Tracheal Shave 

Medically reviewed by Tuan A. Tran, M.D., M.B.A., F.A.C.S. | Written by Nhuhao Do on May 25th, 2021 

Overview  

Tracheal shave surgery is commonly referred to as Adam’s apple reduction. This procedure is often done as part of facial feminization surgery in transwomen and non-binary trans people to achieve a more feminine appearance. It is also known as chondrolaryngoplasty or thyroid cartilage reduction.  

Having a large Adam’s apple is one of the most obvious characteristics of being a male. For people transitioning from male to female, or male to non-binary, Adam’s apple reduction can be a liberating and empowering.  

Who is a good candidate? 

A good candidate for tracheal shave is a healthy adult with realistic expectations of what the procedure can help them achieve along with the understanding of potential risks. Before proceeding with your surgery, your surgeon will go over an informed consent with you; you will be asked to provide a psychiatric evaluation; and other medical screening including, blood tests and electrocardiogram (EKG). 

Leading up to your surgery, if you are taking hormone replacement therapy (HRT), you will be required to stop it for two weeks before surgery, and refrain for another two weeks after surgery. Be sure to discuss in detail with Dr. Tran about the any medications that you take regularly and any recreational drugs you may use. He will advise whether or not you will need to stop taking any of those medications before your surgery.  

People who are choosing to proceed with a tracheal shave are also interested in other facial feminization procedures to be performed simultaneously or in steps spread out over a period of time. These procedures include: 

• Forehead recontouring  
• Hairline lowering 
• Cheek recontouring  
• Rhinoplasty 

• Jaw reshaping  
• Chin Reduction 

More in-depth information can be discussed during your consultation with Dr. Tran. 

Procedure in Detail 

Tracheal shave is an outpatient procedure. If performed alone, it only takes about 30 minutes to 1 hour, from start to finish.  

1. Typically, the procedure is done under general anesthesia. 
2. Dr. Tran will make a small, horizontal incision in a skin crease on the throat. This technique helps minimize the visibility of the scar later on.  
3. An endoscope camera will be inserted into the incision. It will help your surgeon locate the thyroid cartilage and the vocal cords to ensure the safety of the procedure. 
4. The thyroid cartilage and the laryngeal prominence will be shaved down and removed. 
5. The incision will be sutured closed, and the procedure is completed.  

Recovery 

The healing time after tracheal shave is varied for each patient. Some pain and discomfort are expected after a tracheal shave for several days following the surgery.  

Post-operative side effects include: 

• Slight pain 
• Swelling 
• Bruising  

• Sore throat 
• Weak voice 
• Difficulty swallowing  

Icing and taking medications as prescribed by Dr. Tran will help minimize these side effects. For your most optimal recovery, please refer to the post-operative instruction given to you prior to the surgery.  

As always, you are more than welcomed to reach out to our office for any questions that arrive during your recovery period. Generally, it is recommended that you rest for at least two days and avoid vigorous activity and singing or speaking loudly. You will then follow-up with Dr. Tran after 5-7 days from your surgery for your post-op appointment.  

Result 

Once the swelling has subsided, you should be able to immediately notice the results of a tracheal shave. Your neck should look smoother without, or with a much less noticeable Adam’s apple. The incision scar should not be visible unless your neck is lifted. The scar should fade overtime, while, you may opt to apply a silicone scar sheet to boost the healing outcome. A box of silicone scar sheets can also be purchased in-office or at most local drugstores.   

Cost and Consultation 

Many major medical insurances in California, including CalOptima, cover for a tracheal shave as part of facial gender affirming surgery. If you have more questions or would like to schedule a free consultation with Dr. Tran, please contact us via our website, Tran Plastic mobile app or call us today at 714-839-8000.  

 References  

Facial feminization surgery male-to-female. (n.d.). American Society of Plastic Surgeons. Retrieved from plasticsurgery.org/reconstructive-procedures/facial-feminization-surgery/preparation 

Mayo Clinic Staff. (2019, September 11). Facial feminization surgery. May Clinic. Retrieved from
mayoclinic.org/tests-procedures/facial-feminization-surgery/about/pac-20467962 

Tracheal shave of Adam’s apple reduction. (2020, July 6). Dr. Amir Hosein Mofrad. Retrieved from https://www.drmofradclinic.com/en/4256/tracheal-shave-or-adams-apple-reduction/ 

Vashishta, R. (2017, December 7). Larynx anatomy. Medscape. Retrieved from https://emedicine.medscape.com/article/1949369-overview#:~:text=The%20thyroid%20cartilage%20is%20the,known%20as%20the%20Adam’s%20apple.