A tracheal shave — medically called a chondrolaryngoplasty — reduces the prominence of the thyroid cartilage (the Adam's apple), one of the most visible external features of laryngeal masculinization. For transgender women and non-binary individuals, reduction of the thyroid cartilage prominence is often a meaningful part of gender-affirming care. Beach Cities ENTS in Torrance performs this procedure for patients throughout the South Bay, including El Segundo, with careful attention to both cosmetic outcome and voice preservation.
What a Tracheal Shave Involves
The procedure contours the front projection of the thyroid cartilage through a small incision placed in a natural skin crease of the neck. Using a surgical instrument, the surgeon removes or shaves down the anterior (front) portion of the cartilage that creates the visible prominence. The result is a flatter neck profile with no visible cartilage protrusion.
The critical anatomic consideration is the attachment of the vocal cords to the inner surface of the thyroid cartilage. The cords attach at the anterior commissure — a point roughly two thirds down the inner surface of the cartilage. Removing too much cartilage above this point risks disrupting the cord attachment, which could permanently alter pitch. An experienced laryngologist identifies the safe margin — often using a light source or scope to locate the anterior commissure — before any cartilage is removed.
What to Expect: Surgery and Recovery
Tracheal shave is performed under general anesthesia as an outpatient procedure — patients go home the same day. The incision is typically 1–2 cm in a horizontal neck crease, chosen to blend naturally into the skin. Surgery takes approximately 45 to 90 minutes. After surgery, the neck is mildly tender and may be slightly swollen for one to two weeks. Swallowing feels slightly altered in the early weeks; this normalizes as swelling resolves. Most patients return to desk work within a few days and to full activity within two to three weeks.
Scar healing depends on individual skin type, sun exposure, and scar care. Direct sun on the incision should be avoided for several months. The scar typically fades well over six to twelve months and is largely hidden in the neck crease. Patients from Torrance and El Segundo receive detailed scar care instructions at Beach Cities ENTS as part of their post-op follow-up.
Combining with Other Gender-Affirming Procedures
Many patients pursuing tracheal shave are also interested in voice feminization surgery (glottoplasty). These procedures can sometimes be combined in a single anesthetic event, reducing the total number of surgeries and recovery periods. Whether to combine or stage them depends on surgical access, airway management considerations, and your specific goals.
At Beach Cities ENTS, we discuss whether a combined approach or staged procedures make more sense for each individual patient during the consultation. There is no single right answer — what matters is that you have the information to make the choice that is right for your timeline and priorities.
Beach Cities ENTS Reviews
Very knowledgeable and personable - She has been seeing our son since he was one year old for ongoing ENT-related issues. She has helped us navigate complicated issues and seems to favor lowest level of intervention medically required, which we prefer. She always seems genuinely happy to see her patients and she is good with him. We will continue to see her only as long as she is practicing.
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Dr. Levine was great. My Son had surgery and he made us feel comfortable and confident throughout the entire process. He even called on a Sunday to see how he was doing. He was professional, caring, and took the time to answer all of our questions. I am in healthcare and am really particular. The office staff was also friendly, welcoming, and efficient, making every visit a pleasant experience. I highly recommend Dr.Levine and his entire team.
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Frequently Asked Questions
Will a tracheal shave affect my voice?
When performed carefully by a surgeon with laryngology training, a tracheal shave should not affect the voice. The risk of voice change comes from removing cartilage too close to the vocal cord attachment at the anterior commissure. An experienced ENT identifies and respects this landmark before any cartilage is contoured. At Beach Cities ENTS, we approach the tracheal shave as a voice-aware procedure — protecting cord attachment is as important as achieving the cosmetic goal.
Where is the incision placed, and what does the scar look like?
The incision is typically made in a horizontal skin crease of the lower neck, just above the thyroid notch. This placement allows the scar to settle into the natural texture of the neck and become much less noticeable over time. Most patients find the scar fades significantly over six to twelve months. Some patients choose a submental (under-chin) approach, which places the scar higher and out of direct view. We discuss scar placement options during your consultation at Beach Cities ENTS based on your anatomy and preference.
How much reduction is typically achievable?
The amount of cartilage that can safely be removed depends on the size of the original projection and the location of the vocal cord attachment. In most patients, a clinically meaningful reduction in profile is achievable. The goal is a neck that does not draw attention to the cartilage — not necessarily a completely flat surface, but one that is gender-ambiguous rather than distinctly masculine. We discuss realistic expectations for your anatomy specifically during the consultation.
Is tracheal shave covered by insurance?
Coverage for tracheal shave varies by insurer. An increasing number of commercial plans and Medi-Cal cover gender-affirming surgical procedures, including chondrolaryngoplasty, when appropriately documented. Our team at Beach Cities ENTS helps patients determine their coverage and navigate prior authorization before committing to a surgical date. Contact our Torrance office to begin the verification process.
What happens if I am unhappy with the result?
If the reduction is insufficient — meaning the cartilage remains more prominent than desired — revision surgery may be possible to remove additional tissue, depending on how much safe margin remains relative to the vocal cord attachment. Revision procedures are approached conservatively. If the scar is the concern, scar revision or treatments such as steroid injections or laser therapy can improve the appearance. We review the realistic range of outcomes — including the limits of what surgery can achieve — during your consultation at Beach Cities ENTS.