Overview
If you are worried about how your scar might look after thyroid or parathyroid surgery, this page is for you. “Scarless” thyroidectomy (or transoral thyroidectomy) is a technique that removes the thyroid gland without leaving a visible scar on the neck. To avoid visible scars, we use a technique that are used in other surgeries - keyhole incisions. We then hide these incisions in a location that is not visible to others looking at you (inside the lower lip). Using this technique, others won't be able to tell that you had surgery. It protects your health privacy and avoids awkward conversations with random strangers about your personal business.
Scarless thyroid surgery is an excellent option for patients who are concerned about their neck looking worse after thyroid surgery. In one study, patients who had scarless thyroid surgery had a better quality of life than patients who had a normal scar. Specifically, patients are more than 3 times less self-conscious about the way they look after surgery if they have "scarless" thyroid or parathyroid surgery.
Dr Jon Russell is a world expert at this condition and has written the book on how to do this technique. Furthermore, he lectures internationally and has completed more of these surgeries than any other surgeon in the Western Hemisphere.
Procedure
During “scarless” thyroidectomy, the surgeon makes small keyhole incisions inside the lower lip to access the thyroid gland. Specialized instruments are used to remove the gland through these incisions (with or without a robot to help). The procedure is performed under general anesthesia and usually takes an hour or two. Transoral "scarless" thyroidectomy and parathyroidectomy avoids any external incisions, leaving no visible scar on the neck. Transoral thyroidectomy can be done to remove half of the thyroid (hemithyroidectomy) or all of the thyroid (total thyroidectomy). It can be done for cancer, Graves' disease, goiter, and most other conditions that require surgery. In fact, most patients are eligible for "scarless" thyroidectomy and parathyroidectomy. Check out our video about scarless thyroid surgery for more information!
Benefits and Risks
The primary benefit of “scarless” thyroidectomy is the absence of a visible scar. The scar is the number one complaint of patients after thyroid surgery, with about 80% of patients expressing concerns about the appearance of their scar in one recent study completed by surgeons in Chicago. Benefits of "scarless" surgery according to some studies include a quicker recovery time and reduced postoperative pain compared to traditional surgery. As with traditional thyroid surgery, potential risks include infection, bleeding, and damage to the surrounding structures such as the recurrent laryngeal nerve and parathyroid glands. These risks are the same whether patients choose the scarless surgery or traditional surgery. There are several unique risks to the scarless surgery, but these risks (chin changes, numbness, infection) have not been identified regularly in a large number of research studies to date. Your health is always our priority at the Russell Center. If scarless thyroid surgery is not right for you, we will let you know.
While at Johns Hopkins, Dr Russell extensively researched the topic of how scars impact a patient's quality of life, including approximately 100 papers, books and chapters on the topic. Ultimately, the results have consistently agreed suggested that avoiding a neck scar improves the quality of life of most patients.
Recovery and Follow-Up
Recovery from “scarless” thyroidectomy is usually the same as with traditional surgery, with most patients able to return home the same day or after an overnight stay. Mild discomfort in the neck is common and can usually be managed with over-the-counter pain medications. It is important to follow postoperative care instructions to ensure proper healing. After surgery, you will schedule a follow up appointment with your endocrinologist or primary care doctor to check your thyroid function. We will schedule an appointment with our office (either virtual or in person) after surgery to check in and review pathology.
Because many of our patients travel to see us, we make the entire process very straightforward. Usually, we can do a consultation, surgery and a postoperative visit during one trip. Fortunately, most of our patients do not need to stay in the hospital, and complications are very rare. Patients usually travel home shortly after surgery. Virtual follow up visits can be an efficient way to check in when patients are interested.
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