Thyroid Surgery (Thyroid Lobectomy & Total Thyroidectomy)

What Is the Thyroid Gland?

The thyroid is a butterfly-shaped gland located in the lower front of the neck. It produces hormones that regulate metabolism, energy levels, and many body functions.

Why Is Surgery Needed?

Thyroid surgery may be recommended for:

• Thyroid nodules or lumps
• Thyroid cancer or concern for cancer
• Enlarged thyroid (goiter) causing pressure or swallowing problems
• Overactive thyroid (hyperthyroidism) not controlled with medication

Types of Thyroid Surgery

Thyroid Lobectomy

• Removal of one lobe (half) of the thyroid
• Often performed for a single nodule or uncertain diagnosis

Total Thyroidectomy

• Removal of the entire thyroid gland
• Typically performed for thyroid cancer, large goiters, or certain hyperthyroid conditions

How Is the Procedure Performed?

• Surgery is performed under general anesthesia
• A small incision is made in the lower front of the neck, usually along a natural skin crease
• The surgeon removes part or all of the thyroid while protecting nearby structures:
  • Recurrent laryngeal nerve (controls the voice)
  • Parathyroid glands (regulate calcium levels)

Typical duration:

• Lobectomy: 1–2 hours
• Total thyroidectomy: 90 minutes- 2 hours

You will also spend approximately 1–2 hours in the recovery room after surgery

What to Expect After Surgery

Immediately After Surgery

• You may feel tired, groggy, or weak from anesthesia
• Assistance is recommended when getting out of bed initially
• Neck soreness, stiffness, and mild discomfort are common
• Temporary sore throat or hoarseness may occur
• You may move your head as tolerated

Diet

• Resume a regular diet as tolerated
• Soft foods may be helpful for the first few days due to mild swallowing discomfort

Pain Control

• Most patients only require:
  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin)
• Stronger medication may be prescribed if needed
• Throat lozenges or sprays can help with soreness

Medications

• Thyroid hormone replacement may be prescribed depending on the surgery
• Calcium supplements may be required, especially after total thyroidectomy

Recovery and Activity

• Most patients return to normal activities within 1–2 weeks
• Many return to work in 7–10 days
• Light exercise can resume after about 7 days
• Avoid heavy lifting or strenuous activity initially

Driving

• You may drive after a few days when:
  • You can comfortably turn your head
  • You are no longer taking narcotic pain medication

Neck Mobility

• Gentle neck movement is encouraged to reduce stiffness:
  • Chin to chest
  • Ear to shoulder
  • Looking upward

Incision Care and Healing

• You may shower after 24 hours
• Gently wash the incision with soap and water; do not scrub
• Pat dry

Healing Timeline

• Incision becomes watertight in 24–36 hours
• Full healing occurs over several weeks
• Mild swelling or firmness may last a few months

Skin Closure

• Dermabond (skin glue) will peel off in 7–10 days

Scar Expectations

• Most noticeable at 1–2 months
• Gradually fades over several months
• Use sunscreen to prevent darkening
• Optional: vitamin E or moisturizer

Common Temporary Symptoms

• Hoarseness
• Neck stiffness
• Difficulty swallowing (may last 4–6 weeks)
• Sensation of neck fullness
• Numbness around incision

Calcium-Related Symptoms

• More common after total thyroidectomy
• Tingling in lips or fingertips (typically 2–5 days after surgery)

Benefits of Surgery

• Removal of abnormal or cancerous tissue
• Relief of pressure symptoms
• Accurate diagnosis
• Definitive treatment for many thyroid conditions

Risks

Thyroid surgery is generally very safe. Possible risks include:

• Bleeding or infection
• Temporary or rarely permanent voice changes
• Low calcium levels (more common after total thyroidectomy)
• Need for lifelong thyroid hormone replacement (after total thyroidectomy)

Follow-Up

• Post-operative visit is typically scheduled about 2 weeks after surgery
• Contact your surgery coordinator if you are unsure about your appointment

When to Call Your Doctor

Call your doctor if you experience:

• Fever over 102°F not responding to Tylenol or ibuprofen
• Sudden increase in neck swelling
• Difficulty breathing
• Worsening numbness or tingling despite calcium supplementation
• Severe muscle cramping or spasms

Emergency Room

If you need to go to the Emergency Room, please use the following guidelines:

• Age 16 and older: Centennial Medical Center Frisco
• Under age 16: Children’s Medical Center Plano