Home » Voice Surgery » Anterior Commissure Advancement (ACA)
Anterior Commissure Advancement (ACA) is an advanced surgical technique used primarily in voice feminization surgery to raise vocal pitch and refine the tone for a naturally feminine voice. This procedure is particularly effective for patients seeking subtle, stable, and long-lasting pitch elevation alongside other voice-modifying surgeries.
At Yoskarn Clinic in Bangkok, Thailand, Dr. Somyot Kunjak and his expert team, with over 40 years of ENT and phonosurgery experience, perform ACA with precision and care, ensuring results that are both natural and permanent.
ACA works by shortening the effective vibrating length of the vocal folds. The anterior commissure — the front attachment of the vocal cords — is advanced forward, which increases tension along the vocal folds. This results in:
Higher vocal pitch
Smoother vocal tone
Improved resonance and clarity
Unlike non-surgical approaches, ACA provides permanent anatomical changes, making it a reliable solution for long-term voice feminization.
Transgender women seeking a higher and more feminine voice
Individuals who want subtle pitch elevation with natural resonance
Patients combining ACA with Cricothyroid Approximation (CTA) for enhanced voice feminization outcomes
ACA is often paired with post-operative voice therapy, which fine-tunes resonance, intonation, and overall speech patterns.
Comprehensive Preoperative Assessment
Using stroboscopy, acoustic analysis, and laryngeal imaging, Yoskarn Clinic ensures precise planning tailored to the patient’s vocal anatomy and goals.
Surgical Technique
Under general anesthesia, the surgeon carefully advances the anterior commissure of the vocal folds using microsurgical methods, adjusting tension for optimal pitch elevation.
Postoperative Care
Patients follow a structured voice rest and therapy program, ensuring safe adaptation to the new vocal mechanics. Most patients notice immediate pitch improvement, with refinement over a few weeks.
Over 40 years of ENT and voice surgery expertise, led by Dr. Somyot Kunjak, a pioneer in voice feminization.
Advanced diagnostics including stroboscopy and high-definition acoustic analysis for precise surgical planning.
Minimally invasive microsurgical techniques that maximize safety and natural voice outcomes.
Comprehensive care combining preoperative evaluation, surgery, and postoperative voice therapy.
Internationally trusted Bangkok clinic, serving patients worldwide seeking professional, reliable voice feminization care.
At Yoskarn Clinic, ACA is not just a surgical procedure — it is a carefully customized solution to help you speak with confidence, femininity, and authenticity.
Discover world-class rhinoplasty and facial enhancement services where precision meets artistry in Bangkok.
