I don't want a big scar on my neck that's worse than my adams apple.
Anyone know who does it with minimum scarring?
I think that scar is more think of aftercare than surgeon in this "simple" thing
dr McGinn does the scar on ur chin. i dunno if that'd b better...
How big is the scar after surgery?
Dr. O does it under the chin he is real good at making that nasty apple go away. No matter who you decide on never go for right on your throat the scar is not nice imo. ;)
Hi everybody,
you shouldn't worry too much about having a noticeable scar after the surgery. I've seen quite a lot of tracheal shave results and I've never seen any hideous scar.
A bigger problem is to find a proper ENT surgeon.
I've had Adam's Apple reduction in the middle of 2009. As you can see on the image below which I took just a few days ago, the Apple is still existing though not as prominent and pointy as it was before. When I confronted my surgeon with the final result a few months post-OP, she told me that she didn't want to remove all the redundancy in one session. This I wasn't told before. She said I could undergo another surgery but this would cost about half of the former price again.
I paid about 1500 Euro (approx. $1900).
The surgery was performed in local anesthesia and in Germany (I highly recommend to pay the extra money for general anesthesia, having local is very very uncomfortable, partially painful as well). The surgeon btw was a clinic director who habilitated on speech improvement surgery for mtf-transsexuals.
(https://www.susans.org/proxy.php?request=http%3A%2F%2Ft.imgbox.com%2FaaxHaUhv.jpg&hash=532318d236744ba6f4dee4bab9727526f415c048) (http://imgbox.com/aaxHaUhv)
I'm also searching for surgeons for tracheal shave.
aibeecee mentioned somewhere that Dr. Heino Davids did a good job but he doesn't seem to be at the hospital anymore...
http://www.maerkische-kliniken.de/klinikum-luedenscheid/kliniken-institute/klinik-fuer-hals-nasen-ohrenheilkunde-kopf-und-halschirurgie-plastische-operationen/startseite.html
I have a short list of doctors but I'm leaning towards Thai surgeon called Dr. Greechart at Yanhee Hospital right now for his positive reviews on the surgery and very reasonable cost (around $1,100) vs. others $4,500~
Jeffrey Spiegel
Facial Team (Spain and Brazil)
Bart van de Ven (Belgium)
Heino Davids (mia, Germany)
Greechart Pornsinnsirisak (Bangkok)
Brassard (Montreal)
Noorman van der Dussen (Belgium)
Jordan Deschamps-Braly
All I am aware of is several months afterwards my scar was not at all visible. I did use a scar removal product as I have very fair skin and that worked great. My procedure was done by Marci Bowers at time of GRS.
Another thing to think about is whether you are going for vocal chord surgery or not as this has to be taken into consideration too.
Others more knowledgeable than me, please advise.
Ta
Paula
Thanks, Karen. I will use cream just to be safe. I haven't really hard negative things about tracheal shave other than complications with their vocal chord...
Hi Paula1, vocal chord surgery as in VFS? I don't intend to do that, but would like to know how that might affect in case I decided to do that years later...
Quote from: bunny girl on May 05, 2016, 04:11:48 AM
I'm also searching for surgeons for tracheal shave.
aibeecee mentioned somewhere that Dr. Heino Davids did a good job but he doesn't seem to be at the hospital anymore...
http://www.maerkische-kliniken.de/klinikum-luedenscheid/kliniken-institute/klinik-fuer-hals-nasen-ohrenheilkunde-kopf-und-halschirurgie-plastische-operationen/startseite.html
I have a short list of doctors but I'm leaning towards Thai surgeon called Dr. Greechart at Yanhee Hospital right now for his positive reviews on the surgery and very reasonable cost (around $1,100) vs. others $4,500~
Jeffrey Spiegel
Facial Team (Spain and Brazil)
Bart van de Ven (Belgium)
Heino Davids (mia, Germany)
Greechart Pornsinnsirisak (Bangkok)
Brassard (Montreal)
Noorman van der Dussen (Belgium)
Jordan Deschamps-Braly
The ONLY reason ANY surgeon would do a tracheal shave - - by direct incision over the Adam's Apple - - is because the surgeon is not trained how to do the procedure properly. As a collateral consideration (because tracheal shaves are normally an integral part of FFS surgery) that fact (alone) also suggests that the surgeon is likely not actually trained to do FFS surgery, of any kind.
