Overview of the surgery:
Adam’s Apple Shaving is a surgical procedure in which the thyroid cartilage is reduced in size by
shaving down the cartilage to achieve a more feminine appearance. The procedure can be done as an
out patient surgery under local anesthesia or under a general anesthesia. The incision is usually 2-3
cm in length. The surgeon makes a horizontal incision at the highest crease of the skin on the throat
below submental (chin) area then the vertical muscles in the throat are separated to expose the
cartilage. The thyroid cartilage is reduced, usually by shaving in the most prominent area and the rim
of its upper border. The thyroid cartilage contouring is a delicate process and need to be done
meticulously especially for those who have calcified (hard) cartilage due to aging process.
The feminization of the Adam’s apple (trachea shave) takes about 1 hour
Care after surgery:
During the first 24- 48 hours, patient may experience some varying degrees of swelling and
temporary mild voice weakness that includes lowering of pitch and hoarseness following
Apply ice pack to the surgical site for a couple of days to gradually decrease swelling. Swelling
will subside over 1-2 weeks and bruising resolves in 1-3 weeks.
Patient must rest voice following surgery. Avoid shouting or singing for 2 weeks after surgery.
The procedure leaves a prominent red scar that lightens over 1-3 months.
Patient will have stitches often supplemented by surgical tape or butterfly bandages for a few
Wound dressing is performed daily. Stitches and tape must be kept dry at all times.
Patient must avoid electrolysis immediately around the incision until surgeon recommends it
Application of antibiotic ointments, vitamin E oil, or other topical preparations is prescribed
by some surgeons to aid healing process.
A piece of gauze will cover the incision for the first 2 or 3 days after Adam’s apple reduction. For about
7 to 10 days you will probably have a burning sensation and some difficulties when swallowing or
talking. Patients who underwent Adam’s apple removal report that the post op sensation is very
similar to a simple sore throat, including a reduction in the ability to speak loudly.
We guarantee quality service and satisfying results of the operation but in cases of surgical
corrections, patient can assure a free of charge revision. Please see before and after photos of Dr.
Tanongsak patients in the Photo Gallery (photographs showed are with patient’s consent).
Risks and complications:
Complications include permanent change in vocal quality which is the result of too much revision or
over dissection of the cartilage that may injure the vocal cords, infection may also occur and
Types of anesthesia use:
Adam’s apple removal is done under general anesthesia, with other procedures of facial feminization
surgery, or alone.
This procedure may be performed in the cosmetic surgeon’s office-based facility, an outpatient
surgery center, or at a hospital. This procedure is usually done on an outpatient basis
Preparation prior to surgery:
Assessment of the medical history (any allergies, serious medical condition and all
medications taken both prescribed and non-prescribed), physical examination, and laboratory
tests will be performed during consultation.
Blood and urine samples will be collected for routine preoperative laboratory tests. X-rays
may be taken to evaluate the individual’s bone structure.
Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with
circulation and will greatly affect healing process.
You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout
your recovery period.
Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and
supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery.
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase
Surgical fees are fully paid prior to your surgery. Costs may vary and depend upon the complexity of
the operation, where the surgery takes place and what anesthetic agent is administered. The payment
can be in the form of US dollars, Euro, Japanese Yen, Singapore Dollars, and Australian Dollars. We
also accept credit card (Visa, MasterCard) for your convenience but we usually charge additional 5%
Booking and reservation:
Booking will be confirmed as soon as you deposit 10% of the total cost for major surgery and 200 US
Dollars for minor surgery. Please send us the copy of your wire transfer receipt. Please inform us your
flight itinerary one week prior to the surgery.
Appointment with the surgeon:
Consultation will be scheduled upon request. We will arrange it once you have already booked
for the surgery.