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Tracheal Shave and Camouflage

Dr Zukowski and his staff at the Zukowski Center are renowned worldwide for being the best in FFS Facial Feminization Surgery. Based in Chicago America, Mark Zukowski is recognized within the transgender community as being the best.The cartilage covering to the vocal cords is thicker and more prominent in males and when combined with a longer neck gives the resulting prominent Adam’s apple.  This can also be true in individuals where the Adam’s apple is not that visibly prominent because of a sagging and aging neck.  When the skin of the neck is pulled tight, one sees the Adam’s apple projection upon swallowing.  Typically, this procedure is done with an incision under the chin by the experienced FFS surgeon.  If anyone wants to make an incision over the trachea, you should seek to have this procedure done elsewhere.  The rare instance where this incision is placed over the tracheal prominence is for voice modification.  What one does is to take down the triangular shape to the cartilage prominence as well as some of the fullness being very careful not to damage the vocal cords.  We have fiberoptic scopes that we use to look at the cords on the way in during intubation as well as on the way out.  One spreads the neck muscles from over the tracheal prominence.  These muscles will later be tightened as a camouflage layer to insure further smoothness and cover over the tracheal prominence.  When one just makes an incision over the trachea, you can’t adequately reconstruct the anatomy of the neck or do anything other than the most obvious shave highlighted by a very conspicuous scar.  The incision underneath the chin is referred to as one that only lovers and dogs see.  The cartilage is exposed and a high speed burr is used to precisely and as atraumaticly as possible take down the contours of the cartilage.  Smooth contour is obtained and the muscles of the platysma of the neck which have been mobilized are now brought together in a fashion that properly rebalances the muscle configuration of the neck allowing for a very smooth contour that further covers and insulates the Adam’s apple region.

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