Background: Reduction of a prominent thyroid cartilage is technically known as a chondrothyroplasty. It is better known as a tracheal shave and it gets its name because the prominence is indeed shaved down with a scalpel. This is possible because the thyroid prominence is cartilage which only gets much harder later in life.
The tracheal shave procedure is commonly perceived to be a feminizing or transgender plastic surgery procedure. And while this is certainly true, it does not the only reason the procedure is done. In my practice experience about half of the tracheal shaves I do are in the male non-transgender patient. They often have thinner necks with a skeletonized thyroid prominence that is disproportionately visible.
On an interesting side note does such a tracheal prominence appear because the neck is merely very thin or because there is true cartilage overgrowth? I suspect it is really a combination of both contributing factors.
Case Study: This tall young male presented with a thin neck and a large triangular shaped prominence in the center of his neck in the side view. In the front view a v-shaped prominence was very visible below his chin.
Under general anesthesia a 2.5 m skin incisions as made right over the prominence in a skin crease. Splitting the strap muscles exposed the v-shaped union of the central thyroid notch. It was then shaved down to the base of the cartilage on the inner surface of the notch in a completely vertical fashion. The strap muscles were then reapproximated and the skin closed.
His intraoperative results shows the elimination of the sharp thyroid protrusion to a less visible rounder mound. For men it is not necessary to try and completely eliminate its total presence as that may over feminize the neck. Having a bit of a thyroid prominence, like that of the brow bones, is a acceptable male characteristic.
1) A prominent Adam’s apple in men often appears as a sharp v-shaped prominence that sticks out of an otherwise thin neck.
2) A tracheal shave can be done with a same direct skin incision in a skin crease just over or above the neck prominence.
3) The key in male tracheal shaves is to avoid over resection.
Dr. Barry Eppley