Spotlight on the Tracheal Shave

A large or protruding Adam's Apple (thyroid notch) is a distinctly male trait. This is why a tracheal shave can be one of the first surgical procedures for male-to-female (MTF) transgender patients.

"Transgender" refers to people whose gender identity or expression differs from their assigned sex at birth. Transition is a journey and often starts with counseling. Many doctors require that transgender individuals meet with a therapist before they agree to prescribe hormone therapy and/or perform sexual reassignment surgery.

What is a Tracheal Shave?

To perform a tracheal shave, the surgeon crafts a small incision in the upper crease of the neck or similarly subtle spot so the small scar can be hidden. The surgery is often performed with the guidance of a tiny video camera to allow for an up-close-and-personal view of the vocal cords. A surgeon needs to see the vocal cords clearly in order to avoid them during the procedure. Tracheal shave is often done with local anesthesia and intravenous sedation, so you are awake but unaware.

The surgeon then exposes and removes the cartilage lining the thyroid gland and its borders. The goal is to get as much cartilage as possible without touching the vocal cords, after which the incision is closed. Lastly, a small bandage is placed over the incision. The surgery generally takes less than one hour in the operating room.

Tracheal Shave: Risks and Recovery

In the days following the procedure, some mild discomfort is expected. This may include bruising, swelling, tightness and lumpiness around the neck, in addition to mild voice weakness as well as a sore throat. The surgeon can provide a prescription for pain medicine to help for the first few days. He or she will provide other instructions on what can safely be done after tracheal shave. For example, resting the voice will help speed recovery and minimize discomfort, and applying ice packs to the treated area can reduce swelling.

The incision area may be red and thick for the first few weeks, but this will improve.

A tracheal shave should only be performed by an experienced and qualified surgeon. This is a delicate area and if he or she removes too much cartilage, it can affect the voice. By contrast, taking too little may produce an unsatisfactory result. It's a balancing act.

Tracheal Shave Cost

A growing number of insurers will cover the cost of sex reassignment surgery for transgender individuals. Check with your insurance company before scheduling surgery to see what (if anything) is covered. Financing plans may also be available.