Surgeons develop new technique to reduce Adams apple without neck scar: Gender-affirming procedure could help reduce stigma faced by transgender and nonbinary patients

Doctors at the UCLA Gender Health Program have developed a technique to reduce an Adam’s apple bump without leaving a scar on the patient’s neck.

The advance could be an important and welcome one for transgender women and nonbinary people, for whom a neck scar can be a telltale sign of their surgery — often exposing them to discrimination, hate and violence.

A study by the surgeons who developed the technique was published in the journal Facial Plastic Surgery & Aesthetic Medicine. Reviewing outcomes for 77 people who underwent the surgery at UCLA Health facilities, the authors concluded that the procedure is an effective way to optimize care for people receiving gender-affirming surgery.

Specifically, they found that the procedure — which can be performed in 90 minutes by one surgeon — is effective at removing the Adam’s apple, that it can be performed using only the equipment already available in most surgical suites in addition to a few other inexpensive tools, and that it could be readily adopted by plastic surgeons and throat surgeons.

The procedure is called “scarless” tracheal shave, thanks to the lack of a scar on the patient’s neck, although in actuality, it does create a small, hidden scar on the inside of the patient’s lip. That’s the location through which a surgeon inserts cartilage-trimming forceps and a polishing tool to shave down the extra cartilage that forms the Adam’s apple.

“There will always be a scar with any surgery, but this procedure creates a scar that only a dentist would see,” said Dr. Abie Mendelsohn, associate professor of head and neck surgery at the David Geffen School of Medicine at UCLA, and the study’s senior author. “It represents a massive shift in the ability to provide optimal gender-affirming care for patients.”

Mendelsohn said many transgender people fear going about the activities of daily life due to the threat of being “clocked,” or being identified as a trans person by others, against their wishes.

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