Thyroplasty or Adam’s apple reduction

One of the most popular operations requested by women with gender dysphoria, after vaginoplasty and breast enlargement, is reduction of the Adam’s apple through a thyroplasty operation. The prominence of this cartilage is characteristic of biological males, so in cases of exceptional prominence it is advisable to undertake this operation before embarking on real-life experience so as to adapt better.

What is thyroplasty or surgery on the Adam’s apple?

In biological males, the thyroid cartilage (colloquially known as the Adam’s apple) is much more prominent and visible than in women.

Surgery to reduce the Adam’s apple basically consists of reducing and shaping this cartilage so as to aesthetically resemble that of biological females.

The operation

The preparations

During the initial consultation, your surgeon will study the volume and prominence of your thyroid cartilage. He will make an assessment based on the factors that play a part in the operation and its results. Your surgeon will ask you about your medical history and advise on procedures to follow before the operation.

If you have any doubts, this is the moment to ask them. It is important to trust and accept advice from your surgeon.

The operation

Though the choice of anaesthetic type will depend on the surgeon’s assessment in consultation with their medical team, Adam’s apple reduction is performed, in most cases, under local anaesthesia with sedation, and the operation lasts about an hour. After the operation, the patient remains in hospital for several hours and can return home the same day.

The technique consists of making an incision in the most prominent area of the neck approximately two or three centimetres long, aligning with a wrinkle or natural fold in the skin so that the resulting scar is practically imperceptible. Afterwards, the surgeon will reduce the cartilage minutely and carefully so as not to affect the vocal cords.

The patient must demand that the operation is conducted in a hospital centre by an expert surgeon with every surgical and medical guarantee on hand, since there is a risk of over-correction of the cartilage, which could cause damage to a vocal cord, leading to permanent vocal dysfunction.


After the operation, the patient may experience a certain discomfort or swelling over the ensuing 24–48 hours. Your surgeon will advise you on suitable medication to reduce this as far as possible.

During the early days post-op, some patients may notice a lowering of their tone of voice, accentuated to a greater or lesser degree, but this is always transitory.

The results

The results can be seen immediately, though they will become more obvious as the swelling disappears.