Webbing of the anterior portion of the vocal cords is a surgery designed to raise the comfortable speaking pitch by shortening the vibrating length of the vocal cords. It should also remove some of the lower pitches. This is a procedure presently performed by Dr. Remacle in Belgium and another variant is performed by Dr. Hyung Tae Kim in South Korea. Dr. Kim calls his procedure VFSAAC.

I have some experience with the procedure.


Under general anesthesia, a metal tube (laryngoscope) is placed through the mouth to lift the tongue out of the way and visualize the vocal cords directly. Using a microscope, the lining of the vibrating portion of the vocal cords is removed from the front half of the vocal cords. This seems to be the main place where some techniques differ. 

Some people remove the vocal cord covering (mucosa) with scissors and sew the muscles together. Some people remove the covering tissue with a laser, which creates a burn. This may make it more likely for the tissue or muscles to stick together afterwards. From viewing Dr. Kim's lectures, it seems that he removes the lining and also some of the muscle from the front edge of the vocal cord, and some of the tissue beneath the vocal cords. Whether this makes the vocal cords tighter or channels air more smoothly up through the remaining portion of the vocal cords, I'm uncertain.

Sutures are placed, sewing the front half of the vocal cords together. The sewing aspect makes the procedure slightly technically difficult. Tying sutures together at the level of the vocal cords with long instruments that reach from the outside to the vocal cords is an acquired skill.


The procedure is performed under general anesthesia and through the mouth. Consequently, there is no external incision.  it probably can be done in about an hour keeping surgical costs moderate. It preserves the cricothyroid muscle so that an individual should still be able to raise their pitch up into falsetto.


In my limited experience, I noted that the vocal cords can pull slightly apart at the back end of the webbing over time. This probably varies depending on the person's anatomy and the skill of the surgeon in placing the sutures.

There is a small risk to the teeth when placing the laryngoscope. This is particularly true if you have crowns or bridges on the teeth at the front of your mouth.


I have not done enough procedures nor have I heard the outcomes of enough of my colleague's procedures to comment on what the typical pitch elevation is.