Tracheal Shave – Revisited

Wow … so this is kind of a rewrite of my tracheal shave summary regarding my first experience with Dr. Zukowski (hereinafter referred to as “Dr. Z”) for my tracheal shave back in November 2002 …

It seems so long ago, in a galaxy far, far away …

For those without much background in some of the treatment we who suffer from transsexualism seek and endure in an attempt to mitigate our resulting gender identity dysphoria … a tracheal shave is oftentimes referred to as as “removing one’s Adam’s Apple” … you see, though both boys and girls have “Adam’s Apples” … boys generally have more prominent Adam’s Apples than girls do … and is one of the “tells” that people seem to be more astute in looking for when trying to decide if someone presenting as female is/was biologically male. (A “tell” is a physical trait/behavior that might be interpreted by someone to suggest that you are male when you’re attempting to present as female (vice versa too).)

Now a tracheal shave is really not “removing one’s Adam’s Apple” … that cannot be done, at least safely or for good reason. Instead, one’s Adam’s Apple (trachea in medical lingo for the purposes of this post) is shaved back and removed in layers to reduce its prominence … and eliminate a “tell”.

There are risks involved … mainly, the surgeon can’t shave too much … or you risk damage to one’s vocal cords. Since speaking is essential in my line of work … this was a critical issue for me. Fortunately, I didn’t have an extremely prominent trachea … so I knew I didn’t require aggressive shaving.

Surgeons doing this surgery usually make an incision slightly above your trachea (Adam’s Apple) and shave from there or they make an incision under your chin and endoscopically perform the surgery. My preference was for the latter as though both leave a scar, and both usually are very minimal scars, an incision under my chin seemed like it would be less noticeable than one in the front of my throat.

Now a tracheal shave was part of the overall quote I had originally received from Dr. O … and on that quote was line itemed at $2,000 as part of the entire package, but associated hospital, anesthesiologist, nursing charges were not broken out for a stand alone procedure.

Back in 2002 I wasn’t quite prepared to commit to a full ffs agenda, but I did want to have my trachea shaved. Though not too prominent, it was a tell for me, and I felt it’d increase my confidence when presenting in female mode if I eliminated it. And I also figured it was a good, safe weeding out type of surgery. I wanted to see how I reacted to such a step … would it make me feel better or would the removal itself of something from my bod cause me even more anxiety? Finally, I figured it wasn’t something that people would really notice if I had the surgery and chose to do nothing further … people might notice girls with prominent Adam’s Apples, but not boys with Adam’s Apples less noticeable. (Which is very true, months after my tracheal shave, I was with a group of people and the discussion came up … “is that a boy or a girl over there?” … and though the whole “boys have Adam’s Apples, girls don’t” discussion took place … no one noticed I didn’t.)

Now I figured I could get my tracheal shave done closer to my home … as though not a “nothing” surgery, I didn’t consider it one capable of being performed by only a few surgeons. My first contact was with Dr. Schrang out of Wisconsin. He’s known mainly for his SRS work (that’s the plumbing surgery), but I knew he did tracheal shaves. I called his office and his staff was super nice and before I knew it, I had scheduled a time for my tracheal shave … total cost … $3,250. Not bad in my opiniooon.

But shortly after scheduling that, I was hanging out in Chicago at a support group gathering of transgendered individuals … and someone mentioned to me Dr. Z’s name. I had heard it mentioned a few times before, all in very positive terms, but usually I didn’t pay too much attention because 1.) I had always figured I’d just go do Dr. O, and 2.) most of the time I heard it there was a beer or two in my system and my attention span was lacking. Anyways … this time, I was drinking coffee and having just decided to do a tracheal shave, figured I’d check with this Dr. Z dude and see what he had to say. Besides, Chicago was much more convenient for me location-wise.