The proper way to do the procedure is from a small incision under the chin, in an area that is almost impossible to detect during casual face-to-face interaction with other people.
If someone tries to convince you otherwise - - find another surgeon. It is really just that simple.
Yes, it takes a lot more skill. Yes, it takes longer in the operating room to "do it right".
However, anyone that sees the (often very faint, but still present) tell-tale scar over the area where the Adam's Apple is located - - is almost certainly going to figure out why.
Quote from: oneoftwo on May 06, 2016, 06:58:28 PM
The ONLY reason ANY surgeon would do a tracheal shave - - by direct incision over the Adam's Apple - - is because the surgeon is not trained how to do the procedure properly. As a collateral consideration (because tracheal shaves are normally an integral part of FFS surgery) that fact (alone) also suggests that the surgeon is likely not actually trained to do FFS surgery, of any kind.
The proper way to do the procedure is from a small incision under the chin, in an area that is almost impossible to detect during casual face-to-face interaction with other people.
If someone tries to convince you otherwise - - find another surgeon. It is really just that simple.
Yes, it takes a lot more skill. Yes, it takes longer in the operating room to "do it right".
However, anyone that sees the (often very faint, but still present) tell-tale scar over the area where the Adam's Apple is located - - is almost certainly going to figure out why.
I'm scared now... so you get what you pay for. I will ask about the procedures to make sure they do under the chin.
I agree that the better place to have the incision is under the chin as Facial Team and many other surgeons do but the other day I was talking to voice specialist Christella Antoni here in the UK, see: http://www.christellaantoni.co.uk/ and she says that Mr Sandhu at London's Charing Cross Hospital performs VFS (vocal chord surgery) and a tracheal shave via an incision in the crease around the Adam's Apple. She said that if the scar is poor it can always be revised so that it's less visible.
I am still investigating VFS on Susan's, so don't know much about the subject although I had my tracheal shave done in 1989 via an incision in the neck. It does not show as I have a natural crease there fortunately.
Quote from: oneoftwo on May 06, 2016, 06:58:28 PM
The ONLY reason ANY surgeon would do a tracheal shave - - by direct incision over the Adam's Apple - - is because the surgeon is not trained how to do the procedure properly. As a collateral consideration (because tracheal shaves are normally an integral part of FFS surgery) that fact (alone) also suggests that the surgeon is likely not actually trained to do FFS surgery, of any kind.
The proper way to do the procedure is from a small incision under the chin, in an area that is almost impossible to detect during casual face-to-face interaction with other people.
If someone tries to convince you otherwise - - find another surgeon. It is really just that simple.
Yes, it takes a lot more skill. Yes, it takes longer in the operating room to "do it right".
However, anyone that sees the (often very faint, but still present) tell-tale scar over the area where the Adam's Apple is located - - is almost certainly going to figure out why.
Hiya,Quote from: bunny girl on May 06, 2016, 10:06:52 AM
Hi Paula1, vocal chord surgery as in VFS? I don't intend to do that, but would like to know how that might affect in case I decided to do that years later...
Sadly I cannot answer that question as I am still investigating the subject myself, sorry.
Hugs
Paula
Quote from: bunny girl on May 06, 2016, 07:25:37 PM
I'm scared now... so you get what you pay for. I will ask about the procedures to make sure they do under the chin.
Ah... no need to be scared. Just be smart about it !
Most any reconstructive plastic surgeon can do the surgery but may not be able to take it all the way down without damaging the voice. Dr Haben can make your neck flat with CTA and combined with VFS and you will get up to 80 HZ improvement in your pitch. Yeson will not do that type of surgery as he only will do VFS.
Quote from: oneoftwo on May 06, 2016, 06:58:28 PM
The ONLY reason ANY surgeon would do a tracheal shave - - by direct incision over the Adam's Apple - - is because the surgeon is not trained how to do the procedure properly. As a collateral consideration (because tracheal shaves are normally an integral part of FFS surgery) that fact (alone) also suggests that the surgeon is likely not actually trained to do FFS surgery, of any kind.
