Facial Feminization Surgery » Procedures
Tracheal Shave
A prominent trachea or Adam's apple can be embarrassing for a woman. A Tracheal Shave, also called Thyroid Chondroplasty, can be an effective, satisfying and long-lasting solution to this problem. A Tracheal Shave is a delicate process especially for those who have hard cartilage due to the aging process.
How a Tracheal Shave Is Done
- A Tracheal Shave can be out patient surgery
- Sedation may be given
- A mini-incision is placed on upper the crease of neck skin below the chin for a better chance to hide a scar
- Thyroid cartilage is exposed and reduced, usually by shaving the most prominent area and the rim of its upper border
- All bleeding points are carefully checked and stopped
- An experienced surgeon will use special equipment to make certain that the voice will not change from this procedure.
- A small amount of steroid may be placed in the wound to keep the scarring to a minimum
- It takes about 3/4 hour to complete the surgery
Dr. Gabriel Del Corral
Dr. Del Corral is a double board-certified plastic and reconstructive surgeon at the Medstar Center for Gender Affirmation in Washington D.C. and Baltimore, Maryland. He specializes in gender-affirming procedures, including Facial Feminization Surgery. Watch him perform a Tracheal Shave in this video »
Tracheal Shave Incision Options
The most common method of accessing the thyroid area is through a small horizontal incision over or just above the Adam's Apple cartilage, and is referred to as the trans-cervical approach. In most patients, the scar heals well and is barely noticeable, however there are alternative approaches to further minimize scarring. With the submental approach, the incision is made more indirectly, right under the chin, which hides the scar very well.
A newer approach is the transoral transvestibular approach, or TOEVA. Surgeons in Israel developed the technique for use in transgender women, referring to it as Scarless Neck Feminization. The Adam's Apple cartilage is accessed with an endoscope through incisions in the mouth. The reported operative time was 1.5-2 hours, which is longer than the trans-cervical and submental approaches and could increase costs, however Dr. Kamol in Thailand does the procedure in an hour. Surgeons in the United States who offer the TOEVA Tracheal Shave include Dr. Kyle Keojampa and Dr. Rahul Seth, both in California.
Tracheal Shave Recovery
- During the first 24-48 hours swelling may occur
- Mild voice weakness may occur in the first few days after surgery, but should not be long-term
- Ice pack applied to the treated area for a couple of day is always recommended
Risks & Complications
- The voice may change
- Thick scars may occur
- If the trachea is cut too deep the vocal cords may be cut, and will most likely permanently change the voice
References
Surgical techniques and outcomes of thyroid chondroplasty in transfeminine individuals: A systematic review.
Li KR, Lava CX, Bautista Neughebauer ML, et al. J Plast Reconstr Aesthet Surg. 2024;91:56-66.
This study looked at a procedure called thyroid chondroplasty (TC), also known as Tracheal Shave, which makes the thyroid cartilage look more feminine. Researchers compared two methods of performing TC: open surgery and endoscopic (minimally invasive) surgery. While the endoscopic method offers the benefit of no visible neck scar, it has a higher risk of complications compared to the open approach (15% versus 4.3%). The study suggests that more research is needed to help surgeons become more comfortable with the endoscopic method and to reduce complications associated with it.
Scarless Neck Feminization: Transoral Transvestibular Approach Chondrolaryngoplasty [FULL TEXT]
Avi Khafif, Hagit Shoffel-Havakuk, Iris Yaish, Karen Tordjman, and Niddal Assadi. Facial Plastic Surgery & Aesthetic Medicine. Jun 2020.172-180.
Chondrolaryngoplasty or reduction of laryngeal prominence is a gender affirmation surgery for transgender women, or for male patients desiring an aesthetic surgery. Several variations of the procedure were suggested, yet to date, all described chondrolaryngoplasty procedures involved a visible neck scar. This study describes a novel technique for scarless chondrolaryngoplasty, transoral endoscopic vestibular approach (TOEVA)-chondrolaryngoplasty, and to report the results of first ever performed cases.
Last updated: 09/20/24