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Anterior commissure advancement

What is anterior commissure advancement?

Surgery to raise the fundamental frequency (pitch) of the voice by shortening the vibrating part of the vocal chords.

What does anterior commissure advancement do?

How long does anterior commissure advancement last?

The amount of time these effects last for is currently not well understood.

What should I be aware of?

Speech therapy is able to allow the majority of people to raise the pitch and change the qualities of their voice safely and easily.

However, for a minority of people this is not the case, and they may consider voice surgery as an alternative. Unlike speech therapy, voice surgery carries significant risks of complications, and the effects may be irreversible.

Possible side effects of voice surgeries include reduced loudness, decreased vocal range, decreased clarity of voice, and lack of decrease in pitch 1, p.806.

While a variety of different surgical approaches to increasing vocal pitch have been tried, there is currently little research into what the long term effects of these surgeries are, and how long the effects will last is unknown 2, p.244e4.

Depending on the surgical technique, you may have permanent scarring after the operation. Voice surgery also requires additional speech therapy after the surgery 3, p.194.

What else might I want?

Thyroid chondroplasty is often carried out during surgeries that affect the voice - either to reduce the number of operations required, or because those surgeries would otherwise make the Adam’s apple more apparent.


  1. 1.
    Song, Tara Elena and Jiang, Nancy (2017) “Transgender Phonosurgery: A Systematic Review and Meta-analysis.” Otolaryngology–Head and Neck Surgery, pp. 803–808. Link
  2. 2.
    Van Damme, Silke, Cosyns, Marjan, Deman, Sofie, Eede, Zoë Van den and Van Borsel, John (2017) “The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review.” Journal of Voice, 31(2), pp. 244.e1–244.e5. Link
  3. 3.
    Seal, Leighton J (2007) “The practical management of hormonal treatment in adults with gender dysphoria,” in Barrett, J. (ed.), Transsexual and other disorders of gender identity: A practical guide to management, Radcliffe Publishing, pp. 157–190. Link


This page is illustrated using a photograph by Павел Сорокин available at Pexels.

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