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When the larynx grows larger during puberty, it sticks out at the front of the throat. This is what's called an Adam's apple. Everyone's larynx grows during puberty, but a girl's larynx doesn't grow as much as a boy's does. That's why boys have Adam's apples. Most girls don't have Adam's apples, but some do. It's no big deal either way.

But why is it called an Adam's apple? If you think it's called that after the story of the Garden of Eden where Adam ate a piece of the forbidden fruit that got stuck in his throat, you're right. An Adam's apple sometimes looks like a small, rounded apple just under the skin in the front of the throat.

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But plastic surgeons performing this procedure must balance the cosmetic results against the need for caution to prevent irreversible voice changes, according to the outcomes study by Jeffrey H. Spiegel, MD, and colleagues of Boston University Medical Center. Their study presents a new questionnaire for use in assessing the cosmetic outcomes and quality-of-life impact of Adam's apple reduction surgery in transgender and other patients.

The researchers evaluated patient satisfaction after Adam's apple reduction surgery. Known to plastic surgeons as aesthetic chondrolaryngoplasty, the procedure is sometimes called "tracheal shaving." The Adam's apple, developing during puberty from an increase in the size of the larynx and thyroid cartilage, is more prominent in males than females.

Chondrolaryngoplasty is performed in patients who want to decrease the masculine appearance of the Adams apple. It is most often performed in transgender women as part of facial feminization surgery, but may be requested by other patients as well. Since 2006, Dr. Spiegel has performed over 600 chondrolaryngoplasty procedures.

Sixty percent of patients indicated that they were "very" or "completely" satisfied with the appearance of their neck and Adam's apple. Only 13 percent said that they were "not at all" satisfied; 15 percent felt that the results limited their social or professional appearance.

About 55 percent of patients felt that the appearance of their neck/Adam's apple was the "best that it could be," while only 25 percent said they were interested in further surgery. None of the patients experienced any long-term voice changes.

Meanwhile, the new outcomes study, using a procedure-specific questionnaire, will be helpful to plastic surgeons in informing patients about the expected results of Adam's apple reduction surgery. "We can tell them that three-quarters of patients have adequate reduction in the size of the thyroid cartilage, and that the majority are very satisfied with their outcome," Dr. Spiegel and coauthors write.

This apple features a partial red blush that is quite saturated in places over a pale yellow that is echoed by a pale olive-gold russet. It's hard to say, but I think the russet interrupts the blush and accounts for the more subdued pink areas surrounding the saturated red.

Adam's Apple Brandy is handcrafted from 100% estate grown apples. This dreamy-smooth base is aged in American Charred White Oak. Gently distilled and filtered, with aromas of caramel and a sweet even finish.

An apple a day keeps the... Adam's apple away? Not quite, but for those assigned male at birth (AMAB), the Adam's apple is a more prominent feature in the body. Everyone has one, but because it's considered a sexually dimorphic characteristic, during puberty, it becomes more apparent in those who are AMAB. ff782bc1db