What is tracheal shave
Tracheal shave, also known as thyroid cartilage shave, is done as a gender affirming procedure for those seeking a more feminine appearance. This may help to reduce gender dysphoria symptoms, as well as improve overall quality of life for trans-identifying individuals.
Tracheal shave isn't for everyone. Your doctor might caution against surgery if you:
- Have a significant history of voice disorders or prior neck surgery
- Have a severe chronic condition, such as heart disease or diabetes
- Have a large neck circumference or body mass index that's greater than 35
- Are a smoker
What to expect
- Before the procedure you will have a consultation with your surgeon where you will come up with an individualized plan, as well as have a discussion of expectations. Pictures will be obtained from various views for planning as well as comparison following the procedure.
- During the procedure you will be typically be awake, though numbed and slightly sedated. Typically, incisions are under the chin to hide the appearance. Power instrumentation may be used to shave, or remove, portions of the cartilage for a sculpted appearance. The incisions will be closed with sutures and drains may or may not be placed to help avoid blood collecting under the tissues.
- After the procedure it will be important to remain upright as much as possible to help reduce swelling and bruising. You might be instructed to alter your diet to improve comfort and healing. You may be prescribed antibiotics and narcotic pain medication for comfort. Ice therapy will typically be recommended to help reduce swelling.
Results
You can expect immediate improvement of the neck contour following the procedure, however commonly swelling will soon set in and will take a period of time to resolve. Most swelling will be improved in 3-4 weeks, however, do not expect final results for about 1 year after surgery.
Risks of tracheal shave
- Voice changes. The vocal cords attach to the lower aspect of the thyroid cartilage and, in reducing the size, this connection could be inadvertently disrupted. This would result in a deepening of the voice and potential need for further procedures.
- Infection. Though still relatively uncommon, incisions near the airway have a slightly higher infection rate. These can often be managed with appropriate perioperative antibiotics and meticulous technique.
- Failure to achieve desired result. Patients may not notice the improvement they were hoping. Counseling on realistic expectations is imperative prior to undergoing surgery.
- Changes in swallowing. You can expect to have some throat discomfort following the procedure, and potential temporary changes in your swallowing. The vocal cords, and nerves that supply their movement and sensation, are an important barriers in our airway protection during swallowing and maintaining their integrity is important during the procedure.
- Need for additional procedures. If any of the above are noted, it could mean additional procedures or surgeries would be performed for management.
- Swelling/bruising. Significant swelling or bruising is likely to develop after the procedure. Most swelling and bruising are expected to resolve within 3-4 weeks of the procedure.
- Unexpected scarring. The incision scars are hidden as much as possible, though might still be noticeable. The length and visibility of the scar varies from person to person.