Q: Dr. Eppley, Do you have experience with facial feminization surgery? Particularly with forehead recontouring, rhinoplasty, adam’s apple shaving, and hair line lowering?
A: I have considerable experience with facial feminization surgery (FFS) procedures, particularly the four that you have mentioned which are some of the most common FFS operations. All can make very successful feminizing effects. The key to the hairline lowering is the density of the frontal hairline where the incision has to be made. If this is adequate then the hairline can usually be lowered in a single stage of up to 2 cms based on one’s natural scalp laxity. Combining forehead/brow bone contouring with hairline lowering is particularly convenient since the pretrichial incision provides direct access to the entire forehead. Adam’s apple reduction (aka tracheal shave) is the simplest of the procedure and how much is can be reduced is dependent on what incisional access is used. (directly over it or the more remote submental incision) Reshaping the nose through a rhinoplasty to create a smoother and less prominent nose result depends on the thickness of the overlying skin. The thicker the skin the less it will contract and the size of the nose will reduce less.
Please send me some pictures of your face for my assessment and computer imaging to see what changes may be possible for you.
Dr. Barry Eppley
Q: Dr. Eppley, I would like to have the adam’s apple reduction procedure. I am a natural man and I don’t like the size of my adam’s apple. It is very big but I have doubts whether I should do or not do the surgery. I have researched photos of men who have this surgery but I found a few pictures and a few angles but some of the results didn’t seem good. What has been your experience with adam’s apple reduction surgery and how good are the results?
A: I have performed many adam’s apple reductions and about half of them are for men who just have a very prominent thyroid cartilage that is more than just a neck bump. The amount of visible reduction, however, can be variable based on the anatomy of the thyroid cartilage, the thickness of the tissues overlying it and the aggressiveness and experience of the surgeon doing it. I suspect for most men who just want less of a neck bump size, rather than a completely flat neck profile, that the results are very satisfactory. It certainly can be difficult in some patients to get complete elimination of it but that it is not usually the goal of men looking to make a big adam’s apple prominence smaller. I would suggest that you send me some pictures of your neck, particularly from the side, for my assessment to see if this procedure would be worthwhile for you in terms of the amount of reduction that could be achieved.
Dr. Barry Eppley
Q: Dr. Eppley, I am a 42 year old male and I am interested in a Chondrolaryngoplasty. (adam’s apple reduction) I am just very self conscious about my large adam’s apple and I am just tired of being harassed about it. I have heard that the cartilage turns to bone at a certain age so at 42 can I still have this procedure done?
A: While it is true that many cartilage areas in the body get partially calcified as one ages, and the thyroid cartilage is no exception, this is not a concern for you at age 42. At this age the thyroid cartilage is still mainly cartilage and it does not change the ability to shave it down. The reality is that even if you were older and the thyroid cartilage was more calcified, it could still be reduced and would be burred down by a machine-driven rotary drill as opposed to shaving. Thus, you should feel completely comfortable being able to have a successful adam’s apple reduction (chondrothyroplasty) at any age regardless of whether the cartilage is uncalcified, partially calcified or even completely calcified.
Dr. Barry Eppley
Q: I am interested in reducing the size of my adam’s apple as it sticks out like a bulge in my neck. In reading about tracheotomies, I wonder if there was an at-home method in which a man could try the look, feel and sound of having a more feminine adams apple appearance just for say a few weeks before taking surgery. Have you ever heard of anything like this?
A: For the sake of clarification, tracheal reduction and tracheotomies are two different completely different operations with diametric objectives. A tracheostomy makes a hole through the skin and down into one’s windpipe below the thyroid cartilage for the sake of breathing. A tracheal reduction, technically known as a thyrochondroplasty or adam’s apple reduction, reduces the protrusion of paired thyroid cartilages as they bulge out into the neck. If done properly and without removal of too much cartilage, it will not change the pitch or sound of one’s voice. (a tracheostomy will definitely affect one’s voice) If you wanted to see what a tracheal reduction would look like, that is what computer imaging does. You can get a good visual approximation of the final neck contour result. It can help one see what the change would look like on them and is the best way to ‘try it on’ before surgery. There are no non-surgical methods to try and simulate that change in neck appearance.