5 Things to Know about a Thyroid Scar BEFORE You Have Thyroid Surgery or Parathyroid Surgery

You just learned that you need thyroid or parathyroid surgery... so what should you know about your scar?

For most thyroid patients (and thyroid surgeons!) the primary goal of any surgery is to have an excellent outcome without any complications. This means either removing all of the thyroid cancer, curing your parathyroid problem, or finally solving your Graves' Disease concern.

But, most of the time, patients will end up with a thyroid or parathyroid scar in the middle of the neck. What does it look like, how will it heal, and what should you know about these scars? Read on for 5 things you should know about your thyroid or parathyroid scar BEFORE you have surgery.

1- Does the scar really matter?

We agree that safety is the most important thing. But what about the scar? Does it even matter?

If it matters to you, then it matters! Because thyroid and parathyroid surgery leave scars in the middle of the neck, it is an obvious location and people WILL ask you questions about your scar. For some people, they become battle wounds that demonstrate what they have overcome (yay!). For others, however, it causes them to feel self conscious. And finally, for others, they just don't like having to explain to random strangers about their medical problems.

In other words, if a scar matters to you, then it should matter to your surgeon.

2- How well will my scar heal, and what should I do to improve my scar?

After thyroid or parathyroid surgery, most people have scars that heal very well. It will often fade to a fine, almost invisible, line. However that can't be guaranteed. And it does take both time and effort on your part to get the best scar.

To take the best care of your scar after surgery you should keep it covered and out of the sun for at least 6 months. Also, you should massage it regularly with cocoa butter, silicone gel, or the scar cream of your choice (research suggests that silicone products usually work best). Finally, some patients who start to have poor healing might need to do a steroid injection, laser treatment, or even cut out the old scar.

3- Will my thyroid scar or parathyroid scar bother me or other people?

Every single patient and every single scar are different. You will know yourself best, and also if the scar will bother you.

Overall, the research does suggest that some patients are bothered by scars, and that the quality of life can be affected. International research has demonstrated that having a thyroid scar can affect your health related quality of life as much as having vitiligo or psoriasis. Another study found that thyroid scars can also distract the gaze of people who are talking to you. The researchers hypothesized that this could impair communication.

Finally, one study demonstrated that up to 10% of patients are still thinking about plastic surgery to fix their scar 5 years after surgery. The same authors found that about 50% of thyroid scars are considered to be "excellent" when judged by patients themselves several years after surgery.

4- Does the size of my thyroid scar or parathyroid scar matter? (can my surgeon make it better or worse?)

Many surgeons advertise "minimally invasive" thyroidectomy or parathyroidectomy treatments. These treatments advise that surgeons can use smaller scars, with the implication that a smaller scar will be less obvious. Unfortunately, this is not supported by research. Instead, most studies suggest that the size of the scar does not matter.

What does this mean? It means that, if a scar bothers you, then your thyroid scar will probably bother you. No matter how small it is.

Can your surgeon make it better? Well, there is quite a bit of research that suggests that the type of closure might make it better or worse. BUT, much of that research is conflicting. In my own practice, I attempted various techniques over the years before finally finding a technique that healed very well and required minimal care from patients after surgery. (I did spend a year training with plastic surgeons, and so it came in handy to have many different options and techniques to choose from!).

Despite all of this, I am always surprised that every different patient will heal quite differently despite the exact same closure. This is both frustrating and also somewhat relieving! Overall, it is important to make sure that your surgeon does a nice thyroid closure, but much of the healing actually depends on the patient.

5- Do I have to have a thyroid or parathyroid scar?

For most patients, the answer is NO, you DO NOT need a thyroid or parathyroid scar. If you are worried about scar healing, having to explain what happened, or even you just don't want the hassle of caring for a scar after surgery, most patients DO NOT need to have a scar. Between radiofrequency ablation (RFA) and "scarless surgery" options, the majority of patients DO NOT need a thyroid scar or a parathyroid scar. And, even better, complication rates are the same and quality of life is BETTER in some ways after having thyroid or parathyroid surgery without a scar.

Because most surgeons don't offer scarless surgery or RFA, you might need to speak with someone who does. So please, give us a call! There is no surgeon in the United States with more experience in "scarless" thyroid and parathyroid surgery than Dr Jon Russell.

And... the picture that we posted is a picture of one of our patients. Not having a scar at all is the best kind of scar.

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