Laryngology · London
Vocal cord injection, by a specialist laryngologist.
Office-based medialisation and augmentation for a weak, breathy voice and choking on drinks. Done by a fellowship-trained laryngologist with stroboscopy on site and speech therapy built in from week two.
Why patients choose us
- 01
A named laryngologist, not a general ENT list
A consultant laryngologist with voice-clinic subspecialty, high injection volumes and stroboscopy on site. Introductions are private, not public.
- 02
The right material for the timeline
Hyaluronic acid for a diagnostic trial. Radiesse Voice for 12 to 18 months. Fat or a definitive thyroplasty implant when the trial has proven the plan.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private vocal cord injection costs in London.
Indicative ranges across our partner voice clinics. Send the referral and we quote firm figures across two or three options.
In short
An office injection under local: £2,400 to £4,500, home the same afternoon.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Laryngologist consultation with flexible stroboscopy | £350 to £550 | 45 to 60 min | Same visit |
| Office vocal cord injection (LA, hyaluronic acid) | £2,400 to £3,500 | 30 to 45 min | Same visit |
| Office vocal cord injection (Radiesse Voice CaHA) | £3,200 to £4,500 | 30 to 45 min | Same visit |
| GA direct laryngoscopy plus injection (fat or gel) | £4,500 to £7,500 | 60 to 90 min | Same day |
| Type I medialisation thyroplasty (Silastic wedge) | £8,500 to £14,000 | 90 to 120 min | Overnight stay |
| Second opinion on prior laryngoscopy and voice recording | £250 to £450 | 30 min | 48 hours |
Prices vary by unit, by the material chosen, by whether the procedure is office-based or under GA, and by whether a formal thyroplasty is planned. We come back with a firm quote within one working day.
The journey
From referral to voice therapy, what happens, in order.
One team from first message to the six-week stroboscopy review, including the speech therapy that makes the injection last.
- 01
Before
You send us the referral or voice recording
A short, confidential form. Cause of the paralysis or atrophy, any prior surgery, current voice quality and any choking on drinks.
- 02
Before
We come back with a recommendation
Within one working day: whether an office injection, a GA laryngoscopy or a type I thyroplasty is the right first step. Indicative price. An honest read either way.
- 03
Before
We arrange the clinic slot
Usually within one to two weeks. Flexible stroboscopy, GRBAS grading and VHI-10 scoring are completed before the injection is booked.
- 04
On the day
Arrival at the voice clinic
Consent with the laryngologist, topical lidocaine to the nose and larynx, and light sedation if the plan is a percutaneous approach.
- 05
On the day
The injection itself
10 to 30 minutes per side. Transoral, transnasal or percutaneous through the cricothyroid membrane, guided by flexible endoscopy.
- 06
On the day
Home the same afternoon
A short recovery, voice rest for the remainder of the day, written aftercare and home within a few hours.
- 07
After
Voice therapy and review
Speech and language therapy starts within two weeks. Stroboscopy review at 6 weeks. Retreatment planned at 12 to 18 months if needed.
When it helps
When an injection is the right step, and when it is not.
The situations we treat most, plus the red flags where a laryngoscopy and biopsy come before any injection.
-
Unilateral vocal fold paralysis
Weak, breathy hoarse voice after thyroidectomy, cardiac or lung surgery, or a mediastinal tumour affecting the recurrent laryngeal nerve.
-
Aspiration with drinks and thin fluids
A paralysed cord that fails to close on swallowing lets liquid enter the airway. Injection medialisation closes the gap and stops the cough.
-
Viral or idiopathic vocal fold palsy
A cord palsy of unclear cause. A short-acting injection is often used as a trial while spontaneous recovery is awaited over 6 to 12 months.
-
Presbylaryngis (age-related atrophy)
A thin, bowed vocal fold in older patients gives a weak, fatigued voice. Small-volume augmentation restores contact and projection.
-
Sulcus vocalis and vocal fold scar
A furrow or scar tethers the mucosal wave. Superficial hyaluronic acid injection improves pliability and vibratory closure.
