt ...

unless it is combined with other surgeries that require hospital stays. Particular care must be taken by the surgeon to not remove too much cartilage, as doing so can reduce the structure of the

trachea The trachea (: tracheae or tracheas), also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all animals' lungs. The trachea extends from ...

and cause breathing difficulties. Most surgeons who specialize in gender affirming surgery offer the procedure, and some general plastic surgeons will as well. It is one of the more common surgeries performed on

transgender A transgender (often shortened to trans) person has a gender identity different from that typically associated with the sex they were sex assignment, assigned at birth. The opposite of ''transgender'' is ''cisgender'', which describes perso ...

women, along with genital reconstruction. Due to the proximity of the

vocal folds In humans, the vocal cords, also known as vocal folds, are folds of throat tissues that are key in creating sounds through Speech, vocalization. The length of the vocal cords affects the pitch of voice, similar to a violin string. Open when brea ...

, there is the small possibility that they may be damaged during this type of surgery. Generally, however, the patient's voice is unaffected, although there have been reports of slight change in pitch. Some patients will choose to undergo additional vocal surgery at the same time in order to minimize voice-related

dysphoria Dysphoria (; ) is a profound state of unease or dissatisfaction. It is the semantic opposite of euphoria. In a psychiatric context, dysphoria may accompany depression, anxiety, or agitation. In psychiatry Intense states of distress and uneas ...

. If the patient’s voice is affected, they can choose to undergo feminization laryngoplasty to resolve these issues and retighten the vocal folds. Feminization laryngoplasty is also capable of further reducing the Adam’s apple after a tracheal shave if the patient finds the reduction done after an initial shave inadequate, as it explicitly removes tissue that is normally avoided by the surgeon during a tracheal shave.

Recovery

It is recommended by many surgeons that the patient frequently rub the site of the incision to prevent noticeable scar tissue from forming. Swelling and bruising around the site of the incision is common, and patients may also experience difficulty swallowing and speaking, to a greater or lesser degree depending on the individual. The average time for complete recovery is about two weeks, although it can sometimes take longer if the patient has pre-existing medical conditions such as

anemia Anemia (also spelt anaemia in British English) is a blood disorder in which the blood has a reduced ability to carry oxygen. This can be due to a lower than normal number of red blood cells, a reduction in the amount of hemoglobin availabl ...

. The majority of patients are satisfied with the outcome of this surgery. The most common complaints from those unsatisfied are that they still feel that their Adam's apple is too big or that the scar is too noticeable. Issues with the Adam’s apple being too big after a tracheal shave can potentially be solved with feminization laryngoplasty.

References

{{Reflist Feminizing surgery Larynx surgery