Tracheal shave

To make your neck look more feminine.

Tracheal shave

What is a tracheal shave?

If you compare the profile of a man’s and a woman’s neck, you can clearly see the ‘bump’; the Adam’s apple. It’s a typical feature for (adult) men and it gets its name from the first man to walk the earth (according to the Bible) – Adam.

MtF Tracheal Shave Procedure
The difference between the trachea cartilage of a man and a woman.

Boys develop an Adam’s apple during puberty when cartilage grows quickly around the frontal part of the larynx (which also grows, causing the boys’ voices to break). Boys develop a deeper voice and the cartilage starts to protrude more and more as it grows. But there is a solution for everything, even for transwomen with a prominent Adam’s apple. You can reduce the size of your Adam’s apple by undergoing facial feminization surgery, namely: a tracheal shave, also called Adam’s apple removal. Curious to find out what we can do for you?

Tracheal shave Jackie before and after

Tracheal shave before and after picture frontal

Tracheal shave before and after picture frontal

Tracheal shave before and after picture

Tracheal shave before and after picture

Tracheal shave before and after picture of Jackie lateral

Tracheal shave before and after picture lateral

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Note: A tracheal shave does not change the pitch of your voice. For this, our speech therapist Katrien Eerdekens can help you with voice feminization speech therapy.

Procedure of a tracheal shave

A tracheal shave is simple: our facial feminization surgeon, Dr Bart van de Ven, reduces the cartilage so that your Adam’s apple no longer protrudes. It is very important that a surgeon specialized in facial feminization surgery performs this procedure. A tracheal shave involves shaving off some of the cartilage which protects your vocal cords. Someone who has little or no experience in a tracheal shave can easily remove too much cartilage, which can lead to permanent damage to your voice. Or they might remove too little cartilage because they are overcautious, meaning that your Adam’s apple is still visible.

Trachea Shave
The areas that are shaved during a tracheal shave are indicated in dark gray on this anatomical drawing of the trachea.

How can our experts at 2pass Clinic ensure that this operation goes smoothly? First of all, Dr Bart van de Ven is specialized in facial feminization surgery for transwomen. He has been successfully performing this operation for years. Secondly, we do everything we can to make the operation as safe as possible. Before the surgery, we perform a CT scan of your Adam’s apple. We do this at the Sint-Augustinus hospital in Antwerp, which is just a five-minute drive from 2pass Clinic. The CT scan is included in your surgery. This scan is important because it’s the only way we can see where your vocal cords are in relation to the cartilage. And this is the only way Dr Bart van de Ven can remove exactly the right amount of cartilage during the operation. Curious to find out what we can do for you?

MtF Tracheal Shave Procedure

CT scan of the trachea taken before a tracheal shave to measure the distance of the adam’s apple to the vocal cords. This is the maximum that can be safely removed from the trachea without damaging the vocal cords.

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What kind of anaesthesia is used for a tracheal shave?

A tracheal shave is usually combined with other facial feminization surgeries. In such cases, general anaesthesia is used. You can also opt to have Adam’s apple removal surgery as an individual procedure. The tracheal shave is then performed under local anaesthesia. A tracheal shave takes about one hour.

What about the scar after a tracheal shave?

The incision for a tracheal shave l is three centimetres wide and is made under your chin (in a skin fold, if possible). A year after your tracheal shave the only thing you will be able to see is a narrow white line.

How high is the risk that my voice will be permanently damaged?

If the surgeon that will do the tracheal shave does as described below the chance of damaging the vocal cords is probably zero.

Will a tracheal shave compromise my voice feminization surgery?

No it will not effect the outcome of your voice feminization surgery. Dr Bart van de Ven knows the techniques used by Yeson and others and has consulted them. If you want to know all about it you can read the blogpost of tracheal shave and voice feminization surgery.

Should I have the tracheal shave or the voice feminization surgery first?

During a surgery in general anesthesia (FFS, SRS, BFS) the patient needs to be intubated. That means a tube will be placed in between the vocal cords to ventilate the patient during surgery. The voice feminization surgery with the best long term results is the Wendler glottoplasty (the technique the Yeson Centre uses). A Wendler glottoplasty will reduce the space in between the vocal cords, which means it will be more difficult for the anaesthesiologist to put a tube in between the vocal cords without damaging them. On the other hand this should be no problem ifs done with care by an experienced anesthesiologist with a small size tube.

So in the end it doesn’t make a lot of difference: first tracheal shave or the voice cord surgery. But doing the voice cord surgery at the end of your transition will make things easier for the anaesthesiologist. It will also make your voice feminization cord surgeon sleep more quietly.

And after your tracheal shave?

  • Swelling: There may be severe swelling 24-48 hours after your tracheal shave. This is normal and can last for up to six weeks. We understand that this can be distressing, as you think you will not be able to breathe. You really don’t need to worry about this. The trachea is very strong and doesn’t succumb to this temporary pressure.
  • Pain: the pain you experience after your tracheal shave feels a bit like a throat infection. It is difficult to talk and swallow, and you have a burning sensation in your throat. This pain can last for about seven to ten days.
  • Voice: as mentioned above, after your tracheal shave you will experience some difficulty speaking. It will feel as though your voice has become weaker. We know from experience that this is temporary and that you will get your normal voice back after two to three weeks. In theory, vocal cords may become damaged, but thanks to Dr Bart van de Ven’s expertise and the CT scan, that has never happened during a procedure at 2pass Clinic.
  • Scarring: initially, the scar will be red and visible. A year after your tracheal shave all that will be left is a narrow white line and you will hardly be able to see it due to its placement in a natural crease.

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FAQs before a tracheal shave

Sometimes I get asked to model during a photoshoot. How long should I wait to book one after my FFS?

That is a very difficult one. It depends very much upon your healing and we can’t give you any guarantee about how long it takes before you look good enough for a photoshoot.
It could be 4 months, but it could also be a year. Of course it also depends on the amount of work that has been done.

What does this procedure cost?

If you want you can send us good pictures together with your ideas so we can send you a financial and operative proposal. To receive a proposal, please fill in the proposal request online and pay the proposal fee of 50 euro through Paypal.

Of course you are always welcome for a consultation.

Typically how long is it after surgery to get your voice back to “normal”?

The voice cords need about 2-3 weeks to make normal use of the voice possible. We cannot exactly, if you use your voice extensively for professional reasons, when this is 100% back as before. We have no feedback on this matter.

Will a tracheal shave compromise my voice feminization surgery?

No it will not. Dr Bart van de Ven wrote an informative blogpost on a tracheal shave and voice feminization surgery. 



How will the scar be after an adams apple reduction?

All incisions leave a small white line in the end.

As this line is placed in an discrete spot (angle between neck and chin), it will be as good as invisible from most angles.

After two weeks nobody should notice from a distance. After 1 year the scar will be completely healed (white).

How the swelling and the bruise of the tracheal shave looks after 2 weeks?

In general you will hardly notice anything. But occasionaly (1 every 50 patients) there is some postoperative bleeding, which needs about a 6- 8 weeks to completely dissolve.

Will reducing the adam’s apple have any negative effects on my voice?

That is why we plan a CT scan to know exactly where are the vocal cords and how much cartilage can be removed. Until know we didn’t have one patient who had this complication.
It is possible though that oedema (swelling) of the vocal cords caused by irritation by the tube that was introduced by the anaesthesiologist or the surgery itself makes the voice weak and/or coarse for a period of about 2 weeks .

FAQs after a tracheal shave

You still have another question? Feel free to ask! We will answer your question and if generally applicable add it to the FAQ of this page.