The proper way to do the procedure is from a small incision under the chin, in an area that is almost impossible to detect during casual face-to-face interaction with other people.
If someone tries to convince you otherwise - - find another surgeon. It is really just that simple.
Yes, it takes a lot more skill. Yes, it takes longer in the operating room to "do it right".
However, anyone that sees the (often very faint, but still present) tell-tale scar over the area where the Adam's Apple is located - - is almost certainly going to figure out why.
I had my tracheal shave done by Dr. Brassard with incision over the Adam's apple. I agree that the scar remains faintly visible even several years after the surgery but also remains well-hidden within the folds so that it seems like just one the natural lines of the neck but slightly darker. If my head remains in the normal position, the scar is not visible, it's only when I move it upwards that you can begin to see it more. I agree, under the chin would have been better but I didn't know better back then and had my SRS also done with him which I'm mostly satisfied with but not entirely.
Despite that scar, and being with thousands of people including with men in intimate situations and friends with many girls, no one ever noticed anything or made a comment which suggests it's barely visible, if at all. No one's ever questioned that I am a woman or done anything to suggest they "know" but chin IS still better, yes.
Thought my feedback in this context would be quite useful. :)
Quote from: Dena on May 06, 2016, 08:32:20 PM
Most any reconstructive plastic surgeon can do the surgery but may not be able to take it all the way down without damaging the voice.
Dr. Brassard did without damaging the voice. Neck is perfectly flat and I started with a prominent Adam's apple.
Quote from: KayXo on May 07, 2016, 02:45:42 PM
I had my tracheal shave done by Dr. Brassard with incision over the Adam's apple. I agree that the scar remains faintly visible even several years after the surgery but also remains well-hidden within the folds so that it seems like just one the natural lines of the neck but slightly darker. If my head remains in the normal position, the scar is not visible, it's only when I move it upwards that you can begin to see it more. I agree, under the chin would have been better but I didn't know better back then and had my SRS also done with him which I'm mostly satisfied with but not entirely.
Despite that scar, and being with thousands of people including with men in intimate situations and friends with many girls, no one ever noticed anything or made a comment which suggests it's barely visible, if at all. No one's ever questioned that I am a woman or done anything to suggest they "know" but chin IS still better, yes.
Thought my feedback in this context would be quite useful. :)
Dr. Brassard did without damaging the voice. Neck is perfectly flat and I started with a prominent Adam's apple.
Hi KayXo,
I was actually considering Brassard. When did you do these surgeries with him? And would you care to elaborate on why you're not completely satisfied with your SRS? Did he offer you a revision?
I've been googling tracheal shave approaches but can't really find any useful info...
What's Bower's approach considered to be? http://marcibowers.com/mtf/mtf-services/tracheal-shave/
Is hers different from Noorman van der Dussen's submental approach?
http://www.noormanvanderdussen.com/feminization/adams-apple-reduction.html
Do the following doctors also perform via submental approach? Should any of these surgeons be avoided?
Spiegel "A small incision is placed on the upper crease of the neck or in a wrinkle in the skin."
Deschamps "A small incision is made behind the first crease under the chin and leaves little visible or obvious scarring."
Facial Team "An incision is made around 2 cm under the chin, if possible, hidden inside a crease below the submental (chin) area."
Yankee Hospital "The surgeon places a small horizontal incision along a natural skin fold in the neck to expose the tracheal cartilage then proceeds to shave down the tracheal convexity"
Kamol's results look like he makes the incision over the Adam's Apple directly.
http://www.kamolhospital.com/en/gallery-MTF/adam-apple-shaving/
Quote from: bunny girl on May 07, 2016, 10:55:26 PM
Hi KayXo,
I was actually considering Brassard. When did you do these surgeries with him? And would you care to elaborate on why you're not completely satisfied with your SRS? Did he offer you a revision?
Surgery in late 2005. Not completely satisfied with SRS as he was unable to fully remove hair and inside vagina is now hairy. Also, I find the inner lips a little too thick to my liking and outer lips are slightly asymmetrical. He tried to remove hair post-op, without much success. I kept the rest as is as I didn't feel it was worthwhile to go through another intervention. Depth could have also have been slightly better (4.5-5 inches) but good enough.
