Female voice has a higher pitch compared to male voice. However, pitch is only one aspect. Intonation, resonance, vocal quality and articulation are all important aspects of the feminine voice. Language, voice loudness and non-verbal communication all play part in the social perception of a person as female.


Summary of MtF Voice Feminising Surgery

Surgery Time

1-2 hours

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Sleeping Position: Normal Washing: Same day Dressings & Garments: None

Exercise inc. Gym

4 weeks

Time Off Work

7 days

Hospital Stay: Day case

Full Recovery Day case Reasonably Mobile: Same day



Modified Wendler Glottoplasty:  

The aim of this procedure is to adjust the proportions of the vocal cords. Female vocal cords are shorter than male. Glottoplasty reduces the length of the vibrating segment of the cords leading to higher pitch. The procedure is performed endoscopically (keyhole) via the mouth with no external wounds or scars. Using CO2 laser, the lining of the front part of the cords is removed and the two sides are sutured together. The voice can be further fine-tuned using the laser to ‘tighten’ the vibrating segment of the cords.

  Cricothyroid approximation (CTA):  

This procedure increases the tension of the vocal cords, in the same way guitar strings are tightened, leading to increase in pitch. The procedure will involve placing permanent suture between the cartilages of the voice box via an open surgical approach under general anaesthesia. CTA can achieve greater pitch elevation compared to glottoplasty however the results can be more variable. The procedure will be an appropriate first option in individuals with really deep voice or if reduction of Adam’s Apple is required as the two operations can be combined.


This result can improve self-confidence and boost self-esteem, allowing you to feel more comfortable in your female gender.


  • Which procedure is right for me?

    There are two approaches to voice feminisation surgery: endoscopic glottoplasty (no external scars) and open CTA. In general, glottoplasty should be considered first line surgery however that can vary from patient to patient. There are pros and cons to each approach and the appropriate operations would be decided based on your baseline voice, personal preference, and cosmetic factors including the need for Adam’s Apple reduction. This will be discussed in your initial consultation so you can make an informed decision.

  • What happens at the consultation?

    You will meet your surgeon who will ask you about your goals and concerns. A full medical history and examination will be done, before agreeing a plan for you and discussing the surgery and recovery and risks in detail. You may be required to undergo endoscopic examination of the voice box to exclude underlying problems that might impact the outcome of the surgery.

  • What happens on the day of surgery and how long is my hospital stay?

    On the day of your surgery you will attend the hospital where your surgery is taking place. You will be reassessed by your surgeon and your anaesthetist before going to the theatre. The hospital team will complete the necessary pre-operative health checks. Following your surgery, you will be bed bound and closely monitored by the hospital medical team. They will assist you with anything you need. You will be tired and spend most of this time resting. You will be provided with something to eat when you are alert and slowly mobilised with assistance. Once you are awake and mobile, you will be discharged from the hospital to your home. For safety reasons, as with all day-surgery patients, you will need an escort to bring you home and stay with you for a minimum of 24 hours. You can’t travel on the same day so if you are from outside London then you should arrange accommodation for one or two night after surgery. We aim to perform these procedures as day cases. On rare occasions patient will unexpectedly need to stay overnight for monitoring and to recover from the effects of surgery and anaesthesia.

  • Do I need voice therapy if I am having surgery?

    Yes. It is essential to have therapy before and after surgical intervention. Maintaining a surgically elevated pitch without straining the vocal cords will need practice. Voice therapy by an experienced speech and language therapist will be an essential part of that process. In addition, higher pitch is one aspects of the female voice. Intonation is an important aspect of the feminine voice and needs to be learnt and practiced.

  • How much does it cost?

    Mr Al Yaghchi’s initial consultation fee is £225.

    Endoscopic examination of the vocal cords might be necessary. This will be at an extra cost of £100 plus hospital facilities charge. The latter will be around £150 and billed separately by the hospital.

    The cost of glottoplasty is around £4500 including surgical fee, two follow up appointments, anaesthetic and hospital fees. We aim to provide as accurate an estimate as possible for the hospital fee. These can vary based on an unexpected need for overnight hospital stay and any further tests and investigations for pre-existing medical conditions. If you require additional voice procedures, for example limited pitch increase after the initial operation, revision surgery or cricothyroid approximation, this can be provided at an additional cost.

  • What happens if there is a complication?

    In the event of a complication you will be medically assessed as soon as possible by your surgeon or a qualified member of our nursing team. In the unlikely event you need to return to the theatre this will be arranged for you by our team. Hospital and anaesthetist fees may be charged, however there will be no surgical fee. Further information is outlined in our terms and conditions.

“Happy and impressed”

5 5 Star Rating

LTC is by far the best and most supportive healthcare I have had. Mary and the team have been so helpful prescribing my hormones and helping me with interviews. They’ve given me confidence to go into the world being who I am. I wish them continued success a d hope others choose LTC to help them transition!


by Luna McManus | Read More Patient Testimonials

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