And that’s when my Dr. Z experience began … a few days later I sent him an e-mail requesting information … within 24 hours I had received a response from the surgeon himself … Dr. Z. Wow … either this guy has nothing to do or he has a tremendous commitment for providing personal attention. I had never received an e-mail directly from a surgeon before. It turns out it was the latter. Over the course of the following year, I was to learn from personal experience he’s incredibly passionate about the work he does in helping transsexuals and somehow has figured out a way, despite helping lots of us, to make each of us feel like his only patient. I’m pretty sure he’s phucking with the time-space continuum somehow … as I don’t know how he fits it all in one day. Anyway … after a few e-mail exchanges … we scheduled a Saturday afternoon consult … to accommodate my schedule … sa-wheet !! In the meantime, I checked out his credentials … tried to find whatever I could about him … he’s former Navy where he got lots of practice honing his general plastic surgery skills … brought with him a reputable list of credentials … a Northwestern University grad, lots of articles written, awards … blah, blah, blah … and seemed like one of those few people making cutting edge use of endoscopic surgery techniques. So when I met with him … I figured skill wise, background wise … he met my requirements, actually more so than I would have demanded … now I just need to see if what he’s like … face to face.

First of all, Dr. Z doesn’t enter a room … he takes it over. And he immediately put me at ease … totally respectful … totally comfortable to talk with … and it didn’t take long at all for our personalities to mesh and us communicating in typical Amy-fashion … with a few laughs, but covering the necessities. And him answering my attorney direct questioooons. When talking with Dr. Z, two things are apparent … one, his east coast youth (upstate New York), and two, his passion in his work. The upstate New York thang only means that he has a strong personality … you know when he’s around, and that’s combined by his passion for his work … when telling you of his thoughts for what he can do … would recommend … he’s entralled in describing it. But what I really liked about him was that though he was all into … “this is what I’d recommend” and brought a proper and comforting level of surgeon confidence … when I asked “why?” or “what about this?” … he always answered readily, logically and rationally. And he was willing to accommodate my concerns (more so on that in my ffs summary).

Anyways, he quoted me $3,650 for his package … $400 more than Dr. Schrang, but included in Dr. Z’s quote was some liposuction to my neck (as age had left me with some fat deposits there) which Dr. Z was confident would increase the asthetic look of my neck line and along with the tracheal shave and some muscle recontouring he wanted to do … would leave me with a very feminine neck presentation.

I waited a few days for the excitement to wear off and then re-evaluated … yeah … Dr. Z is who I wanted to try … so I cancelled with Dr. Schrang and booked Dr. Z for early November 2002. It was a great decision in my opinion.

Dr. Z treated me kindly … I was a phreaked out mess … was going there by myself … and no one knew the real purpose of my trip except for Shaft. Dr. Z and his staff made sure I had things covered, questions answered, schedules coordinated and managed me very, very well (that’s a good thing).

Dr. Z arranged to meet with me for a pre-admit interview on a Wednesday evening … late … around 7:30 p.m. … to allow me to work a full day in my office and then drive to Chicago afterwards. He took my pre-op pics, we went over the risks sheets, he answered each and every question patiently and clearly that I could come up with and he went over in detail what he was going to do on me again. And this is what had the biggest impact on why I trusted Dr. Z to do the rest of my ffs when I was ready for that … he didn’t oversell what he was doing. Oh, don’t get me wrong, he was confident in his ability to address my desires and give me some great results … but he told me what I could expect … how long recovery would be, bruising would last … and that it’d be six months before I’d be able to look at my neck and go … “Wow“. And that didn’t mean removing the tracheal prominence … that would be noticed immediately. It meant that after the tracheal shave and his other procedures … I’d end up with a nicely feminine neck … “one my dear husband will someday hopefully like to ring on occasioooon” 🙂

Specifically, Dr. Z was going to perform my tracheal shave endoscopically, shaving and burring down the necessary part of the trachea and then contouring the neck line further from the trachea back up to the incision point under my chin. He was going to tighten and weave some of the muscles over the trachea to further hold it down, reducing the amount that needed to be shaved. Liposuction in my neck area was also going to be performed, and though I didn’t think I needed it … geezuz, did I ever need it there !! 🙂

I was the second surgery the next day, Thursday … so in the AM I just went to the grocery store, stocked up on applesauce and Vernor’s … got my prescriptions filled … managed a few office phone calls … and generally just killed some time until 1:00 pm …

