A Look at Surgical Techniques for Transgender Male-to-Female Voices

Dr Toby Meltzer

Dr. Toby Meltzer, a plastic surgeon and advocate for LGBT healthcare access and equality, holds an MD from Louisiana State University where he was named to the Alpha Omega Alpha honor society. Currently, Dr. Toby Meltzer serves as president and founder of the Meltzer Clinic in Scottsdale, Arizona. Over the course of his career, he has had transsexual and transgender patients, and has contributed to peer-reviewed articles in medical journals related to this work.

Men who transition to women are often seek to “feminize” their voices as part of the process. Also known as laryngoplasty, surgery to alter vocal pitch typically makes changes to the larynx, often referred to as the voice box. In male-to-female transgender patients, laryngoplasty shortens vocal cords and reduces the size of the thyroid cartilage in the voice box.

Among specific procedures, thyrohyoid approximation can increase vocal pitch in male-to-female patients by raising the voice box to a higher position. Thyrohyoid approximation effectively shortens the pharyngeal chamber, which raises the resonance of the pharynx and increases vocal pitch. Minor increases in vocal pitch can also be scheduled through laser tuning, a less-invasive option. Laser tuning can increase vocal pitch slightly by tightening the vocal cords.

Recovering From Facial Feminization Surgery

Dr Toby Meltzer

Board certified in plastic and reconstructive surgery, Dr. Toby Meltzer provides surgical care to members of the trans community through his own medical practice in Scottsdale, Arizona. Dr. Toby Meltzer has been in private practice since 1996 and has since performed thousands of surgeries, including gender confirmation, breast augmentation, and facial feminization.

Facial feminization surgery (FFS) is a procedure that modifies the appearance of a patient’s facial characteristics so they appear more feminine. It is tailored to each individual and may involve such things as face-lifts, forehead procedures, hairline alterations, nose procedures, or cheek augmentation.

Recovering from FFS largely depends on the specific procedures each person undergoes. Because of this variation, complete recovery can take anywhere from a few months to a year.

Typically, patients who undergo FFS initially have bandages and support garments placed around their face. These bandages minimize swelling and usually stay on for roughly one week. Patients remain in the hospital for about a day following their procedure, but it’s recommended that they do not travel long distances and instead either get a hotel for a few days or live nearby the hospital where the surgery was performed.

As patients recover, they will notice that bruising and swelling on the face peaks two to three days after the initial procedure. They may also need pain medication for four to six days postoperative to ensure they stay comfortable during recovery.

Despite the swelling and pain patients may experience, they are usually capable of eating normal, soft foods, including yogurt, soup, and scrambled eggs. By 10 days, many individuals can resume their normal activities and can subsequently return to work after two to three weeks. As patients work up to this, they should do so gradually based on their own comfort levels and doctor recommendations.

A Study Focused on the Results of Elevated Vocal Pitch in Transsexuals

Dr Toby Meltzer

A well established Scottsdale, Arizona reconstructive and plastic surgeon, Dr. Toby Meltzer focuses on gender confirmation patients and the trans community. Well published in his field, Dr. Toby Meltzer coauthored the paper “Cricothyroid approximation to elevate vocal pitch in male-to-female transsexuals: results of surgery” (Annals of Otology, Rhinology, and Laryngology, 2002).

The paper brought focus to pitch elevation and other voice production functional changes that enable a smooth transition to a new gender identity among transsexuals. At the time of the study, there was extremely limited data surrounding the effectiveness of various pitch-raising techniques.

The research involved gathering acoustic data from 20 post-cricothyroid approximation surgery patients that measured changes in vocal pitch before and after surgery. Areas of focus encompassed perturbation, pitch, and pitch range, with an average 22-month follow-up time.

The researchers found that fundamental frequency was elevated a half octave, while perturbation remained largely the same. In addition, pitch range upper limits rose by four semitones. This remained elevated over time, even as the lower pitch range tended to move downward toward the levels before surgery. Most patients surveyed were satisfied with the long term results, as they felt that their postoperative voices were more feminine.

What Is the Oregon Medical Political Action Committee?

 

Oregon Medical Association
Image: theoma.org

For over 25 years, Scottsdale, Arizona surgeon Dr. Toby Meltzer has performed sophisticated reconstructive and aesthetic procedures for transgender individuals at his private specialized clinic.
Prior to opening the Meltzer Clinic, Dr. Toby Meltzer spent several years working at the Veterans Administration Medical Center in Portland, Oregon. He continues to serve as an assistant professor at Oregon Health Sciences University and is an active member of the Oregon Medical Association.

The Oregon Medical Association‘s (OMA) mandate is to improve health care conditions for Oregon residents by supporting medical providers. Through its medical political action committee, the Oregon Medical Political Action Committee (OMPAC), OMA has enabled medical providers and professionals in related fields across the state to have a collective amplified voice in local and regional politics.

After carefully reviewing candidates based on their platforms regarding care standards and other aspects of the medical industry and conferring with OMPAC consitutants, the advocacy group offers support to politicians who prioritize the interests of professionals in the medical field and their patients.

OMPAC is bipartisan and managed by an selected Board of Directors. OMA members can join OMPAC by obtaining a full or alliance membership.