Jess speaks with Dr. James Thomas, a laryngologist who may be the leading expert in pitch-altering vocal surgeries. They talk about what options are available, what kinds of results are possible, and what to expect in terms of recovery and complications. Surgeries discussed include the Cricothyroid Approximation, Feminization Laryngoplasty (FemLar), and Vocal Cord Webbing.

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• (00:00) - Show Intro
• (01:34) - Introduction to Dr. James Thomas
• (03:43) - Stroboscopes
• (04:52) - A Rare Sub-Sub-Specialty
• (06:59) - Voice Physics: Pitch vs Resonance
• (10:42) - Testosterone and Voice Changes
• (12:15) - The Cricothyroid Approximation
• (15:04) - Cricothyroid Approximation Results and Drawbacks
• (18:15) - Inventing "Femlar"
• (23:31) - Femlar: Before and After
• (25:29) - Success Rates and Real Outcomes
• (27:42) - Risks, Complications, and Revisions
• (30:54) - Webbing and Lasers
• (32:59) - Choosing Surgery Options
• (34:42) - Recovery Timelines
• (36:30) - How Pitch Range Shifts
• (37:38) - Trachea Shaves
• (40:18) - Transparency About Complications
• (44:06) - Revisions vs. "Tuneups"
• (47:35) - Ethics and Patient Vulnerability
• (51:34) - Insurance and Political Climate
• (55:01) - Voice Surgey and Voice Therapy
• (01:00:09) - Future of the Field
• (01:02:04) - Pitch Lowering
• (01:03:47) - Closing Thoughts
• (01:06:22) - Credits