A prominent Adam's apple is a very masculine feature and, consequently, its reduction is one of the first surgical procedures sought in patient's transitioning from male to female.
The laryngeal shave reduces this most prominent part of the laryngeal cartilage (Adam's apple). Since the trachea has no prominences, but is the “windpipe” below the larynx, this procedure should not be called a “tracheal shave”. It is generally performed through an incision in the anterior neck over the prominence or higher up. The incision site depends on whether concomitant voice surgery is being performed, the size of the prominence, the skin type and the patients wishes. Contrary to what one might initially think, an anterior neck incision placed in a natural skin crease and closed meticulously usually heals with an imperceptible scar. Since the vocal cords attach approximately halfway down the front portion of the laryngeal cartilage, it is only the upper one half of the cartilage that can be reduced. Fortunately, most of the Adam's apple is in the upper one half. However, even in the most obliquely angled prominences, the results of a laryngeal shave are usually quite satisfying. Finally, since most larynges undergo some degree of calcification after puberty, burring of the prominence with an electric bur is the usual approach rather than shaving down with a scalpel blade.
Laryngeal Shave (before & after)
Chin and Jawline
Since a strong chin is considered a masculine trait, in many instances it has to be reduced in either the frontal or the profile view. These techniques usually require drilling bone down or, more commonly, cutting through bone with repositioning and fixation. A strong or defined jawline can actually be considered a desired aesthetic quality and is actually sought after by many modeling agencies. This is true as long as the angles or posterior part of the jawline are not too over-powering or more prominent than the cheeks. If this part of the anatomy is very prominent, a reduction in this area is usually more easily accomplished with Botox injections to reduce the size of the overlying masseter jaw muscle and parotid salivary gland, rather than removing bone. However, that can be done if needed.