How Surgeons Minimize Scarring and Voice Changes During a Tracheal Shave

For patients considering a tracheal shave, concerns often center on visible scarring and potential voice changes. These fears are understandable. The neck is a highly visible area, and the vocal cords are essential not only for speech but also for identity, confidence, and daily function.

A tracheal shave, medically referred to as chondrolaryngoplasty, requires a high level of knowledge and surgical judgment. At Modern Surgical Arts of Denver, Dr. Kamran Dastoury approaches tracheal shave surgery with a strong emphasis on accuracy and functional preservation, not just cosmetic improvement.

Why Tracheal Shave Safety Depends on Anatomy

The thyroid cartilage sits directly in front of the larynx and protects the vocal cords. The vocal cords attach to the cartilage at a specific point called the anterior commissure. This attachment plays a critical role in voice pitch, strength, and stability.

If cartilage is removed too aggressively or too close to the attachment point, the vocal cords’ structural support can be compromised. This is why reports of voice change are typically linked to over-resection, not the procedure itself. Understanding this anatomy and respecting its limits is essential for safe results.

Incision Placement and Scar Visibility

Minimizing scarring starts with thoughtful incision placement. There is no single “best” incision for every patient; the correct approach depends on anatomy, skin type, and cosmetic goals.

One commonly used option is a submental incision, placed beneath the chin in a natural shadow. This location helps conceal the scar once healed and is often preferred when scar visibility is a top concern.

Another option is a direct neck incision, placed within a natural crease of the cervicomental fold. When properly planned and meticulously closed, scars in this area typically fade well and are difficult to detect over time. Some surgeons also offer transoral (intraoral) approaches, which avoid an external neck scar entirely. This technique requires advanced anatomical expertise and is not universally appropriate.

How Surgeons Protect the Voice During a Tracheal Shave

Voice preservation depends less on how much cartilage is removed and more on where and how it is reduced. Experienced surgeons limit cartilage removal to areas above the anterior commissure, preserving the structures that support vocal cord tension. Instead of aggressive removal, cartilage is gradually contoured in controlled layers to achieve a smoother profile while maintaining laryngeal stability. Temporary hoarseness after surgery is common and usually caused by swelling. This typically resolves within weeks. Permanent voice changes are uncommon when anatomical boundaries are respected.

What Can Go Wrong, And How It’s Prevented

Potential risks include visible scarring and voice changes, though both are uncommon when proper technique is used. Scar concerns may arise from incision placement, wound tension, or individual healing tendencies. Postoperative scar care, such as silicone therapy and sun protection, plays a vital role in optimizing results. Voice complications are rare and are most often associated with excessive removal of cartilage near the vocal cord attachments. Conservative reduction and anatomical mapping significantly reduce this risk.

Why Surgeon Experience Matters

A tracheal shave is not simply cosmetic contouring. It requires detailed knowledge of laryngeal anatomy, sound surgical judgment, and experience working near voice-critical structures. Surgeons with extensive experience are better equipped to balance aesthetic goals with functional safety, especially for patients who rely heavily on their voice.

At Modern Surgical Arts of Denver, Dr. Kamran Dastoury approaches tracheal shave surgery as a precision procedure, not a one-size-fits-all solution. By carefully selecting incision placement, respecting vocal cord anatomy, and prioritizing conservative cartilage reduction, he works to minimize both visible scarring and voice-related risks.

Schedule a Consultation

A private consultation with Dr. Kamran Dastoury at Modern Surgical Arts of Denver allows you to discuss your goals, review your anatomy, and learn how surgical planning can help minimize scarring while protecting your voice. Schedule a consultation by completing our online contact form to learn whether this is the right procedure for you.

References

• Thyroid cartilage anatomy: https://en.wikipedia.org/wiki/Thyroid_cartilage
• Surgical techniques and complication prevention: https://pmc.ncbi.nlm.nih.gov/articles/PMC7061662/
• Voice safety considerations: https://saxonmd.com/blog/does-a-tracheal-shave-change-your-voice/
• Recovery and scarring management: https://saxonmd.com/blog/what-is-tracheal-shave-recovery-like/
• Clinical safety overview: https://centreforsurgery.com/can-a-tracheal-shave-affect-your-voice/

General patient guidance: https://www.webmd.com/a-to-z-guides/what-is-tracheal-shave