Tracheal Shave Recovery
If you’re considering a tracheal shave, also known as a chondrolaryngoplasty or Adam’s apple reduction, one of your top questions might be, “What is tracheal shave recovery like?” As a facial plastic surgeon, I perform this surgery often, especially for patients looking to reduce the prominence of their Adam’s apple and achieve a smoother, more feminine neckline. Here, I’ll cover what to expect in the days, weeks, and months following a tracheal shave, so you can feel informed and prepared.
What is a Tracheal Shave?
A tracheal shave is a surgical procedure that reduces the size of the thyroid cartilage, also known as the Adam’s apple. In addition to helping people achieve their desired aesthetic, it can be a gender-affirming surgery for transgender women. During the procedure, a small incision is made in the neck, and using specialized tools, I carefully shave down the cartilage to create a smoother neck contour.
To protect your vocal cords, I use a laryngoscope (a small camera inserted through the mouth) during surgery. This approach minimizes the risk of damaging the vocal cords and reduces the likelihood of permanent voice changes. Permanent changes in voice pitch after a tracheal shave are rare, though some temporary hoarseness is common as you heal.
Immediate Recovery: The First 48 Hours
In the first couple of days after surgery, you can expect some soreness and swelling in the throat area. Much of this is due to the breathing tube used during surgery, which can irritate the throat, as well as swelling around the voice box itself.
Here’s a closer look at what to expect:
- Throat Soreness: Right after surgery, it’s normal for your throat to feel tender and a little swollen. Many patients compare this feeling to a sore throat, but it usually starts to improve after the first 24–48 hours.
- Voice Hoarseness: Some voice hoarseness is also typical. This occurs as the muscles around the voice box experience mild swelling and adapt to the changes. For most people, hoarseness only lasts a few days to a week, after which their voice returns to normal. By taking care of your voice (avoiding loud talking or yelling) and staying hydrated, you can support quicker recovery.
One Week After Surgery: Managing Hoarseness and Swelling
By the end of the first week, most patients find their sore throat has eased, and their voice is starting to sound more like itself. While some minor hoarseness may still be present, it tends to resolve gradually over the next few days.
It’s during this period that any external bruising or swelling from the surgery starts to diminish. Most patients feel comfortable resuming daily activities within a week, though it’s important to follow my guidance on activity restrictions, such as avoiding heavy lifting or intense exercise, to avoid straining the neck muscles. The photo below shows how things look after one week. A skin glue called dermabond is used to cover the incision. At this point, it is ok to start using moisturizer to help the glue come off.
Scar Care for the Incision
The incision for a tracheal shave is usually very small, made just under the chin or along the natural creases of the neck. This placement helps hide the scar once it’s healed. However, like any incision, it requires some care to heal optimally and remain as inconspicuous as possible. Here’s how I recommend caring for your incision:
- Silicone Gel with Sunscreen: I usually advise my patients to use a silicone gel with sunscreen, like Silagen, on the incision once it’s fully closed. Silicone gels help minimize scarring and promote smooth healing. Sunscreen is essential to prevent pigmentation changes, as UV exposure can cause scars to darken or thicken.
- Avoid Stretching: While it can be tempting to look down or bend the neck frequently, it’s best to avoid stretching the incision area, especially in the early days after surgery. Gentle movement is fine, but too much stretching can increase the likelihood of scar thickening.
- Follow-Up for Any Scar Issues: While most tracheal shave scars heal beautifully, sometimes patients may notice a small amount of thickening or redness at the site. If this occurs, a steroid injection can help minimize scar tissue formation. This is rarely needed but can be effective for patients with naturally thicker or keloid-prone skin.
Voice Considerations During the First Few Months
One aspect of tracheal shave recovery that’s worth considering, especially for professional speakers, singers, or anyone who uses their voice intensely, is the way the muscles around the voice box may feel post-surgery. Tightness in these muscles can subtly affect pitch and tone, though for most people, the changes are minor and temporary.
- Tightness Around the Voice Box: It’s common to feel some tightness around the voice box for several months after a tracheal shave. For the average patient, this is a mild sensation that doesn’t interfere with daily speech. However, if you’re a singer or someone who relies on a specific vocal range, you may find that pitch control feels slightly different until the tightness subsides.
- Temporary Pitch Variations: Some patients may notice a minor change in pitch or tone that resolves as the muscles around the voice box relax over time. If this is a concern, we can discuss strategies for optimizing voice health, including staying hydrated and avoiding strain, especially during the early months.
Months 3-6: Final Results and Feeling Like Yourself Again
By the three-month mark, most patients feel fully healed and have resumed all their usual activities. At this stage, swelling around the incision and voice box has almost entirely resolved. The scar should be fading and blending into the natural skin tone. You’ll likely feel that your neck looks smoother and that your voice feels completely normal. For patients who were concerned about pitch or tone in the early months, this is when things generally feel back to baseline.
Tips for a Smooth Tracheal Shave Recovery
- Hydrate: Drinking plenty of water supports healing, reduces throat irritation, and promotes optimal vocal health.
- Use a Humidifier: Especially in the first few days after surgery, using a humidifier can keep the throat and vocal cords from drying out, helping to reduce irritation.
- Limit Strain on the Voice: Avoid yelling, singing, or any other activity that may strain the voice during the initial healing period.
- Stay Out of the Sun: This applies particularly to the incision area. Exposure to UV light can lead to pigmentation changes, making scars more noticeable. A high SPF sunscreen, preferably one designed for scars, is your best line of defense if you have to be outside.
- Gentle Neck Exercises (if advised): Once I’ve cleared you for stretching, gentle neck exercises can improve mobility and relieve any lingering tightness in the area.
Rare Complications to Be Aware Of
While tracheal shaves are generally safe procedures, like any surgery, they do carry a few potential risks:
- Scar Thickening or Keloid Formation: Some people are more prone to keloid or hypertrophic (raised) scars, which can appear thicker or redder. While these are uncommon, patients with a known history of thick scars may wish to discuss this with me during their consultation. Steroid injections can help minimize these types of scars if they occur.
- Persistent Voice Changes: Permanent voice changes are extremely rare, particularly when a laryngoscope is used to monitor the vocal cords during surgery. If there are any minor voice changes, they’re usually temporary and resolve as healing progresses.
- Prolonged Swelling or Numbness: Some patients may experience prolonged swelling or numbness in the neck area, although this too is rare. If swelling persists, I can recommend specific treatments to help bring it down.
Final Thoughts on Tracheal Shave Recovery
Tracheal shave recovery is typically smooth, with most patients resuming daily activities and feeling back to normal within weeks. The mild soreness, tightness, and possible hoarseness are generally short-lived, and with proper scar care, the incision heals very discreetly. Most patients are delighted with their results, finding that the procedure subtly enhances their appearance and confidence.
If you’re considering a tracheal shave and have more questions about the recovery process, I encourage you to reach out for a consultation. I’ll be happy to guide you through each step of the procedure and help you plan for a smooth, comfortable recovery.
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