They do Wendler glottoplasty and LAVA. I think it is similar to what Prof Remarcle does in those cases that do not get enough change with glottoplasty alone. However, I find the image of the glottoplasty on their website looks not so great:
It may still work, the thread would dissolve and what happens then would have to be checked by real voice samples of independent patients. I think in a lot of cases where a dissolving thread was used, there is some risk of widening of the commissure (creating an U instead of a V chape). This can lead to incomplete glottal closure and thus "breathiness" in the voice. But it is not a certainty, just a higher risk of it. The LAVA creates some scarring on the outer parts of the vocal folds. this increases tension and reduces mass. There may be some risk of it having negative impact because of the more rigid scar tissue, but since it is far from the active part of the vocal chords, the effects do not necessarily have to affect the voice. I am not very familiar with it though.
I would defeinitely try to find contact to patients first , before considering going there. But Spain is a rather trans friendly country, I can imagine that there is a demand for these surgeries and professionals will evolve from that and gain experience.
Personally I still think that the differences Dr Kim from Yeson describes in his publication between his method and that of other surgeons using the older Wendler Glottoplasty method are not neglible.
