A tracheal shave, properly called chondrolaryngoplasty, reduces the forward projection of the thyroid cartilage in the neck. The prominent upper edge is shaved down through a small incision so the neck reads as smooth in profile.
It is one of the shorter and more contained procedures in transfeminine surgery, but it addresses something that cannot be hidden, dressed around or changed by hormones — and that many patients find is the feature most noticed in conversation.
How much does a tracheal shave cost in 2026?
Typical market ranges for surgeon, anaesthesia and facility fees. Indicative figures, not quotes.
| Country | Typical range | Approx. in EUR |
|---|---|---|
| United States | $7,500 – $14,000 | €7,000 – €13,000 |
| Canada | C$9,500 – C$17,500 | €6,500 – €12,000 |
| United Kingdom | £5,000 – £9,500 | €6,000 – €11,000 |
| Turkey (Hetzner Health partner surgeons) | €1,500 – €2,800 | €1,500 – €2,800 |
| Usually included | Usually extra |
|---|---|
| Surgeon’s fee and surgical team | Flights to and from Turkey |
| General anaesthesia or sedation | Hotel nights beyond the planned stay |
| Day-case theatre | Voice feminization surgery, if added |
| Endoscopic assessment of the vocal cords | Facial procedures, if combined |
| Pre-operative assessment and blood tests | Scar treatment products after the first months |
| Dressings and post-operative medication | Travel insurance |
| Suture removal and wound check | Revision surgery, if it is ever needed |
About these figures: indicative ranges for budgeting, not an offer. See our Medical Disclaimer.
What is a tracheal shave?
The “Adam’s apple” is the front angle of the thyroid cartilage — the largest cartilage of the voice box. During a testosterone-driven puberty this cartilage enlarges and its front angle becomes sharper, which both deepens the voice and creates the visible prominence.
Surgery reduces the part of that prominence sitting above the level where the vocal cords attach inside. The cords themselves, and the structural integrity of the voice box, are left intact.
| Feature | Before | After |
|---|---|---|
| Neck profile | Angular, with a defined forward bump | Smooth, gently curved |
| Cartilage shape | Sharp anterior angle | Rounded upper edge |
| Visibility when swallowing | The bump rises and falls prominently | Movement much less noticeable |
| Vocal cords | Unchanged | Unchanged |
| Voice pitch | Unchanged | Unchanged |
| Neck skin | Unchanged | One fine horizontal scar |
What it does not do is change your voice. Pitch comes from the length and mass of the vocal cords, not from the outside of the cartilage. If your voice is the concern, see voice feminization surgery, which is a different operation on a different structure.
How is the safe limit decided?
This is the technical heart of the procedure. Inside the thyroid cartilage, the vocal cords attach at a point called the anterior commissure. Everything above it can be reduced; cutting at or below it risks the voice permanently.
| Method | What it contributes |
|---|---|
| External palpation and landmarks | A first approximation, but anatomy varies between individuals |
| Endoscopic visualisation during surgery | A camera passed through the mouth shows the commissure directly from inside |
| Needle localisation | A fine needle passed through the cartilage marks the internal level externally |
| Awake technique under sedation | You speak during surgery so the surgeon hears voice quality in real time |
| Conservative removal | Leaving a margin above the commissure, accepting slight under-correction over voice risk |
Ask which of these your surgeon uses. A tracheal shave performed on external landmarks alone is how the small number of permanent voice complications happen.
Who is a good candidate?
| You are likely suitable if | Why it matters |
|---|---|
| You have a visible cartilage prominence in profile | This is precisely what the procedure reduces |
| Your voice is healthy and unproblematic, or is being treated separately | Voice surgery sequencing should be settled first |
| You are in good general health | It is a short general anaesthetic or sedation |
| You do not smoke, or will stop 4 weeks either side | Nicotine impairs healing and worsens neck scars |
| You accept a small permanent neck scar | It is discreet, but the neck scars visibly in some people |
| You can stay in Turkey 6–8 days | Sutures come out on day 5–7 |
When should surgery be postponed or avoided?
- Planned voice feminization surgery that has not been scheduled — the sequencing matters and operating twice on the same cartilage complicates the second procedure.
- Professional voice use — singers, actors, broadcasters and teachers should weigh the small voice risk carefully and have a laryngology assessment first.
- Existing voice problems that have not been assessed by an ENT specialist or laryngologist.
- A history of keloid scarring, since the neck is a common site for thickened scars.
- Thyroid disease with an enlarged gland or nodules, which needs assessment before operating in this area.
- Previous neck surgery or radiotherapy, which alters the tissue planes.
- Ongoing nicotine use, including vapes and patches.