QuoteSpiegel "A small incision is placed on the upper crease of the neck or in a wrinkle in the skin."
Deschamps "A small incision is made behind the first crease under the chin and leaves little visible or obvious scarring."
Facial Team "An incision is made around 2 cm under the chin, if possible, hidden inside a crease below the submental (chin) area."
Yankee Hospital "The surgeon places a small horizontal incision along a natural skin fold in the neck to expose the tracheal cartilage then proceeds to shave down the tracheal convexity"
Wait a minute...isn't 2 cm under the chin or behind the first crease under the chin the same as where my incision was done, just above the adam's apple? I'm getting the impression they all do it the same, in the end.
Quote from: KayXo on May 08, 2016, 03:46:31 PM
Surgery in late 2005. Not completely satisfied with SRS as he was unable to fully remove hair and inside vagina is now hairy. Also, I find the inner lips a little too thick to my liking and outer lips are slightly asymmetrical. He tried to remove hair post-op, without much success. I kept the rest as is as I didn't feel it was worthwhile to go through another intervention. Depth could have also have been slightly better (4.5-5 inches) but good enough.
Wait a minute...isn't 2 cm under the chin or behind the first crease under the chin the same as where my incision was done, just above the adam's apple? I'm getting the impression they all do it the same, in the end.
Thanks for your input! It's a bit concerning that your internal hair didn't fall off after 10 years... some people say that inside the vagina will turn in to mucosa after a while and hair will therefore won't stay there long... maybe estrogen cream will help to turn it into mucosa. Also, I was reviewing a photo of Brassard's work recently and found the innie bit too thick. As for the depth, did you have an enough donor material for the surgery?
Facial Team has a youtube video:　http://facialteam.eu/feminization-of-the-neck/ffs-tracheal-shave-surgery/
By the looks of things, it appears only Facial Team performs this procedure "under the chin." Can't really see Noorman van der Dussen's..
Quote from: bunny girl on May 08, 2016, 06:24:45 PM
It's a bit concerning that your internal hair didn't fall off after 10 years... some people say that inside the vagina will turn in to mucosa after a while and hair will therefore won't stay there long... maybe estrogen cream will help to turn it into mucosa.
I take (and have taken) high doses of estrogen for years which affect the entire body including the vagina. Cream won't make a difference, I think.
QuoteAs for the depth, did you have an enough donor material for the surgery?
He said I did. 4.5-5 inches is normal with Dr. Brassard, some surgeons like Suporn can achieve greater depth due to different technique (?).
Quote from: oneoftwo on May 06, 2016, 06:58:28 PM
The ONLY reason ANY surgeon would do a tracheal shave - - by direct incision over the Adam's Apple - - is because the surgeon is not trained how to do the procedure properly. As a collateral consideration (because tracheal shaves are normally an integral part of FFS surgery) that fact (alone) also suggests that the surgeon is likely not actually trained to do FFS surgery, of any kind.
The more I do my research, your statement has become less credible... no offense but would you care to explain why surgeons who do a tracheal shave directly over the adam's apple are not properly trained to do this procedure? Is this based on empirical study or findings or on what people say?
I've contacted many doctors (incl. ones certified by American Board of Plastic Surgery and members of American Society of Plastic Surgeons) who perform FFS on transgender patients, and more than a few told me that via submental approach is not adequate. So maybe it's just every doctor's preference as to which method they use regardless of their training. Some surgeons seem to prefer the incision under the chin for purely the cosmetic appearance.
Jeffrey Spiegel: from his website; "A small incision is placed on the upper crease of the neck or in a wrinkle in the skin."(actual email replies are all generic, though they take over a week to get back. secretaries/admin in his clinic must be dumb)
Facial Team: slow response. sent in pics for review. "An incision is made around 2 cm under the chin, if possible, hidden inside a crease below the submental (chin) area."
