Glottoplasty (Vocal Fold Webbing) for voice feminization

Although a female voice is not only an octave apart from a male voice, the mainstay of feminization laryngoplasty for pitch raising surgery is glottoplasty.
The surgical techniques of a  glottoplasty is optimizezed bei surgeons like Wendler, Kim, Hess and other phonosurgeons.

The main objectiv of a vocal feminization surgery (Glottoplasty) is to increase the fundamental tone by tensing, shortening and / or thinning the vocal folds always in a symmetrical manner.
The surgery is designed to raise the comfortable speaking pitch by shortening the vibrating length of the vocal cords and increase in the vibration frequency of the vocal folds. It will also remove some of the lower pitches.

Nähte bei der Stimmfeminisierung (Glottoplastik)
Nähte der Glottoplastik MEDICAL VOICE CENTER

The front third of the delicate vocal folds, which is only a few millimeters long, is gently thinned out with the finest microsurgical instruments and permanently sewn together with a hair-thin, resistant thread.


Under general anesthesia, a metal tube (laryngoscope) is placed through the mouth to lift the tongue out of the way and visualize the vocal cords directly. Using a microscope, the lining of the vibrating portion of the vocal cords is removed from the front half of the vocal cords. The vocal folds are surgically shortened by anterior suturing and subsequent permanent union, so that a higher fundamental frequency is enforced in the posterior remaining, oscillating segment. An additional combination with anterior-lateral augmentation, btx injection and thinning of the inferior vocal folds may be useful.

Because in gender recognition our ear also responds to the resonance spectrum in the vocal tract (‚timbre‘) , the surgical suppression of the supraglottic resonance chambers usually provides an additional supportive effect of voice feminization. The surgery is performed under general anesthesia and through the mouth. Consequently, there is no external incision.  The whole procedure can be done in about 1 1/2 hour and the patient is able to go home the same day.

After a voice feminization surgery an active voice therapy Trans*Voice-Therapy is highly recommended.