How will my scar look?
After surgery your incision will be kept taped for several months with Micropore Tape, which you will replace every few days. This stops excessive tissue movement and results in the best cosmetic result. After 3 months scars are often red and visible and then they gradually fade. It may take 12 months before the scar fully heals to a fine white line in the skin crease.
What about creams and massage?
These may be used when your tape has been initially replaced. Many patients have a personal preference otherwise Vitamin E cream is recomended. Massage the cream around the wound and it will often help with the swelling and tightness that is common for some time after surgery. Please note oil is not recomemded as it will stop the tape from sticking.
Can laser surgery improve scar appearance?
Laser surgery has no place in this type of operation and cannot improve the appearance of the scar.
What if a keloid develops?
Around 1% of patients’ are predisposed to keloid reaction in the scar, which leads to a red, itchy and swollen scar. If an early keloid develops it can generally be successfully treated by the application of
silicone gel dressings for several months.
How long will I be in hospital?
Minimally invasive or keyhole surgery is generally performed as a day only or overnight stay procedure. Open thyroid and parathyroid surgery usually requires only a one night stay in hospital, however if all the thyroid gland is removed, or more than one parathyroid gland needs to be removed, two nights may be required.
Will my parathyroid glands be taken out with my thyroid?
If you are having thyroid surgery ("thyroidectomy") then every attempt is made to preserve all your parathyroid glands. Mostly they are left In place with their blood supply attached but, if that is not technically possible, they may need to be removed and transplanted into the adjacent muscle. Sometimes very small parathyroid glands are buried under the thyroid capsule and cannot be identified at operation and so get taken out with the thyroid specimen. Transplanted parathyroid glands take between 6weeks to 6 months to recover, however the body can generally get by with just part of one parathyroid gland if necessary.
How long will the operation take?
Thyroid and parathyroid operations generally take between one to two hours.
Will I need a general anaesthetic?
This type of surgery requires a general anaesthetic in order to stop muscle movement during the delicate dissection. However the anaesthetic technique used is very light often referred to as a “twilight anaesthetic” as a local anaesthetic in the form of a cervical nerve block achieves the pain control. As a result you may have a numb face and ear for 24 hours afterwards.
Will I have a drain?
Nowadays drains are only used occasionally for very large goitres or if there was difficulty with bleeding so it is unlikely that you will have a drain.
Will I have stitches or clips and when will they need to be removed?
Nowadays the incisions are closed with tape (“steri-strips") and so there is no need to have any stitches removed.
Will there be any swelling or changes in the neck after surgery?
Some swelling above the incision due to lymph accumulation is common after open surgery and may take several months to completely go down. Likewise some numbness directly above the incision due to small skin nerves being divided and this may also take months to recover. Occasionally some "tethering" of the scar occurs as a result of the skin getting stuck to the underlying muscle. This usually Improves with time and massage therapy but may take 12 months to resolve.
What about neck stiffness and exercises?
Some neck stiffness is common as a result of the prolonged extension (backward tilting) of the head under the anaesthetic. The exercises recommended will reduce but it may last for some weeks and require physiotherapy as well.
Can I eat and talk after surgery?
You can generally talk straight after surgery and, depending on your reaction to the anaesthetic, you should be able to have a light meal the same evening. However many patients are aware of some difficulty getting food down a bit like "swallowing over a step” for some months after surgery. This feeling will always get better with time. Occasionally this tightness is uncomfortable and may respond to myofascial release therapy by a qualified massage therapist.
How long do I need off work and activities?
For minimally invasive surgery often only a few days up to a week is needed to recover from the anaesthetic. For open operations one to two weeks may be required off work. Most physical activities such as sport and car driving can be resumed within the week depending on how you feel.