The Risks of Tracheal Shave Surgery

Tracheal shave surgery, also known as chondrolaryngoplasty, is a common procedure for transgender women seeking to reduce the appearance of their Adam's apple. While theoretically, this surgery poses a minor risk to the voice, an increasing number of patients are experiencing long-term vocal impairment.

In this article, we explore the risks of tracheal shave surgery.


Gathering Data on Vocal Risks

The goal of this article is to educate and empower transgender individuals considering tracheal shave surgery. If you or anyone you know has received this procedure, please fill out the linked survey.

The compiled data will help:

  • Create the largest database on tracheal shave outcomes to better inform patients.
  • Identify potential new vocal risks not widely known.
  • Pressure surgeons to improve technique and protect trans lives.


How the Surgery Works

During a tracheal shave, a small incision is made above the Adam's apple. The surgeon then sculpts away portions of the thyroid cartilage to reduce prominence.

In theory, this should not significantly impact the voice. Acute vocal changes are common for 7-14 days post-surgery as swelling resolves. However, some patients experience lasting vocal impairment.


Signs of Vocal Damage

Common signs of vocal injury from tracheal shave surgery include:

  • Hoarse, breathy voice quality
  • Decreased volume and vocal power
  • Loss of upper range or falsetto
  • Pitch drops
  • Vocal fatigue
  • Noisy, rough voice quality

These changes may persist long after the normal recovery period, indicating potential surgical complications.


Explaining the Vocal Risks

There are several ways tracheal shave surgery may damage the voice.

  • Acute swelling is expected and temporary.
  • Anterior commissure detachment occurs when cartilage removal destabilizes vocal fold attachments. This can cause lasting hoarseness and pitch drops. Correcting it requires revision surgery.
  • Subcutaneous adhesions may form between cartilage and neck tissue. This is rare with tracheal shave but can restrict vocal fold movement.
  • Maladaptive vocal behaviors may develop in response to surgical changes. This can often be corrected through voice therapy.



Tracheal shave poses a small but real risk of lasting vocal damage. Better data, education, and surgical skills are needed to protect transgender individuals. Anyone considering this surgery should fully understand the potential vocal risks before consenting. Vocal health must be made a priority.