Bart van de Ven: haven't contacted because he charged 50EUR for an online quite
Greechart Pornsinsirisak: "The surgeon places a small horizontal incision along a natural skin fold in the neck to expose the tracheal cartilage then proceeds to shave down the tracheal convexity"
BrassardNoorman van der Dussen: submental approach
Jordan Deschamps-Braly: "A small incision is made behind the first crease under the chin and leaves little visible or obvious scarring."
Mark Filstein: "not via submental" I'm reading between the lines "
directly around the adam's apple"
Marc DuPere: "The incision for the tracheal shave is under the chin."
Robert Shenker: maybe doesn't do tracheal shave
Tom Pousti: maybe doesn't do tracheal shave
Alexander SinclairJoel Beck: "Creates a small incision beneath your chin or right above the Adam's apple."
Preecha: "A small, horizontal incision is made on the bottom of the Adam's apple."
Vartan Mardirossian: "Making a small incision at the upper crease of the neck, just below the chin."
Harrison Lee: "incision under the chin"
Incision should be between 1-2cm placed in a skin crease under the chin not directly over the adam's apple. Most of the time, the incision heals great and almost invisible after healing.
Also, in my opinion, the safest and most complete way to reduce the prominent Adam's apple is to perform it with visualization of the vocal cords and its attachment to the thyroid cartilage. Under general anesthesia and using a laryngeal mask airway, a bronchoscope is placed with visualization of the vocal folds and the surgeon once over the Adam's apple, marks with a needle the anterior commissure of the vocal folds. All the cartilage above the vocal fold attachment can be safely removed. Without this visualization with the bronchoscope, it is all guess work on how much you can remove. Shaving or removing cartilage at or below the anterior commissure vocal fold attachment will cause hoarseness and destabilizes the voice box.
Quote from: keojampamd on May 23, 2016, 01:03:33 AM
Incision should be between 1-2cm placed in a skin crease under the chin not directly over the adam's apple. Most of the time, the incision heals great and almost invisible after healing.
Also, in my opinion, the safest and most complete way to reduce the prominent Adam's apple is to perform it with visualization of the vocal cords and its attachment to the thyroid cartilage. Under general anesthesia and using a laryngeal mask airway, a bronchoscope is placed with visualization of the vocal folds and the surgeon once over the Adam's apple, marks with a needle the anterior commissure of the vocal folds. All the cartilage above the vocal fold attachment can be safely removed. Without this visualization with the bronchoscope, it is all guess work on how much you can remove. Shaving or removing cartilage at or below the anterior commissure vocal fold attachment will cause hoarseness and destabilizes the voice box.
I don't have a skin crease under the chin lol and wow, you seem so knowledgeable about medical equipments!
I did extensive research on surgeons worldwide about this procedure and came to a conclusion that even board certified ones sometimes place the incision right over the adam's apple, saying that that's the most effective way :o
Also I realized that it would be cost efficient to have this surgery with SRS, FFS or BA because a standalone procedure doesn't justify the cost of anesthesia in my opinion. (breakdown of Facial Team cost for example, 2,350EUR for the surgery and related expenses + general anesthesia 2,100EUR). Top of the price range today is US$7K vs $4.5K (Deschamps and Lee) a few years ago. Mid range is $4K.
Although I'm someone who tends to choose the most expensive option (if that means the best), right now I'm inclined to go with a Thai surgeon (Greechart) for this surgery. I've seen results of well-known surgeons and compare them to Greechart's but honestly couldn't see any difference. Also, patients of these well-known surgeons don't seem completely satisfied with their results, though they look fine to me. So far I only hear good things about Greechart's tracheal shave (incision in the neck away from adam's apple, inconspicuous scar and flat neck, not to mention it's only $1K) but please let me know if you hear disconcerting things about his tracheal shave. I read negative reviews about him but they were about BA and other surgeries. My second choice is either Facial Team or Noorman van der Dussen.
Has anyone seen results of Noorman van der Dussen and Facial Team (other than the one on their website) or underwent the surgery with either of them? No info on tracheal shave by Noorman is available online in English....
Actually I don't really care for Facial Team anymore. Their website/video are very misleading or rather spread misinformation about the procedure. For those of you thinking about tracheal shave as a standalone procedure under local anesthesia, even though their website says it can be done, they won't @ Facial Team.