Dr. Rafii doing a Voice Procedures

As we age, our larynx (the medical term for the voice box) ages with us. The voice changes initially during puberty, when the laryngeal muscles grow, causing a deepening of the voice. As we grow older, the soft and pliable vibratory layer of the vocal cords (known as the superficial lamina propria) becomes thinner and stiffer, causing our voice to undergo changes. Additionally, like in other parts of the body, joints and ligaments within the larynx can also stiffen and lose their full range of motion. These aging-related changes to the larynx are referred to as Presbylaryngis.

What Are the Symptoms of Presbylaryngis?

The typical voice changes caused by presbylaryngis can include a weaker, breathier voice, decreased vocal stability, loss of vocal range, and a decreased ability to sustain a note. Changes in the vocal pitch can occur as well–men may notice their vocal pitch get higher, whereas in women, the pitch may get lower.

Other Ways Aging Can Affect the Voice

Of course, aging doesn’t only affect the voice. It turns out that changes in other parts of the body, including the respiratory, musculoskeletal and nervous systems, can also have secondary effects on the voice. For example, as we age, our breathing muscles like the diaphragm and the intercostal muscles between the ribs weaken, and the flexibility of our chest cavity decreases. Together, these changes decrease the force with which we can blow air through our vocal cords.

For many people, age-related voice changes are a normal part of life and do not have a significant impact on their ability to live their life and do the things they do. However, different people place different demands on their voice, and aging can affect some people’s voice more than others. Treatment should be considered when presbylaryngis has an impact on a person’s quality of life. This can range from personal discontent about how one’s voice sounds, to issues that interfere with one’s ability to perform their job. People who use their voice in a professional capacity, such as singers, performers, or people in business and sales, place high demands on their vocal abilities, and may have less tolerance for age-related voice changes.

Finding the Right Specialist

As a fellowship-trained laryngologist, Dr. Rafii is an expert in diagnosis and treatment of the aging voice. During your visit, Dr. Rafii will take a comprehensive voice history, conduct a perceptual voice evaluation (an objective assessment of your vocal function), and use high resolution videostroboscopy for direct visualization of the vocal cords. He will work in collaboration with you to determine what treatment plan is best for you. A variety of treatment options are available, and may include vocal exercises, working with a voice therapist or vocal coach, and vocal cord rejuvenation procedures such as filler injections. Filler injections can be done during a regular office visit, allowing for fast results and convenience. The main drawback of filler injections is that the results are temporary. In select cases, surgical augmentation of the vocal cords can be done as a long-term solution.

If you think you may be experiencing aging related changes to your voice, call or message us today for a comprehensive voice evaluation with Dr. Rafii.


Dr. Benjamin Rafii is proud to be recognized as a Top Doctor in Los Angeles Magazine in 2021, 2022, and 2023 for ENT. Located conveniently in SAG-AFTRA Plaza in the heart of LA, we serve patients throughout Los Angeles, including Beverly Hills, Central LA, Hollywood, West Hollywood, West LA, Santa Monica, Brentwood, Culver City, Silver Lake, Echo Park, and DTLA. We also gladly serve domestic and international patients traveling to Los Angeles; please contact our office for assistance in making travel arrangements.