Adam's Apple Shaving (Thyroid Cartilage Shaving)

Adam's Apple Shaving (Thyroid Cartilage Shaving) is a surgical procedure in which the thyroid cartilage is reduced in size by shaving down the cartilage to achieve a more feminine appearance. The procedure can be done as an out patient surgery under local anesthesia or under a general anesthesia. The incision is usually 2-3 cm in length. The surgeon makes a horizontal incision at the highest crease of the skin on the throat below submental (chin) area then the vertical muscles in the throat are separated to expose the cartilage.  The thyroid cartilage is reduced, usually by shaving in the most prominent area and the rim of its upper border. The thyroid cartilage contouring is a delicate process and need to be done meticulously especially for those who have calcified (hard) cartilage due to aging process.

Duration of the operation:

The feminization of the Adam’s apple (trachea shave) takes about 1 hour

Post operative care:

• During the first 24- 48 hours, patient may experience some varying degrees of swelling and temporary mild voice weakness that includes lowering of pitch and hoarseness following surgery.
• Apply ice pack to the surgical site for a couple of days to gradually decrease swelling. Swelling will subside over 1-2 weeks and bruising resolves in 1-3 weeks.
• Patient must rest voice following surgery. Avoid shouting or singing for 2 weeks after surgery.
• The procedure leaves a prominent red scar that lightens over 1-3 months.
• Patient will have stitches often supplemented by surgical tape or butterfly bandages for a few days.
• Wound dressing is performed daily. Stitches and tape must be kept dry at all times.
• Patient must avoid electrolysis immediately around the incision until surgeon recommends it to continue.
• Application of antibiotic ointments, vitamin E oil, or other topical preparations is prescribed by some surgeons to aid healing process.

Recovery period:
A piece of gauze will cover the incision for the first 2 or 3 days after Adam’s apple reduction. For about 7 to 10 days you will probably have a burning sensation and some difficulties when swallowing or talking. Patients who underwent Adam's apple removal report that the post op sensation is very similar to a simple sore throat, including a reduction in the ability to speak loudly.

Possible risk and complications:
Complications include permanent change in vocal quality which is the result of too much revision or over dissection of the cartilage that may injure the vocal cords, infection may also occur and hematoma.

Anesthesia use:
Adam's apple removal is done under general anesthesia, with other procedures of facial feminization surgery, or alone.

Hospital admission:
This procedure may be performed in the cosmetic surgeon’s office-based facility, an outpatient surgery center, or at a hospital. This procedure is usually done on an outpatient basis

Preparation before the surgery:

• Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
• Blood and urine samples will be collected for routine preoperative laboratory tests. X-rays may be taken to evaluate the individual's bone structure.
• Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
• You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
• Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.