The shape of the larynx differs between men and women. In men, the Adam’s apple forms a prominent bulge in the middle of the neck, whereas in women this is typically absent. For transgender women, the Adam’s apple can be surgically reduced to create a smoother, more feminine and aesthetically pleasing neck contour. This procedure is called reduction laryngoplasty (also known as a tracheal shave).
Reduction laryngoplasty does not alter the voice itself but is often performed together with pitch-raising surgery in the same session. In this way, both a more feminine vocal quality and a feminine neck appearance can be achieved simultaneously.
However, it is important to note that this surgery involves operating on the cartilage surrounding the vocal folds. Excessive or poorly performed interventions may cause permanent vocal damage. For this reason, aesthetic laryngeal surgery should only be performed by ENT (ear, nose, and throat) surgeons experienced in laryngeal procedures. Plastic surgeons, although skilled in cosmetic surgery, generally lack the specialized expertise required for safe surgery on the vocal folds and larynx.