What preparation is needed?
| When | What happens |
|---|---|
| At enquiry | Photographs of the neck in profile, head neutral and slightly extended |
| At planning | Examination of cartilage prominence, voice assessment, decision on sequencing with any voice surgery |
| Before travel | ENT or laryngology review if you have any voice concerns |
| 4+ weeks before | Stop smoking, vaping and all nicotine |
| 2 weeks before | Pause aspirin, anti-inflammatories, fish oil, vitamin E and ginkgo unless advised otherwise |
| 1–4 weeks before | Pause or adjust oestrogen if your surgeon requests it |
| On arrival in Turkey | Bloods, anaesthetic review, incision marked with you sitting upright |
Ask for the incision to be marked with you sitting up and the head in a neutral position. A line marked with the neck extended on the operating table can end up in the wrong crease.
How is the procedure performed?
- The incision is marked in a natural horizontal crease, usually above the level of the bump so the scar falls into shadow under the chin.
- General anaesthesia or sedation is given; the procedure takes 45 to 90 minutes.
- A 2–3 cm incision is made and the strap muscles separated in the midline, without cutting them.
- The thyroid cartilage is exposed and the prominent upper front edge identified.
- The safe limit is established — by endoscopy, needle localisation or both — marking how far down reduction may go.
- The cartilage is shaved with a scalpel or burr, contouring rather than flattening, and checked repeatedly against the skin surface.
- Symmetry and profile are assessed with the neck in a neutral position before closure.
- The muscles are re-approximated and the skin closed with fine sutures, often with a small drain for the first day.
What does recovery look like?
| Time | What to expect |
|---|---|
| Days 1–2 | Neck swelling and tightness; mild difficulty swallowing; voice may be hoarse from the breathing tube |
| Days 3–4 | Swelling peaks then eases; bruising possible across the front of the neck |
| Day 5–7 | Sutures removed; swallowing comfortable |
| Days 7–10 | Back to work; normal quiet voice use |
| Weeks 2–3 | Voice fully back to baseline in most patients; swelling largely gone |
| Weeks 4–8 | Scar pink but flattening; final contour visible |
| Months 6–12 | Scar matures and pales |
Aftercare:
- Reduced voice use for one to two weeks — quiet speech is fine, shouting and singing are not, and whispering is worse than speaking softly.
- Sleep with your head elevated for the first week.
- Avoid extending the neck backwards sharply for two weeks; it puts tension directly on the scar.
- No strenuous exercise for two to three weeks.
- Silicone gel or tape on the scar from around three weeks, once the surgeon approves.
- Strict sun protection on the neck scar for a full year — this area darkens easily and permanently.
What are the risks and possible complications?
- Temporary hoarseness or vocal fatigue, common for one to three weeks
- Permanent change in voice pitch or quality — uncommon, and the reason for careful identification of the vocal cord attachment
- A visible, widened or thickened neck scar; keloid formation in susceptible patients
- Under-correction, leaving a residual bump
- Over-resection, causing a hollow or a notched contour
- Difficulty or discomfort swallowing for the first days
- Bleeding or haematoma in the neck, uncommon but requiring urgent attention because of the airway
- Infection, uncommon
- Numbness of the skin above the scar, usually temporary
- Airway swelling, rare but a reason for overnight observation in some cases
- Anaesthetic risks common to general anaesthesia or sedation
This list is not exhaustive. Seek emergency care immediately for difficulty breathing, rapidly expanding neck swelling, or a sudden and marked change in your voice. Your individual risks belong in a documented consent discussion with the operating surgeon.
Can it be combined with other procedures?
| Combined with | Why it is often done together |
|---|---|
| Voice feminization surgery | Same cartilage; doing both in one operation avoids operating on it twice |
| Facial feminization surgery | Different site, short procedure, minimal added recovery |
| Jaw or chin work | Adjacent region; the jaw and neck contour are read together |
| Top surgery | Different site, easily combined in one anaesthetic |
| Neck liposuction | Improves the overall neck profile where there is fullness under the chin |
What results can you expect?
A smooth neck in profile and much less movement visible when you swallow. The change is localised and unambiguous — this is one of the few procedures where patients generally know immediately whether it worked.
It will not raise your voice, tighten neck skin or change your jawline. And a small scar is traded for the bump, which is a deal most patients consider straightforward but should be a conscious one.
On before-and-after photographs: each reflects that patient’s cartilage anatomy, how much lay above the safe limit, and how their skin scarred. They record one outcome, not a prediction.
How Hetzner Health arranges the process
- Online assessment — profile photographs of the neck and your voice history reviewed by a partner surgeon.
- Sequencing advice — whether voice surgery should come first, be combined, or is not part of your plan.
- Written plan and quote — technique, how the safe limit will be identified, inclusions listed.
- Travel — you book flights; we arrange hotel, transfers and an interpreter.
- Pre-operative day — bloods, anaesthetic review, incision marked with you sitting upright and the neck neutral.
- Surgery — day case, coordinator reachable throughout.
- Day 5–7 — sutures out, wound check, written scar-care and voice-rest instructions.
- After you are home — remote review at 1, 3, 6 and 12 months, including a scar assessment at three months.
Before you decide: this page is general information and does not replace an examination. How much cartilage can be safely reduced depends on where your vocal cords attach inside it, which can only be established by examination and, during surgery, by direct visualisation.