A large or protruding thyroid cartilage (a.k.a. Adam’s Apple or pomus Adamus) can be a source of embarrassment to the male transsexual as well as to certain aesthetically-sensitive males. Reducing the size of the upper portion of the thyroid cartilage, known technically as a chondrolaryngoplasty, is often an essential procedure in appearing more feminine. A feminine-appearing face with a protruding thyroid cartilage is a sure giveaway of one’s sexual origin.
Thyroid cartilage reduction, or a tracheal shave, is a fairly straightforward procedure both to do and to undergo. The cartilage is reduced by making a small horizontal incision directly overlying the most prominent portion of the cartilage in a natural skin crease. The cartilage is literally shaved down with a scalpel but not so far as to risk passing through the underside of the cartilage. The vocal cords lie on the inside of the cartilage. The incision is then closed with dissolveable sutures placed on the inside of the skin. There is very minimal pain and swelling afterwards.
Complications from a tracheal shave are few with hypertrophic (thick) scars being the most common. Scars across the thyroid cartilage definitely have a tendency towards becoming thicker so scar treatments and massage are essential. Of some significance is that undesirable voice changes have been reported and can occur as the ‘box’ of the thyroid cartilage may become unstable if it is thinned too much, changing the tension or stretch of the vocal cords. Most voice changes are temporary however.
All tracheal shaves that I have performed have been done under general anesthesia, usually with other feminizing procedures such as rhinoplasty or forehead contouring. As a stand alone procedure, it may be able to be done under local anesthesia or IV sedation.