SoCal ENT offers compassionate, high-quality gender-affirming care using the Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) technique. Our skilled surgeons ensure natural-sounding results with no external incisions, emphasizing a smooth recovery in a supportive and inclusive environment.
Your voice is how you connect, express emotion, and share who you are. For many transgender women and nonbinary individuals, the voice can feel out of sync with identity. Vocal feminization surgery (VFS) helps bridge that gap, refining pitch and tone to sound more feminine and aligned with how you see yourself.
At Southern California Center for Ear, Nose, Throat, and Allergy, we approach every gender-affirming service with empathy and precision. Using the advanced Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) technique, our surgeons achieve smooth, natural results without external incisions, ensuring both confidence and comfort through recovery.
Purpose – Raises voice pitch and refines tone for a feminine sound
Technique – VFSRAC, performed endoscopically with no external scars
Procedure Time – About 45–60 minutes under general anesthesia
Recovery – Two weeks of voice rest, with full results in 3–6 months
Results – Permanent, natural feminine voice quality
Vocal feminization surgery adjusts the length, tension, and position of the vocal cords to create a higher pitch and lighter tone. We specialize in the VFSRAC technique, which gently modifies the vocal folds from inside the throat, avoiding any external incisions or visible scars.
This method enhances both pitch and resonance, not just frequency, allowing for a voice that sounds natural in everyday conversation. Because airflow and vocal function are preserved, the results feel authentic and sustainable long-term.
Your experience begins with a detailed consultation with our ENT specialists. We’ll review your vocal profile, discuss your transition goals, and ensure you’re medically ready for surgery.
In preparation, patients may be advised to pause certain medications like NSAIDs or herbal supplements, and to stop smoking to promote healthy healing.
During the procedure, a slender endoscope is inserted through the mouth, allowing your surgeon to adjust the vocal folds without any external cuts. The folds are carefully shortened and repositioned to increase pitch, then secured with micro-sutures thinner than a strand of hair.
The procedure typically takes under an hour, and most patients return home later that day.
The VFSRAC method offers a precise and elegant approach to voice feminization. Because it’s performed entirely through the mouth, there are no visible scars or external healing sites.
The surgery preserves natural airflow and vibration, which helps maintain a soft, natural tone instead of a strained or artificial sound.
Patients appreciate that the transformation is permanent once healed, providing a confident, effortless voice that matches their gender identity. The minimally invasive technique also means less discomfort and faster recovery than older surgical options.
Vocal feminization surgery may be appropriate for transgender women or nonbinary individuals who want a more feminine voice and have not achieved their desired results through voice therapy alone.
Candidates should be in good health, have realistic expectations, and be prepared for a short period of complete voice rest during recovery.
If you smoke, you’ll need to quit before surgery to lower the risk of complications. During your consultation, our specialists will discuss whether VFS is a good fit for your health, goals, and transition journey.
Resting the voice is the most important part of healing. For the first two weeks, you’ll need complete silence — no talking, whispering, or throat clearing.
After that, you’ll gradually reintroduce speech with the guidance of a speech-language pathologist or voice therapist. Over the next several months, the voice continues to stabilize. Some temporary hoarseness or throat sensitivity is normal early on. Most patients begin to notice significant improvements around the three-month mark, with full results in about six months.
Our care team provides detailed aftercare and will support you throughout recovery to protect your vocal health and ensure lasting results.
Results unfold gradually but beautifully. As swelling decreases and your vocal cords adapt to their new structure, pitch and tone become clearer and more consistent.
Within three to six months, most patients achieve a stable, feminine voice that feels genuine, expressive, and sustainable for daily speaking.
Because the VFSRAC approach respects the body’s natural airflow and vocal anatomy, results sound smooth and effortless.
No. Vocal feminization surgery is performed under general anesthesia. You may feel some mild soreness or hoarseness afterward, which improves within a few days.
Yes. Because the VFSRAC method preserves the natural movement of the vocal cords and airflow, your new voice will sound authentic, not mechanical.
Yes. When performed by experienced ENT surgeons, VFSRAC is considered a safe, low-risk procedure. Side effects like temporary hoarseness or mild bleeding typically resolve quickly.
Results are permanent. Maintaining vocal health with therapy helps keep your tone clear and strong.
Voice therapy is highly recommended after surgery. It helps you learn new vocal techniques, refine pitch control, and prevent strain.
That’s perfectly fine. Surgery can complement your previous progress by providing additional pitch elevation and resonance refinement.
You’ll need two full weeks of voice rest, followed by a gradual reintroduction to speaking under professional supervision.