-
Small glottic insufficiency gap
A minor gap after surgery, radiotherapy or benign lesion excision. A small augmentation closes the deficit without a formal thyroplasty.
-
Trial before definitive thyroplasty
A short-acting injection tests whether medialisation will help the voice and swallow before a permanent Silastic implant is offered.
-
Red flag: hoarseness over 3 weeks
Persistent hoarseness, particularly in smokers, needs laryngoscopy and biopsy to exclude laryngeal cancer, not a private injection booking.
Procedure options
Injection is a family of techniques, and thyroplasty sits beside it.
What each option involves, and which fits which patient. Voice therapy is not optional, it is what makes the injection last.
-
Office injection, hyaluronic acid (Restylane)
Short-acting, 3 to 6 months. Ideal as a diagnostic trial or as a bridge while a recovering nerve is observed. Reversible if the voice worsens.
-
Office injection, Radiesse Voice (CaHA)
Calcium hydroxylapatite in a gel carrier. Durable medialisation for 12 to 18 months. The workhorse for confirmed unilateral paralysis.
-
Autologous fat injection (GA)
Fat harvested from the abdominal wall and injected into the paraglottic space. Feels most physiological. Retention is variable at 6 to 12 months.
-
Long-lasting gel (Restylane definitive)
A more durable hyaluronic acid gel for patients not ready for open surgery. Repeatable and adjustable at review.
-
Type I medialisation thyroplasty
A Silastic wedge placed through a small neck-window under local anaesthetic. The definitive answer once a trial injection has proven the benefit.
-
Percutaneous vs transoral approach
Percutaneous through the cricothyroid membrane suits most patients. Transoral with a curved cannula is used when the anatomy or gag reflex demands it.
-
Voice therapy (essential adjunct)
Speech and language therapy trains breath support, resonance and vocal hygiene. Combined with injection it outperforms either alone.
-
Second opinion review
A laryngologist review of your prior scope, stroboscopy clips and voice recording. Sometimes the answer is therapy alone, not another injection.
Our London network
A small panel of laryngologists, we picked them.
Voice-clinic laryngologists at the Royal National Throat Nose and Ear Private Laryngology Service, Guy's and St Thomas' Private Voice Clinic, Chelsea and Westminster Private ENT and HCA The Portland ENT. Introductions made privately.
-
Fellowship-trained laryngologists on the BAO-HNS register with a dedicated voice-clinic practice
-
Flexible fibre-optic and rigid stroboscopy available in the same visit
-
Speech and language therapy embedded, not an afterthought
-
Thyroplasty and open airway pathways when injection is not the definitive answer
Safety and recovery
Realistic outcomes, honestly.
Immediate voice improvement in 80 to 90 per cent of patients, and near-complete resolution of aspiration in glottic insufficiency. The main planning points are voice rest, therapy from week two, and the retreatment interval.
-
Sedation and local anaesthetic
Most office injections are done awake with topical lidocaine and light oral sedation. GA is reserved for larger volumes, fat harvesting or an anxious airway.
-
Transient worsening of the voice
The voice can sound strained or muffled for 24 to 72 hours after injection while swelling settles. This is expected and resolves without treatment.
-
Over-injection and strained voice
Too much material narrows the glottis and gives a pressed, effortful voice. Hyaluronic acid can be reversed with hyaluronidase; CaHA is left to resorb.
-
Malposition of the injectate
Material placed too superficially blunts the mucosal wave. A high-volume laryngologist and endoscopic guidance keep this uncommon.
-
Laryngospasm and airway reaction
A brief cough or spasm at the moment of injection is common; sustained laryngospasm is rare and settles quickly with reassurance and oxygen.
-
Granuloma and allergic reaction
Local granuloma is uncommon and usually settles with voice rest and steroids. True allergy to hyaluronic acid or CaHA is very rare.
-
Voice rest for 24 hours
No shouting, whispering or singing for the first 24 hours. Normal conversational voice from day 2. Written aftercare provided.
-
Voice therapy from week two
Speech and language therapy is scheduled from week two. Skipping it halves the durability of the injection result.
-
When to call
Persistent breathlessness, stridor, severe pain, fever, or a sudden loss of voice at any point after discharge: call the unit or attend A&E the same day.
