Tracheal Shave / Adams Apple Reduction

The Adam’s apple is an obviously masculine trait.

Adam’s apple, in Latin Prominentia laryngea or Pomum Adami, refers to the clearly protruding and palpable section of the thyroid cartilage (cartilago thyroidea) of the men’s larynx at the upper end of the thyroid larynx.

The high pitched or low pitched voices depend on how much the larynx grow during puberty.  By changing the size, the vocal cords are lengthened, become thicker and, as a result, the voice becomes lower. However, the protruding part of the thyroid cartilage is not involved in vocalization.

Adam’s apple reduction or Tracheal Shave is a surgical procedure on a pronounced Adam’s apple and is not intended to change the pitch of the voice.
Shrinking the Adam’s apple is an operation that requires a skin incision. It takes about an hour and is carried out on an outpatient basis under general anesthesia. The first step is to check how much cartilage can be removed from the larynx without damaging the vocal cords. These are located directly under the Adam’s apple. During the operation, it is marked to exactly where the cartilage should be removed.
The surgeon makes a horizontal incision a few centimeters in the neck area, if possible hidden in a skin fold. From there, a small tunnel is created to reach the thyroid cartilage. The thyroid cartilage that forms the Adam’s apple is exposed. Then the vertical muscles in the neck are pushed aside to expose the cartilage. The the surgeon will remove the most prominent part of the notch and the top of the V. The excess cartilage is removed and the Adam’s apple is made smaller.

Reduktion des Adamsapfels

The name Adam’s apple is derived from the biblical story of the „Fall“. Since Adam ate the forbidden fruit, all men have to wear a mark for it.

In addition to the origin of the name from biblical narratives, there is also the explanation that the name comes from Hebrew. The old Hebrew word for “thyroid cartilage” is the same as for “apple”. The name “Adam” stands for “man” in ancient Hebrew.

The healing process after the surgery

As after any operation, there is swelling of the larynx area, which can be treated with decongestant medication and cooling. Bruising and swelling are common and vary from person to person. The swelling usually subsides within 2 to 14 days. The doctor can remove the excess secretion by inserting a thin drainage tube.
Postoperatively, a pressure bandage with light pressure can be applied briefly to reduce the risk of bleeding. After shrinking the Adam’s apple, it is advisable to restrict speaking. The moderate pain can be managed well with mild to moderate pain relievers. The sutures are removed after 7-14 days, depending on the seam technique. Postoperative scar care is important in order to ensure the most inconspicuous scar healing possible. You should avoid hair epilation next to the incision until your surgeon recommends continuing.
Most procedures leave a distinctive red scar initially that should clear up over the next 1 to 3 months. A year after the procedure, you should only see a thin white line.

Further names / Synonyms

  • thyroid cartilage reduction (TCR)

  • chondrolaryngoplasty

Complications

  • Bad cosmetic results / too much or too little demolding and / or uneven contours.

  • Some complain about a permanent change in the quality of the voice. This can include weakness, lowering the pitch, hoarseness, and raising the pitch. The more cartilage that is removed, the greater the risk.

  • You may have temporary skin dimples along the incision.

  • Pain and difficulty swallowing, mostly caused by intubation during general anesthesia rather than the surgery itself.
    Numbness and tightness in the tissues.

The above descriptions are excerpts and do not replace a detailed consultation with the doctor

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