Tracheal Shave Surgery in MTF Gender Reassignment

gender dysphoria transgender symbol

Every person regardless of gender, race, sexuality or gender identity has insecurities about their body. As we age, especially during puberty, body changes can be quite hard. For trans-women, this can be excruciating and hard to deal with.

When you look at a male and a female neck, there is an obvious difference, man has far more noticeable trachea cartilage known as the Adam’s apple.  The Adam’s apple is regarded as a sign of masculinity and is considered ‘unsightly’ for most women and for pre-op trans-woman, this can be one of the most unsightly reminders of being contained in the wrong body.

Tracheal shave surgery is available for achieving the desired look. It involves the literal shaving of the trachea cartilage to produce a feminine looking neck.

What is tracheal shave surgery?

In simple words, it refers to the reduction of the Adam’s apple or trachea cartilage in trans or even cisgendered women. Among pre-pubescent children there isn’t much of a difference in their neck profile; but as puberty takes place, the cartilage in people assigned male at birth (AMAB) starts to grow and shows a very noticeable bump. This is referred to as the Adam’s apple, after the biblical name of the first man on earth. It is considered a characterization of masculinity and is generally not desired by trans and cis-gendered women.

A tracheal shave is usually conducted as part of facial feminization process particularly in trans-women assigned male at birth. The goal of a tracheal shave in facial feminization process is to give the neck and throat of the patient a more feminine appearance by reducing considerably the size of the trachea cartilage or Adam’s apple. In medical terms, thyroid cartilage is being removed from the larynx.

How is a tracheal shave performed?

The ultimate goal of a tracheal shave is to remove as much cartilage as possible but the trick is to avoid damage to the voice box. The procedure generally lasts 30-40 minutes.

If tracheal shave is the only operation being sought, it can be performed under local anesthesia as an outpatient procedure, or in an operating room under general anesthesia. This will depend on your doctor’s recommendations.

It is highly crucial to find a doctor who has specialized particularly in tracheal shaves and facial feminization. Techniques vary from doctor to doctor. The procedure is performed by making a small incision about 1-1.5 cm under the chin. After separating the tissue that is overlying, the thyroid cartilage is exposed. To prevent the scar from being noticeable, the surgeon will determine the location of the incision.

Preventing damage to the vocal cords is very important and your surgeon will find the precise location of the vocal chord with the help of an endoscope. This will allow the surgeon to make an informed decision.

trachea neck adam's apple

Risks And Complications

The tracheal shave is one of the most commonly sought after surgery in the facial feminization process and is generally mild and carries few complications. However, it does not guarantee that it is entirely safe.

  • The area is very sensitive, and if too much cartilage is removed, it can affect the voice. Similarly if too little is removed, it can provide an unsatisfactory result. It is very important to find an experienced doctor who specializes in the procedure to produce the desired result.
  • The most immediate effects would be a weak voice and a sore throat after a few days following the procedure.
  • Tightness, swelling, lumpiness and bruising around the performed area is also to be expected. If major discomfort occurs, the surgeon should be contacted.
  • The incision area will be marked red and will be thick for a few weeks. This will subside after a few weeks.
  • Infections may also appear in the surgical area.

If serious irritation or bleeding and bruising occur, the surgeon should be contacted immediately.

Post-Surgery Care

  • It is ideal to rest the voice and not to undertake any activity that may strain your voice. Resting your voice will speed up the recovery process.
  • To deal with the swelling, application of ice-pack is recommended.
  • Your doctor may also recommend pain killers to deal with the pain.
  • Mild topical steroids may also be applied to reduce the appearance of scarring.

Destabilization of the voice box, permanent hoarseness and breathing problems are some serious complications. But if the surgeon is experienced and well versed in the procedure the chances of critical complications are almost non-existent.  It is of utmost importance to find a qualified surgeon.


The result will be a smoother and a noticeably reduced Adam’s apple. The results are permanent, and most patients are highly satisfied. However, as stated numerous times, the result depends on the surgeon. It is crucial to seek a qualified surgeon that will produce your desired results.

What is the cost of the procedure?

The price varies on your location. In some cases, it can be covered under insurance. In the US, it can range from 3000 USD to 4000 USD. In Thailand, it averages from 800 USD to 2000 USD. If the price is too expensive, you may look for medical tourism elsewhere where the surgery is performed routinely. Proper research and consultation should be carried out.


How long does the surgery last?

A: Generally 30-40 minutes.

Is it dangerous?

A: All surgeries include complications. The tracheal shave is not a major surgery but mild side effects like bruising, redness, etc. are to be expected.

What about scarring?

A: The surgeon will always make the incision as less noticeable as possible. After a year, only a white line will be visible.

Will my voice be permanently damaged?

A: If the surgeon is qualified, the chances of permanent damage is virtually zero. Do seek a highly trained doctor specializing in this area.

Does Insurance cover facial feminization surgery?

A: Few clinics accept insurance. It depends on your geographical location and the clinic you are seeking. Research your options.

How long do the results last?

A: The results will be permanent and lifelong.

Can Only Trans-women undergo this surgery?

A: No. In fact, many cisgender women and men seek this surgery according to their aesthetic goal.

How much does it cost?

A: It depends on the country you are seeking. In Thailand, it can cost you anywhere from 850-1300 USD.

Will it affect my facial feminization process?

A: No. It will not compromise.




Save time and energy

For doctors or clinics recommendation, more information on the topic of this article or a free quotation

Subscribe to the Newsletter