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Endocrine Surgery - Scarless Thyroidectomy

The department is one of the very few to be doing endoscopic thyroidectomy (scarless neck thyroid surgery) allowing an excellent cosmetic result. In addition, surgeries for parathyroid and adrenal tumours are performed routinely.


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What is the Thyroid gland and what is its function?

The Thyroid gland is Butterfly shaped organ located in the neck sitting on your windpipe just below the adam’s apple. It has two halves (left and right lobes) connected by a central bridge (isthmus).

The thyroid gland is responsible for secreting a hormone called “Thyroxine” which controls the body’s metabolism, which is essential for maintaining normal health.

What are the types of thyroidectomies?

Depending on the nature of thyroid disease or the location of the thyroid lesion, your surgeon may suggest one of the following surgeries:

  • Hemithyroidectomy: Removal of one lobe of the thyroid and the isthmus
  • Total Thyroidectomy: Removal of the entire thyroid gland (both lobes of the thyroid and the isthmus) leaving no tissue behind.
  • Near Total Thyroidectomy: Occasionally, for surgical reasons, your surgeon may leave a very tiny amount of thyroid tissue behind. It is done to protect important structures that run very close to the thyroid gland in the neck.

Will I Get a bad scar in my neck?

Conventional Thyroid surgeries involve a cut in front of your neck. However as in any surgery involving the face and neck, scars will be usually only mildly noticeable

What are the potential complications that I should know?

The thyroid gland is close to many nerves and blood vessels and hence the surgery carries a minor risk involving injury to these structures. These are more likely to occur in patients undergoing

  • Surgery for cancer
  • Lymph node surgery
  • Surgery for a large thyroid (goiter)
  • Revision thyroid or lymph node surgery

Nerve Injury:

  • There are nerves running in close proximity to the thyroid gland which is responsible for the quality and the pitch of your voice – Recurrent laryngeal nerves and the superior laryngeal nerves one each on each side.
  • Injury to these nerves may result in a change in voice
  • These voice changes are usually transient lasting for few days to few weeks.
  • However, in very rare scenarios especially in thyroid cancer surgeries, there is a minimal risk of permanent voice damage. Hence professionals whose career involves their voice – like singers and teachers need to discuss with your surgeon prior to surgery.
  • Uncommonly injury to laryngeal nerves on both sides may warrant placing a breathing tube through the windpipe (tracheostomy). In most instances, it is short-term.

Low Calcium levels:

  • We have four parathyroid glands, two on each side, each about the size of a grain of a lemon seed attached behind the thyroid gland.
  • They are involved in regulating calcium levels in the blood.
  • Normally the surgeon identifies and saves some or all of these glands.

However, during thyroid surgery the parathyroid glands can be bruised, damaged, or excised, causing low calcium levels in blood manifested by a sensation of tingling in the fingers and lips (pins and needles sensation) and/or cramps in the fingers.

  • Even if the parathyroid glands are saved, there may be stunning of the glands causing low calcium levels for several days to weeks.
  • These may be managed by replacing calcium usually orally by tablets.

Other Potential Complications

Neck Numbness:

  • Some patients may experience numbness around the thyroid surgery scar after their operation. This usually subsides with time.

Swallowing Difficulties:

  • Mild swallowing difficulties may occur usually pain-related improves with analgesics

Wound related issues:

  • Swelling around the wound may be seen for a few days – these are usually normal after surgery.
  • Wound Infections are rarely seen
  • Occasionally fluid may accumulate behind the wound called a seroma. Normally subsides with time.

Thyroid Storm:

  • An Extremely rare complication in patients with the overactive thyroid gland (thyrotoxic patients) undergoing surgery
  • Caused by a sudden excessive amount of thyroid hormone released into the bloodstream during surgery.
  • Hence all thyrotoxic patients must be put on medications to achieve normal thyroxine levels prior to surgery.

Are there any complications during or after thyroid surgery?

  • Thyroid surgery is generally a safe procedure.
  • The vast majority of patients undergoing an operation on the thyroid gland have no complications.

However, as with any surgical procedure, there are some risks associated with the operation and these will be fully explained to you by your surgical team.

Why do I need to undergo Thyroid surgery?

It is usually performed for the following reasons.


  • Any increase in the size of a thyroid gland, from any cause, is called a goiter
  • Increase in the size of the gland may lead to compression on the windpipe (trachea) or the food pipe (esophagus). This may warrant surgery.
  • Even in the absence of pressure effects, a goiter can cause discomfort or cosmetically unacceptable appearance. In such a scenario you should discuss the risk and benefit of surgery with your surgeon

Development of a lump (nodule) in the gland:

  • Nodules or lumps may develop in the thyroid gland which may be single (solitary nodule) or multiple (multi-nodular goitre)
  • The elderly are more prone to develop nodules. Nodules are seen in 50% of women and 30% of men after the age of 50.
  • These nodules are assessed by clinical examination, ultrasound examination, needle biopsy or all three tests as your surgeon suggests
  • Sometimes these nodules may be cancerous and your surgeon will advice surgery involving removal of the thyroid gland

Over-active thyroid gland

Over-active Thyroid gland secreting excessive thyroxine may sometimes require thyroidectomy Eg. Graves Disease or toxic adenoma.

What is lymph node surgery and when is it needed?

Lymph nodes are small bean shaped structures present at various locations in the body, which are helpful in the body’s immune system by filtering toxic substances that are harmful.

In patients who have a diagnosis of thyroid cancer, the lymph nodes around the thyroid gland may be involved and need to be removed as part of the cancer operation – This procedure is called as Central Lymph Node Dissection.

Is there any Key Hole surgery for thyroid as with the abdomen?

Yes! Key Hole surgery with a Scarless neck is an option in thyroid surgeries.

- The feasibility of such surgery depends on the size of the thyroid gland.

- Your surgeon will assess clinically and the ultrasound scan and will give you an option for a keyhole surgery or what is called an “Endoscopic Thyroidectomy”.

Will I need Thyroid replacement tablets after my operation?

Patients who have had a total thyroidectomy or near-total thyroidectomy will need thyroid tablets postoperatively and this will be life long.

Do I still need to worry about my surgery?

Thyroid Surgeries are Safe surgeries with minimal risks. Speak to your surgeon before Surgery and clarify all your doubts and concerns. Your surgeon will allay all your fears regarding the surgery.


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