Feminization Laryngoplasty — Before & After Audio Recordings

As the first patient, she had the feminization laryngoplasty surgery and I was very conservative in what I removed. We did to revision surgeries taking off a bit more of the vocal cords each time.

She initially had a complication from a Trach shave where her pitch dropped. She then had several procedures trying to correct this including cricothyroid approximation, vocal cord webbing and a laser procedure. Her initial voice is after all of these procedures.

She had a revision feminization laryngoplasty surgery to try and further improve her voice after this recording but I have no further follow-up on the outcome.

She had a previous cricothyroid approximation which raised her pitch slightly. The "before" recording here is after the cricothyroid approximation surgery. Between the 2 surgeries she had some improvement in pitch.

Her main issue of the surgery has been low-volume since she works at a job with a lot of loud background noise.

She had a previous cricothyroid approximation that did not improve her voice. She was again not much improved after the feminization laryngoplasty with a thyrohyoid elevation.

Her initial surgery was complicated by an infection and a temporary tracheostomy. She had revision surgery with only slight improvement. Looking back 5 years later at her video recording her voice would be improved with a laser vocal cord tightening which I was not doing at that time.

Her vocal pitch was improved after the feminization laryngoplasty surgery, but was somewhat rough and had a very low volume. She continues to smoke cigarettes. She had a laser tuneup which smoothed her voice out and improved the volume she estimates by about 30%. She still puts slight effort into her voice when speaking on the phone but it is perceived as a female. However, she still has trouble competing with background noise.

She initially had a rough voice after her feminization laryngoplasty. She has had two laser touchup procedures, the most recent being 15 months prior to this recording. This has brought her pitch up although she still has a few notes that are diplophonic. The laser procedures have reduced the amount of diplophonia and have made it easier for her to speak. She principally experiences the diplophonia when she gets loud or if she gets tired. She still has some air leak since the vocal cords do not come completely together.

Before Feminization Laryngoplasty, she worked on her voice for about 3-4 years with a voice therapist specializing in transgender voice. She felt that she still could not accomplish a female voice and was almost always called "sir" on the phone. While she had a previous Tracheal shave before the feminization laryngoplasty, she had no complications with her voice at that time. She came back for a follow-up at 3 years after her surgery to have a laser tuneup, the results of which are still pending and we were able to do a long-term follow-up recording.

She says that the surgery has changed her life. She is called "ma’am" on the telephone 100% of the time. She has not done any voice therapy. Occasionally she detects a roughness in her voice at the end of the day or if she tries to yell. Her volume is less than it used to be.

She had a cricothyroid approximation about 10 years before her first visit which helped for awhile and then her voice faded in pitch and quality. She then had a thyrohyoid elevation which did not change her pitch. 10 years after the thyrohyoid elevation she had a limited feminization laryngoplasty. About 18 months later she had a microlaryngeal laser debulking procedure. Her initial voice recording is after the cricothyroid approximation since that is when I met her and her most current recording is two months after her laser procedure, approximately 2 years after her feminization laryngoplasty.

At 13 months of follow up after her feminization laryngoplasty with thyrohyoid elevation, she notices that her voice has continued to improve gradually over time. She has done some speech therapy and feels that that has contributed to the result as well. She is called as a female on the phone 100% of the time.

Recording is taken one month after surgery.

She had a previous Trach Shave and had no falsetto. After surgery, she healed with a weak voice and she underwent a revision tightening surgery. Here she is two months after the revision.

She had a cricothyroid approximation 2 year earlier. Her voice was initially very high, but then fell back to a lower pitch. So her "before voice" in this recording is after a cricothyroid approximation and her after voice is 5 months after the Feminization Laryngoplasty.

She had two KTP laser tunings after Feminization Laryngoplasty to smooth out an initially rough voice. She does smoke cigarettes. We are going to perform another laser tune up in the near future.

Voice at two months after Feminization Laryngoplasty

It is a home recording of the after voice, but very smooth at two months after Feminization Laryngoplasty.

This recording is at two months post surgery, and her pitch is significantly elevated already.