A Novel Single-Incision Approach for Thyroid Cartilage Augmentation Using Thyroid Alar Grafts

Masculinization of the thyroid cartilage (“Adam’s apple”) is an important yet underreported component of gender-affirming surgery. Traditional augmentation techniques using autologous rib cartilage provide durable projection but introduce additional donor site morbidity. We describe a novel single-incision technique utilizing autologous thyroid alar cartilage grafts for thyroid cartilage augmentation. A 29-year-old transmale underwent augmentation via a high cervical incision. Bilateral thyroid alar cartilage grafts were harvested, fashioned into a neothryoid notch construct, and secured to the native cartilage to enhance anterior projection. The patient was discharged without complication and reported high satisfaction with both aesthetic and tactile outcomes at 15 days and 9.5 months postoperatively. This approach leverages the favorable properties of thyroid alar cartilage while avoiding the morbidity associated with distant donor sites. The technique allows for effective augmentation through a single, less-invasive operative field. Thyroid alar cartilage grafting represents a promising, less invasive alternative for masculinization of the thyroid cartilage in appropriately selected patients.