Refers to surgical techniques that help changing the voice quality and style to a desired one. The voice turns out to be a different one that makes a different impression on the subjects’ interacting society. Also helps to elevate self-confidence with its benefits such as increased income, establishing new friendships and breaking the border of social limits.

Masculinity problems in male voice: Most men desire to have a deep or a deeper voice. A deep voice is a sign of masculanity, authority and leadership. Even a man with a normal but a little bit high voice sometimes may result in misunderstanding of politeness or even femininity. This would be a burden for men whom desire to be working in the fields of management and marketing. Deep voice can be obtained by basicly relaxing the vocal folds.

Diamond Laryngoplasty (Window Anterior Commissure Laryngoplasty by DrKocak):

The name comes from the shape of the rhomboid window on thyroid cartilage. It has the capacity of lowering the pitch by 25%, at the average of 45 Hz. It adds lower tones that refers authority and preserves the higher harmonics. It is performed under local anaesthesia. The surgeon can easily adjust the pitch and obtains deterministic and persistent results. The technique is applied in obtaining the Million Dollar Voices for managers (CEOs). The researchers found out that a 1% decrease in voice pitch is associated with a $30 million increase in the size of the firm managed, and in turn, $19 thousand more in annual compensation.

Diamond Laryngoplasty BW HD
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Laser Relaxation Glottoplasty:

It relaxes the vocal folds by releasing the tense vocal fold layers by laser. The technique is used to deepen and improve the voice quality in cases with “sulcus vocalis”.

Pitch Problems and feminity.

Having a higher pitch do not mean feminity, it may be an ambiguity. The speaking average fundamental frequency over 180 Hz is mostly perceived as female on non visual comminucations such as telephone calls. But a feminine voice requires more such as breathiness and softness. The pitches between 150 to 180 Hz. the sex of the speakers may not be well defined and perceived ambiguous. Both women, men and even transexuals complain at these ranges. Adding some breathiness or softness may help in small number of cases but a radical approach is mostly searched.

To obtain a feminine voice there requires two main approaches:

  • Shifting pitch to 180 Hz and over.
  • Adding feminine measures on the voice.

Cricothyroid Approximation (CTA)

Cricothyroid Approximation (CTA) is standard technique for pitch elevation. It is based on approximating the two cartilages (thyroid and cricoid) of voice box with permanent sutures or plating. It elongates and tenses the vocal folds and provides approximately about 40-45 Hz of increase in pitch after the voice set at more than 6 months postoperatively. For example If a subjects’ fundamental frequency is 140 Hz. CTA surgery adds 45 Hz. then the result is 195 Hz. Since 195 Hz is over 180 we can expect a female or female like voice on audio communications. Although we try to approach or exceed the 180 Hz. level, for a standart community an accepted female voice is about in between 205 to 220 Hz. and most cases are happy within that ranges. Therefore for a highly satisfied result a preoperative limit should be more than 160 Hz.

A women in business as a manager may desire lower tones in contrary a women in entertaining business the tones at the near childish levels are desired.

Laser Reduction Glottoplasty (LRG)

Laser Reduction Glottoplasty (LRG) is a surgical technique introduced for failures in CTA3 But now also used in cases to obtain qualitative measures of feminity. The technique adds 40-45 Hz like CTA but also adds feminine quality at subjective ratings. LRG reduces the masculine rectangular shape to a feminine triangular shape at vibrating portion. The best results attained in masculine female voices and transexuals at pitches higher than 160 Hz.

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Nodal Surgery (Wendler Glottoplasty)

The vibration throughout the length of vocal fold determines the fundamental frequency. The vibration occurs between two points; anterior commisure and the tip of arytenoid vocal processes. When the points of vibration is changed then the nodes changes consequently. A well known nodal surgical technique is Wendler glottoplasty also called as “webbing procedure”. The anterior node is shifted posteriorly to shorten the nodes that results a fundamental frequency elevation then we can obtain a high pitched voice. It adds about 70 Hz to the fundamental frequency.

Mastronikolis NS(1), Remacle M, Biagini M, Kiagiadaki D, Lawson G. Wendler glottoplasty: an effective pitch raising surgery in male-to-female transsexuals. J Voice. 2013 Jul;27(4):516-22. doi: 10.1016/j.jvoice.2013.04.004.