Transoral Tracheal Shave Seattle

The Adam’s apple is a defining feature of the neck that can impact how others perceive a person’s gender. Both male and female people have cartilage just above the thyroid gland that helps protect the more sensitive vocal cords and bony structures. However, in people assigned male at birth, more cartilage is present, which causes a traditionally male neck to have a noticed lump. In comparison, the cartilage in a person assigned male at birth’s neck is generally not overly visible. For transgender women and gender non-conforming people, the Adam’s apple can be a source of gender dysphoria. Dr. Javad Sajan is a leading plastic surgeon in Seattle who introduced the scarless tracheal shave procedure to the Pacific Northwest. He performs the best transoral tracheal shave Seattle provides.

A tracheal shave surgery—more formally called a chondrolaryngoplasty—is primarily performed as gender affirming procedure for transgender women. It helps create a more feminine facial and neck contour. It achieves this by shaving down the cartilage of the Adam’s apple using a high-speed microsurgical drill and an ultrasonic piezo drill so that it is not as prominent. People assigned female at birth, non-binary, and gender non-conforming people also sometimes undergo tracheal shave surgery.

The procedure is frequently a part of facial feminization procedures. Dr. Javad Sajan at Allure Esthetic Plastic Surgery is Seattle’s top expert in facial feminization and tracheal shave surgery. He uses a new technique called transoral tracheal shave for surgery that removes the need for external scarring.

With any tracheal shave surgery, many patients may find themselves feeling hesitant due to the sensitive anatomy of the neck. Voice changes are among one of the biggest concerns. This is why traditional tracheal shave surgery cuts directly over the location of the Adam’s apple, leaving an external scar.

Labeled on the photo as “thyroid cartilage,” the Adam’s apple lays just in front of the trachea and just below the skin. Thus, it does not require much recession to reach the cartilage. Sensitive structures like the trachea, vocal cords, or thyroid lay far behind or well away from the Adam’s apple.

The new transoral method takes advantage of the neck’s anatomy. It creates a tunnel through the mouth to reach the Adam’s apple cartilage without external incisions or scarring. It also poses little risk to nearby structures because of the use of endoscopy to promote a high level of accuracy.

All surgical procedures come with some degree of risk. Most patients who undergo transoral tracheal shave may not experience major complications. Possible risks of a scarless tracheal shave include:

• Complications of general anesthesia
• Damage to the vocal cords
• Nerve damage
• Inability to complete surgery through an intraoral incision
• Infection
• Prolonged or severe side effects
• Asymmetry

Compared to the traditional technique, there is no additional risk with the transoral incision. Both have a low chance of damaging the vocal cords as long as proper techniques are used.

Yes, a similar or the same incision inside the mouth is already used for other procedures performed during facial feminization surgery. For example, jawline and chin feminization use nearly identical incisions. Buccal fat removal uses slightly different incisions inside the mouth. They are close by and the two procedures could easily be performed together.

One difference between the traditional and scarless tracheal shave is that the transoral technique does require a slightly different and longer recovery protocol than a traditional tracheal shave. If a patient undergoes a facial feminization at the same time, their recovery instructions will differ. A scarless tracheal shave recovery may include:

• A liquid diet for about three to four days
• Icing the neck and face to reduce swelling
• Take it easy for one to two weeks, including one week off work
• Voice rest for one week
• Avoid pressure to the area
• Do not partake in strenuous activities until okayed by Dr. Sajan
• Give the body time to recover and do not judge the results right away

Most healthy trans women or others experiencing gender dysphoria related to their Adam’s apple are likely good candidates for a transoral tracheal shave. Patients will still discuss their entire medical history with Dr. Sajan. While rare, people who may not qualify or who may require a specialized plan for a transoral tracheal shave include:

• Anyone pregnant or actively trying to conceive
• If taking hormones, patients may need to adjust their dosages temporarily
• Patients with previous transoral surgery
• Any patient with certain blood disorders, undergoing cancer treatment, or untreated/unmanaged major medical conditions
• Patients unable to provide fully informed consent
• Some voice or vocal cord disorders

For the most part, there are relatively few situations where a trans woman or patient seeking a scarless tracheal shave would not qualify. Sometimes Dr. Sajan may determine the traditional method is preferred due to certain anatomical features or other factors.

Tranoral tracheal shave surgery starts at $14,995. This is the out-of-pocket cost. Patients using insurance often only pay their deductible, but this will vary based on the plan. Patients can also visit our price list and Price Simulator to get an idea of how much the procedures they want may be. Financing is available through outside financing companies including Care Credit.

Dr. Javad Sajan of Allure Esthetic Plastic Surgery has performed hundreds of gender affirming surgeries. As a local leader in both plastic surgery and gender affirming surgery, Dr. Sajan attended an exclusive conference that demonstrated the newest surgical techniques in facial feminization. Allure Esthetic and Dr. Sajan are among the first to offer transoral—or scarless—tracheal shaves in Washington State. Dr. Javad Sajan performs the best scarless tracheal shave Seattle offers.

Allure Esthetic is designed to offer optimal gender affirming care. The entire time understands how daunting and vulnerable seeking gender affirming care can feel. With a team that works with the trans community often and has dedicated themselves to providing a comfortable and safe environment for our trans patients.

To learn more and schedule an appointment, call 206-209-0988. Patients can also reach out online via chat, contact form, online booking, or Price Simulator.