What long-term risks / side effects should be considered / could occur?
It is advantageous to choose a surgeon with experience in vocal cord surgery so that the risk of voice deterioration is avoided as much as possible. With experience and the appropriate techniques, this risk can be reduced. It is also important not to have unrealistic expectations about the outcome of the surgery. In some cases, very short vocal folds cannot be loosened further because there is always a risk that the voice will then become unresponsive. An experienced surgeon can describe the expected results to avoid disappointment later.
As with any surgical procedure, there are certain risks associated with anesthesia. When you meet with the anesthesiologists before surgery, they will discuss the risks of anesthesia with you and tell you how your behavior can minimize the risks.
Other possible effects and possible complications:
Voice: Roughness of the voice is not a complication, but is inevitably related to slackening of the vocal folds. Surprisingly, this is exactly the expected and desired new voice that some patients desire. However, it is important to mention this fact because this discrepancy has to do with individual and cultural aspects of the voice perceived as masculine and physiologically healthy voice quality. Other complications and disadvantages may include temporary loss of upper vocal range and even complete or permanent loss of head voice function (so-called falsetto voice), as well as limitation of volume. Strained breathing may also cause an audible harsh breathing sound during breathing with high airflow during forced inhalation and exhalation.
Skin: Suture dehiscence (“suture rupture”) along the incision line, unfavorable healing with a permanently clearly visible scar, accumulation of fluid under the skin (seroma), accumulation of clotted blood in the tissue (hematoma), permanent injury to the skin nerves with sensory disturbances, co-movement of the neck skin during swallowing, increased instability of the larynx with risk of rupture (not only in case of external impact). Sometimes additional surgery is necessary to correct problems or improve the final result. If severe scar shrinkage occurs later as a complication, skin grafting or flap surgery may be required. Dissatisfaction with the appearance after surgery may also be a consequence.
If any of these symptoms occur or you are otherwise unsure, please contact us or another physician, as well as if you experience fever, severe pain at the surgical site, postoperative bleeding, chest pain, shortness of breath, a irregular heartbeat.
When can I resume my normal daily activities after voice deepening?
No voice rest is required and patients can use their new voice shortly after surgery. But it takes several months for the voice to adjust. Non-strenuous activities can be resumed after only a few days. Sports activities can be resumed after two weeks. You should wait a month before lifting weights.
Prospects of success
The aim of the surgery is mainly to lower the speaking voice (pitch) and sometimes to avoid or prevent a high-pitched voice, although this may occasionally occur involuntarily. Thyroplasty type 3 is the most common surgical method for permanent deepening of the voice. Experience has shown that the desired effect is likely to occur several days to weeks after surgery. In the days following surgery, there is a mild, temporary tissue reaction with local swelling, so that the voice heard immediately after surgery does not yet correspond to the final voice. The voice will change over the following weeks as the vocal fold swelling subsides. Further check-ups are therefore necessary. Depending on the circumstances of the surgery, the final assessment may not be made until several months after surgery. Success also depends on the extent of the existing changes and on endogenous, individual factors such as scarring, voice technique or voice use.
The new voice must also be practiced and adapted to the body’s entire vocal system. Due to the slackening of the vocal folds, there is a significant likelihood of a permanently rougher voice. Some patients want to achieve this very vocal feature because they are convinced that this is associated with the perception of a more masculine voice. Very likely, the ability to speak very loudly is also limited. Voice quality continues to improve, and voice pitch becomes more masculine and deeper over a period of 8-12 months. The result of the surgery is irreversible, as the shortening of the cartilage cannot be reversed.