Chondrolaryngoplasty (commonly called tracheal shave) is a

surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

procedure in which the

thyroid cartilage The thyroid cartilage is the largest of the nine cartilages that make up the ''laryngeal skeleton'', the cartilage structure in and around the trachea that contains the larynx. It does not completely encircle the larynx (only the cricoid cartilage ...

is reduced in size by shaving down the

cartilage Cartilage is a resilient and smooth type of connective tissue. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck an ...

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 or laryngeal prominence is the protrusion in the human neck formed by the angle of the thyroid cartilage surrounding the larynx, typically visible in men, less frequently in women. Structure The topographic structure which is e ...

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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 two ...

(

local Local may refer to: Geography and transportation * Local (train), a train serving local traffic demand * Local, Missouri, a community in the United States * Local government, a form of public administration, usually the lowest tier of administrat ...

general A general officer is an Officer (armed forces), officer of highest military ranks, high rank in the army, armies, and in some nations' air forces, space forces, and marines or naval infantry. In some usages the term "general officer" refers t ...

, 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 (plural 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. Fo ...

, and the protruding cartilage is shaved down with a

scalpel A scalpel, lancet, or bistoury is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, podiatry and various arts and crafts (either called a hobby knife or an X-acto knife.). Scalpels may be single-use disposa ...

, 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. 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 health care ...

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, also known as the windpipe, is a Cartilage, cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air-breathing animals with lungs. The trachea extends ...

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

vocal folds In humans, vocal cords, also known as vocal folds or voice reeds, are folds of throat tissues that are key in creating sounds through vocalization. The size of vocal cords affects the pitch of voice. Open when breathing and vibrating for speech ...

, 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 "Voice therapy" or "voice training" refers to any non-surgical technique used to improve or modify the human voice. Because voice is a social cue to a person's sex and gender, transgender people may frequently undertake voice training or therapy ...

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 unea ...

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 or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, th ...

. 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.

References

{{Reflist Gender-affirming surgery (male-to-female) Larynx surgery