When I arrived at Dr. Z’s surgical suite on Friday … things happened fast … Chris welcomed me … a nurse started getting me ready … Dr. Z checked in on me … the anesthesiologist, who had called me the night before, met with me and we went over things again … Dr. Z checked in on me … I was phreaked, but think I hid it pretty well … I was taken into the operating room … laid out on the table … started working my stand-up routine … got poked with the “go to sleep” drugs … and the next thing I remembered was coming around in the recovery room. Dr. Z gave me a great compliment … said I had his staff cracking up … apparently I’m pretty funny when I’m under the drugs … and I was working some bit about a hamburger chasing me that had them laughing … or maybe they were laughing at me … I can’t remember !! 🙂

Anyways … I felt fine … groggy of course, but fine … I had this huge thing around my neck as you can see in the pictures … so my mobility was pretty limited. Dr. Z was kind enough to personally drop me off back at my hotel room so I didn’t have to do the cab thing (hotel limo service dropped me off at his offices earlier in the day), made sure I made it back to my room and was okay. So nice !! I checked in with my parents and also called Shaft. Dr. Z called me later that evening to make sure I was okay too. In the meantime, I ordered … a hamburger and fries from room service. Mmmmm … hamburgers !!! 🙂 I watched a lot of television … go figure. The next morning, though I looked all freaky with the stuff on my neck … I went to the breakfast buffet … hey, it was included in the room charge and it was a good buffet !!! I got a lot of looks … but stuffed myself silly with scrambled eggs and sausage patties drowned with lots and lots of coffee (yeah, I do the Atkins thing). The dude that was working the table and bringing me my multiple refills of coffee courteously laughed at my self-deprecating comments and even turned the television to my morning show of choice … I tipped him well … especially since I don’t think he spoke a lick of American … English … Australian.

I drove to Dr. Z’s office … he checked me out … removed the neck thing … reattached another compression garment … and said I could head home.

As far as after-effects go … It was mainly bruising and some tight muscles. I think the liposuction is what caused the bruising. I had a fair amount of bruising that moved down my chest and a bit remained near my left front jawline for about 6 weeks. It was about 8 weeks before a final, tiny bruise on my neck seemed to fade.. My lower neck was still swollen one week later. The muscle tightening was the most noticeable discomfort, and that’s just because I had to stretch the muscles back out. So leaning my neck back was uncomfortable along with turning in either direction. No a problem at all with my voice. And as far as pain goes … I didn’t take one pain pill afterwards.

Now in retrospect … I was fine and all … but I really should have had the courage to ask someone to come with me and drive me back … Shaft had offered, but I was being stubborn …. secretive … private. It was stupid. My neck mobility was somewhat limited and driving was a challenge. I made it home safely, but still. It was stupid on my part.

Dr. Z called me a few hours after I left his office to make sure I had made it home okay and asked me questions on how things were going. Geezuz … how does he have the time? I was well and all. 🙂

When I wasn’t wearing the compression garment (worn to contain the swelling from the liposuction), no one really noticed the surgery. I returned to work on Monday, meaning I only missed two days of work. My voice wasn’t impacted at all … I was speaking as I always did. My throat was a little sore the day after surgery, but that was from the breathing tube shoved down my throat …. practice ;). Unless I pointed out the incision … no one seemed to notice it … and not once did anyone say to me … “Dude, what happened to your Adam’s Apple” … kewl. 🙂

And me … wow … I was estastic … it was great !!! One of the tells that bothered me the most was now eliminated … and I had a wonderful surgical experience with Dr. Z. And then a few months later … with that done … I was sort of evaluating all over who was going to get the pleasure of beating the krap out of my face … Dr. O or Dr. Z …. I changed my mind a dozen or so times … until about 6 months after my tracheal shave … when I was getting dressed one day … and noticed in the mirror … my neck. And that everything Dr. Z told me … was exactly the result. His cutting edge, creative endoscopic approaches to some procedures … and his eye for detail … gave me a fine looking neck. Add to that his passion and concern for his work … and his totally kick ass personality which is just an added bonus … and I made my decision.

Anyways … following are some pics from my tracheal shave.

Before Pictures taken the evening before surgery:

2 Hours After Surgery:

The Day After Surgery:

One Week After Surgery:

Two Months After Surgery:

One Year After Surgery:

I’ll add a few more post-one-year pics in the next few days. I just wanted to get this posted because I had been promising people.

Shaft’s Belly A Year Ago:
(And it’s not getting smaller !)