• Candidates who wish to undergo a sex reassignment by changing their external appearance.
• Candidates who are in good physical, mental and psychological health.
• Candidates who have realistic expectations from the procedure.

• Too much or too little revision, uneven revision
• Excessive scarring
• Permanent change in vocal quality such as weakness, lowering of pitch, raspiness, hoarseness, raising of pitch.
• Haematoma
• Infection
• Permanent loss of voice
• Death

• During the initial consultation, a thorough discussion on the expectations of the patient as well as the complete medical history of the patient is understood
• Photographs are taken for further comparison after procedure.
• The doctor discusses and advises on options of anaesthesia, type of facilities, various techniques and cost with the patient.
• The doctor provides guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications
• The patient must arrange for transportation and assistance to and from the hospital

• The patient is administered local or general anaesthesia.
• A horizontal incision is made on the upper crease of the neck skin below the chin area.
• The muscles are separated to expose the thyroid cartilage which is reduced by
  • carving it with a knife or
  • using a bone cutting instrument in case of calcified cartilage
• All bleeding points are checked and stopped and the incision is sutured and bandaged.

The procedure takes 45 minutes to complete.

The surgery is performed as an outpatient procedure.

• The patient may experience some swelling and bruising. Swelling usually subsides in 2 to 14 days.
• Some patients may have mild voice weakness in the first few days following surgery while bruising may alleviate in 1- 3 weeks.
• Patient may note some breathiness or hoarseness in the first few days following surgery
• Patients will have a prominent red scar that lightens over the next 1 to 3 months
• Patients may experience temporary numbness and tightness in the soft tissue, lasting a day to a week.
• The stitches and bandages are removed after a week.
• Patients may have temporary dimpling of the skin along the incision.

• Ice pack must be applied to the treated area for a couple of days
• The patient must rest the voice following surgery.
• Most women experience temporary numbness and tightness in the soft tissue, lasting a day to a week.
• Stitches and tape must be kept dry
• Patients should avoid electrolysis immediately around the incision until permitted by the surgeon
• Patients are advised to apply antibiotic ointments, vitamin E oil, or other topical preparations to aid in healing.
• Patients may also be given exercises to break up scar tissue during healing.