Gender Affirming Surgery - Scarless Thyroid Cartilage Reduction
Dr. Shih

The protruding Adam's apple is an important masculine feature. It is indeed quite troublesome for women with obvious appearance of Adam's apple or those who want neck feminization. When the thyroid cartilage is finalized in adulthood, the estrogen hormone therapy shows no benefits for thyroid cartilage appearance reshaping. Therefore, the surgery seems be the only solution.

In the past, most of the Adam's apple debulking surgeries were performed with open wound surgery, and the wound was mostly hidden at the junction between the chin and the neck. Even so, the subsequent neck movement will still make the scar more obvious, especially in Asian cases. Transoral endoscopic thyroid cartilage debulking can be achieved with a clearer operation view and hidden scars. The postoperative recovery is quick, thus, we suggested endoscopic thyroid cartilage debulking might be a better option.

The comparison between preoperative (upper) and postoperative (lower) pictures.
Pre-OP Note

Neck bandage preparation, hormone therapy suspended for 2 weeks.

  • Locationthe sulcus between lip and teeth.
  • Anesthesiageneral anesthesia.
  • Duration4-6 hours.
  • TargetThyroid cartilage shaving/resection + platysma plication.
Post-OP care
  • Decreasing speech frequency within 24 hours.
  • Try the liquid diet (lower temperature) for 7 days.
  • Neck bandage use for 7 days (24 hours a day).
  • No smoking.
Possible complications
  • Hoarseness or weak voice.
  • Subcutaneous seroma.
  • Postoperative subcutaneous bruising.
  • Paresthesia of the lower lip.
Last updated2023.10.10