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Thyroid cartilage reduction, thyroid cartilage laryngoplasty, or "trach shave," is a surgery to reduce the size of the Adam’s apple. It is done through a small incision that is hidden under the chin. It is done under general anesthesia as an outpatient surgery. This may also be done with other gender-affirming surgeries. It can be done at the hospital or an outpatient surgery center depending on when you want surgery, and on the OR schedule.
Thyroid cartilage reduction is an option to treat gender dysphoria for transgender, non-binary, and gender non-conforming/diverse patients with an obvious Adam’s apple. The entire Adam’s apple cannot be removed, but patients will notice a reduced amount showing in the neck. Surgery does not change the pitch of the voice.
Many health care plans now cover this surgery to treat gender dysphoria. We follow the World Professional Association for Transgender Health (WPATH) standards of care. We don’t require a letter of readiness from a mental health provider. But it may be required by your insurance carrier.
Your doctor will submit a prior approval to your insurance to see if it is covered. It is also helpful to check with your insurance plan about coverage. UW Health also offers pricing for surgery that is not covered by insurance.
How We Protect the Voice
During surgery, we place a needle through the neck to mark how much cartilage will be removed. We pass a small camera through the breathing tube and use it to confirm the needle is safely above your vocal cords. The cartilage above this needle is removed and the vocal cords below are not. This will reduce the risk of damage to the voice.
Stop smoking or using tobacco 4-6 weeks before surgery.
You will be given guidelines on:
Medicines and vitamins
Stopping aspirin or other blood thinners.
Gender-affirming hormones do not need to be stopped unless stated by your doctor.
You may have soreness, swelling, bruising or numbness to the skin. This will go away in time. Swelling may take weeks to go away.
You may feel sick to your stomach from the anesthesia.
You will have stitches, that will dissolve on their own.
You will have a scar on your neck hidden under your chin. This scar will fade over time.
There are no eating or speaking restrictions.
Only light activity for 2 weeks. No strenuous activity, aerobic exercise or jogging.
Do not lift more than 15 pounds for 2 weeks.
Talk to your doctor about your return to work.
You should walk as much as you like after the first 48 hours.
Ask your surgeon when it is safe to shower.
Do not soak your incisions. No tub baths, swimming, or whirlpools for 2 weeks.
Avoid sun exposure to the face for 3 months. The sun can darken the incisions, cause swelling and slow the healing process. Use sunscreen with at least SPF 30 and a brimmed hat when outdoors.
Avoid tobacco and other nicotine for at least 4 weeks.
We will schedule a follow up visit if it has not yet been set up. Typically, we would monitor your healing at one week and at one month after surgery.
Who to Call
UW Health Transformations Clinic
2349 Deming Way