Tracheal Shave for the Prominent Adam’s Apple

Q: I am inquiring as to whether you perform tracheal shaves? I have been bothered by the bulge in my neck caused by my Adam’s apple. As a female, it does not give my neck a very nice profile and looks too manly. I have read that the protruding cartilage can be shaved down. Is there much scarring and what is the recovery like?

A: A tracheal shave, known medically as a chondrolaryngoplasty reduces the size of the thyroid cartilage through a small horizontal incision in the neck. While often thought of as only a transgender procedure (facial feminization), I have performed more of these procedures on men and women who are merely just uncomfortable with the prominence of their Adam’s Apple.

The procedure is actually fairly simple and does truly consist of shaving down the protruding cartilage with a scalpel. Through a small horizontal incision in a favorable or prominent skin crease near the thyroid cartilage, the vertical strap muscles are separated to get direct access to the protruding cartilage. It is shaved down as much as possible to get a throat line that appears smoother and less angular. One must be careful to not take too much cartilage away which can de-stabilize the attachments of the underlying vocal folds, risking potential hoarseness after surgery. While the goal is as smooth a neckline as possible, sometimes it can merely be reduced significantly but not made completely flat. The small neck incision will go on to heal very nicely with little scarring.

Recovery is quite quick with minimal discomfort. I do not place patients on any type of restrictions after surgery. There are no sutures to remove. There is some mild swelling and bruising which goes completely away in two weeks. There may be some temporary discomfort on swallowing. Usually, there is little to no change in the pitch of a patient’s voice. There are some topical scar treatments that can be done beginning three weeks after surgery to optimize the fading of the fine line scar.

Dr. Barry Eppley