Reading your voice clinic report
Your injection report in four parts. Read the last one first.
Whichever material was used, the report the laryngologist sends you keeps to the same shape.
- 01 Header
Diagnosis, cause and side
The diagnosis (paralysis, atrophy, sulcus, scar), the presumed cause, the affected side and the duration of symptoms.
- 02 Technique
Material, volume and approach
Which material was used (Restylane, Radiesse Voice, fat, definitive gel), the volume in millilitres, the approach and any complications.
- 03 Findings
Stroboscopy before and after
Glottic gap, mucosal wave, symmetry and closure pattern before and after the injection, with GRBAS and VHI-10 scores.
- 04 Impression
Voice therapy plan and review interval
Read this first: the therapy referral, the expected duration of benefit, and when to book the stroboscopy review.
Recognised by major UK insurers
Cover for vocal cord injection varies by insurer and by indication, usually funded when medically indicated. We confirm cover before booking.
Ready when you are
Send the referral. We match you to a laryngologist within one working day.
Weak, breathy voice or choking on drinks after surgery. Presbylaryngis with vocal fatigue. A small gap after prior treatment. We come back with two or three named options and firm figures, or an honest read that says an injection is not the answer.
Frequently asked
Everything we get asked about vocal cord injection.
Quick answers on materials, sedation, therapy and when a thyroplasty is the better call.
-
What is a vocal cord injection and who is it for?
A vocal cord (vocal fold) injection medialises or augments a weak cord, closing the small gap that gives a breathy voice and lets fluids enter the airway. It is used for unilateral vocal fold paralysis, age-related atrophy (presbylaryngis), sulcus vocalis, vocal fold scar and small glottic insufficiency after surgery or radiotherapy.
-
What is injected and how long does it last?
Hyaluronic acid gel (Restylane) is short-acting at 3 to 6 months and used as a diagnostic trial. Radiesse Voice (calcium hydroxylapatite) lasts 12 to 18 months and is the workhorse for confirmed paralysis. Autologous fat lasts 6 to 12 months with variable retention. A definitive Silastic thyroplasty implant is offered once an injection trial has proven the benefit.
-
How much does a private vocal cord injection cost in the UK?
Office-based injection under local anaesthetic is £2,400 to £4,500 depending on the material. A GA laryngoscopy with injection is £4,500 to £7,500. A type I medialisation thyroplasty with a Silastic wedge is £8,500 to £14,000. We confirm a firm figure within one working day.
-
Is the procedure painful and will I be awake?
Most office injections are done awake with topical lidocaine to the nose and larynx and light oral sedation. You feel pressure and briefly cough, but the injection itself is not painful. GA is reserved for larger volumes, fat harvesting or when the anatomy is difficult.
-
Do I still need voice therapy after an injection?
Yes. Speech and language therapy from week two trains breath support, resonance and vocal hygiene. Combined with injection it outperforms either alone and extends the durability of the result. Skipping therapy halves the benefit.
-
When would you recommend a thyroplasty instead of a repeat injection?
If a trial injection has clearly improved your voice and swallow, and the paralysis is likely permanent (typically after 9 to 12 months of observation), a type I medialisation thyroplasty with a Silastic implant is the definitive answer and avoids repeat injections every 12 to 18 months.
Related treatments and conditions
Looking for something else?
-
Sialendoscopy
Salivary duct endoscopy for stones and strictures.
Learn more -
Uvulopalatopharyngoplasty (UPPP)
Soft-palate surgery for snoring and sleep apnoea.
Learn more -
Balloon sinuplasty
Minimally invasive dilatation of the sinus openings.
Learn more -
Adenoidectomy
Removal of the adenoids for obstruction and infection.
Learn more -
Dysphagia therapy
Swallowing rehabilitation with speech and language therapy.
Learn more -
Voice feminisation therapy
Behavioural voice therapy for gender-affirming voice change.
Learn more -
Vocal cord paralysis
The condition guide covering causes, tests and options.
Learn more -
Dysphonia
Assessment and management of hoarseness and voice change.
Learn more