Feminising chondrolaryngoplasty, also known as “tracheal shave,” feminises the appearance of the neck by effectively reducing the prominence of the Adam’s apple and is performed through an incision across the front of the neck. Regardless of the incision placement or length, the scar can serve as an undesirable “mark” and a source of continued misgendering for the patient.
The procedure for Adam’s apple reduction involves making an incision in the submental region. Once this is done, the throat muscles are held apart while the thyroid cartilage is shaved down so that the throat looks smoother without having a protruding Adam’s apple.
What to expect
Pre-operative:
- Bring a list of your questions and concerns to your pre-operative visits. Understanding the expectations for recovery, based on your plan, is essential. - Get a physical exam to assess your health and learn more about your medical history.
- You will need surgery referral letters from two qualified mental health professionals.
- You will be given guidelines on eating, drinking and adjusting current medications before the surgery can take place.
- Smoking is a relative contra-indication to subcutaneous mastectomy. Because of the increased risk of infection i.a., you are advised to stop smoking as soon as possible.
- After you have discussed which surgery technique is best for you, Dr Kanhai will draw up a plan for the operation.
- The anaesthesiologist will provide information on the anaesthesia, and doctor Kanhai about the type of the operation, and the follow-up procedures that might be necessary.
- Dr Kanhai will also ask about any risk factors for blood clotting issues (past deep vein thrombosis or pulmonary embolism), bleeding problems (like haemophilia), or family/personal history of issues with anaesthesia.
- You will undergo a physical examination to ensure readiness for the operation.
Peri-operative:
- We will give you general anaesthesia through a vein in your arm. You will be asleep throughout the procedure and won’t feel any pain during surgery.
- Dr Kanhai will make a small, horizontal incision in the submental region. This ensures that the scar won’t be as visible later on.
- A tiny camera will be inserted in the tragia. The camera is used to locate the vocal cords.
- The thyroid cartilage and its borders will be shaved down and removed.
- Once completed, the incision will be sutured closed. He will stitch the incision with dissolvable stitches, that will naturally dissolve and will be absorbed by the body as the incision heals.
Post-operative:
- After surgery, you will be taken to the recovery room and will be observed for a period of time before being discharged.
- Swelling typically peaks within the first 24 to 48 hours and takes about six weeks to resolve.
- There will be some discomfort, especially with talking or swallowing, for about 7 to 10 days.
- Gently rub the incision to reduce the chances of scar tissue forming and causing a noticeable mark.
- The scar may be visible for several months. As time progresses, it diminishes to the point that it is almost invisible within a year.