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Tracheal Shave (Chondrolaryngoplasty): What It Does and Does Not Change

Key takeaways

  • A tracheal shave (chondrolaryngoplasty) reduces the prominence of the thyroid cartilage, often called the Adam's apple.
  • It changes the appearance of the throat; it does not change your voice or its pitch.
  • If pitch is your goal, voice work is the route: voice therapy is first-line, with voice surgery considered after it.
  • It is a feminising option under the WPATH Standards of Care, Version 8 (SOC-8), 2022, based on individualised assessment.
  • Regret after gender-affirming surgery is about 1 in 100 across pooled studies: low but not zero.

By Jessica Tran  |  Medically reviewed by Mr Tobias Lindgren, FRCS(Plast)

Published · Last revised · Last reviewed · 3 min read

A tracheal shave (chondrolaryngoplasty) reduces the prominence of the thyroid cartilage, often called the Adam’s apple; it changes the appearance of the throat and does not change your voice. It is a feminising procedure focused entirely on contour1. If pitch is your goal, that is a separate route: voice therapy is first-line, with voice surgery considered after it2.

This was the procedure I most misunderstood at first. I assumed reshaping the throat would also lift my voice, and it does not; the two are completely separate. This guide, reviewed by a consultant gender-affirmation surgeon, sets out exactly what a tracheal shave does and does not do, and how it fits the wider plan. For the full picture, see our overview of gender-affirming surgery and of feminising surgery for trans women.

What is a tracheal shave?

It is a procedure that reduces the prominence of the thyroid cartilage, the structure at the front of the throat commonly called the Adam’s apple. It is performed through a small incision, usually placed in a natural crease of the neck, through which the surgeon smooths down the prominent cartilage to soften the throat contour.

It is one of the more focused feminising procedures: a single, well-defined goal of reducing one visible feature, rather than the multi-area plan of facial feminisation surgery.

What a tracheal shave does not change

A tracheal shave does not change your voice, its pitch, or how it sounds. The thyroid cartilage prominence and the mechanism of voice production are different things; reshaping the outside of the cartilage does not raise pitch1.

This is the single most important thing to understand before booking one. If your goal includes a more feminine voice, the route is voice work, where therapy is first-line and surgery such as glottoplasty is considered afterwards. See voice feminisation surgery for how pitch is actually addressed. I wish someone had drawn that line clearly for me earlier; it would have saved me a lot of confusion about which procedure did what.

Recovery and what to expect

Recovery is relatively contained, but it is still surgery with a real healing period and a small neck scar placed in a skin crease. Your surgeon sets out the timeline for your case, including when swelling settles and any restrictions in the early days.

The procedure is done conservatively to protect the vocal cords beneath, and recognised risks, including any effect on the voice if the vocal cords are involved, are explained at consultation as part of informed consent. As with all the procedures here, your surgeon quotes the specifics for you rather than a generic figure.

How it fits the pathway

A tracheal shave is one feminising option among many and can be standalone or combined with other procedures such as facial feminisation surgery. It is accessed through the same assessed pathway as other gender-affirming surgery, under the WPATH Standards of Care, Version 8 (SOC-8), 2022, based on informed consent, capacity, and individualised assessment2. On the NHS, care is accessed via a Gender Dysphoria Clinic, where a first appointment commonly takes several years1.

Regret after gender-affirming surgery is about 1 in 100 across a large pooled meta-analysis, low but not zero3. Nothing here is personal medical advice; decisions are made with your own clinical team, who can assess you individually. To understand the assessment and referrals, see the pathway to gender-affirming surgery.

Frequently asked questions

What does a tracheal shave do?

A tracheal shave (chondrolaryngoplasty) reduces the prominence of the thyroid cartilage, the structure often called the Adam's apple. It is a feminising procedure that changes the contour of the front of the throat. It does not change your voice.

Does a tracheal shave change your voice?

No. A tracheal shave changes the appearance of the throat, not the voice or its pitch. If your goal is a higher-pitched or more feminine voice, that is addressed through voice therapy first and, if appropriate, voice surgery, not through a tracheal shave.

Will a tracheal shave affect my ability to speak or swallow?

The procedure is planned to reduce cartilage prominence without compromising the vocal cords, and a surgeon takes care to protect them. As with any surgery there are recognised risks to discuss at consultation, including effects on the voice if the vocal cords are involved, which is why the procedure is done conservatively. Your surgeon explains these as part of informed consent.

How is a tracheal shave done?

It is performed through a small incision, usually in a natural skin crease of the neck, through which the surgeon reduces the prominent part of the thyroid cartilage. The aim is a smoother throat contour. Your surgeon explains the approach, the scar, and recovery for your individual case.

Is a tracheal shave usually combined with other surgery?

It can be a standalone procedure or part of a wider feminising plan, for example alongside facial feminisation surgery. Whether to combine procedures depends on your goals and your surgeon's assessment. Each is decided individually under the WPATH Standards of Care, Version 8 (SOC-8), 2022.

Is regret common after gender-affirming surgery?

Regret after gender-affirming surgery is about 1 in 100 in a large pooled meta-analysis (Bustos et al., 2021, around 7,900 patients). That is low but not zero. Most people report improvement in wellbeing, and the figure is reported honestly so you can decide with full information.

References

  1. Gender dysphoria: Treatment, NHS. ↩
  2. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, World Professional Association for Transgender Health (WPATH). ↩
  3. Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis, Plastic and Reconstructive Surgery, Global Open (Bustos et al., 2021). ↩

Written by Jessica Tran. Medically reviewed by Mr Tobias Lindgren, FRCS(Plast).

Our guides are written from personal experience and reviewed by a qualified clinician for accuracy. Read our editorial policy.

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