Pitch-altering surgeries

This information is for patients considering a surgery on their vocal cords or voice box to alter their pitch. The first three surgeries are primarily designed for transgender male-to-female patients to raise the pitch. Genetic males have vocal pitch and vocal resonance that are often too low to be perceived as a female.

• Feminization laryngoplasty
  • an operating room procedure to shorten the length of the vocal cords and the size of the thyroid cartilage in a transgender patient to obtain a more feminine voice. This procedure raises pitch.
  • it has the potential to raise the pitch further than the cricothyroid approximation, but has a greater risk of needing a revision.
  • it does alter resonance to a small degree.
  • a thyrohyoid approximation can be performed at the same time to affect resonance. 
• Thyrohyoid elevation
  • removes the upper portion of the thyroid cartilage and raises the larynx in the neck.   
• Cricothyroid approximation (CTA)
  • an operating room procedure to pull two cartilages closer together to mimic the cricothyroid muscle action of raising the pitch.
  • when done on one side it is usually to replace the action of a paralyzed muscle.
  • when done on both sides it may be used for feminization of the male voice to raise the lowest pitch you can produce. 
• Reduction laryngoplasty
  • an operating room procedure to reduce the profile of the Adam’s apple. This procedure does not alter the pitch but often accompanies the cricothyroid approximation procedure.
  • It is also known as a "Tracheal Shave" or "Trach Shave", though it is a procedure on the larynx (voice box) which connects to the top of the trachea (windpipe). 
• Microlaryngoscopy
  • removes smoker's polyps, usually a disorder of female talkative cigarette smokers.
• Pitch-lowering surgery
  • a segment of cartilage can be removed from the voice box to loosen the vocal folds and lower the pitch, and sometimes the thickness of the vocal cord can be augmented.
• Laser tuning
  • a person's comfortable speaking pitch - male or female - can be raised a few semi-tones with an office laser procedure. It can also be used to raise the pitch of a person with smoker's polyps.
• Consent forms
  • The legal part that you sign when you are ready and understand the risks.