Surgery is often the first and most important step in the treatment of thyroid cancer. For many patients, it offers the best chance of cure.
This article explains what to expect before, during, and after thyroid surgery – including the types of procedures, recovery process, and possible risks.
Types of Thyroid Surgery
The type of surgery recommended depends on the size and type of thyroid cancer, whether it has spread, and your overall health.
Your surgeon will discuss the best approach for your situation. The two most common procedures are:
Hemithyroidectomy (Lobectomy)
This operation removes one half (lobe) of the thyroid gland. It may be suitable when the cancer is small and confined to one side.
- You may not need lifelong thyroid hormone replacement if the remaining lobe functions well.
A thyroid function test is usually done 4–6 weeks after surgery. If levels are adequate, only yearly blood tests are needed.
If thyroid hormone levels are low, a low dose of thyroxine may be prescribed.
- This surgery typically has a shorter operating time and slightly fewer risks.
Total Thyroidectomy
This procedure removes the entire thyroid gland and is usually recommended if:
- The cancer is larger
- Both lobes are affected
- Nearby lymph nodes are involved
Following total thyroidectomy:
- You will need to take thyroid hormone tablets (thyroxine) daily for life.
- Radioactive iodine (RAI) therapy may be recommended after surgery to eliminate remaining thyroid tissue or microscopic cancer cells.
What Happens During Surgery
- The operation is performed under general anaesthesia and usually takes 2–3 hours.
- A small incision is made at the base of the neck, often along a natural skin crease to minimise scarring.
(Click here to learn more about scarless thyroid surgery, otherwise also known as trans-oral endoscopic thyroidectomy vestibular approach, or TOETVA)
- A temporary drain may be placed to remove fluid. This is usually removed before discharge, but may stay in longer if needed.
- Most patients stay in hospital for 1–2 nights following surgery.
Recovery After Surgery
- It is normal to experience some neck discomfort, bruising, or a tight sensation.
Take regular pain relief such as paracetamol or ibuprofen for the first few days.
Stronger medications like oxycodone or tapentadol may be prescribed if required.
- A dressing will cover your wound.
Keep it clean and dry. You may shower, but avoid bathing.
Use a hairdryer on a cool setting to gently dry the dressing afterwards.
Leave the dressing on until your post-operative appointment, usually about one week after surgery.
(Click here for more information about wound healing)
- Most patients return to light activities within a few days.
Depending on your work, allow 1–2 weeks off to recover.
- If you have had a total thyroidectomy, your calcium levels will be checked after surgery.
Temporary calcium supplements may be prescribed if needed.
- A follow-up appointment will be arranged to review your pathology results and discuss further treatment if required.
Risks of Thyroid Surgery
While thyroid surgery is generally safe, all operations carry some risk.
When performed by an experienced surgeon, serious complications are uncommon.
Risk – What it means – How common
- Bleeding or haematoma – Blood collecting in the neck, may require drainage – Rare (<1%)
- Infection – Wound infection – Rare
- Voice changes or aspiration – Hoarseness or swallowing issues due to nerve injury – Temporary ~5%, permanent <1%
- Low calcium (hypocalcaemia) – If the parathyroid glands are affected – Temporary ~30%, permanent <2%
- Seroma – Fluid collection under the skin after drain removal – Occasionally; usually resolves without treatment
- Scarring – A visible scar is expected but usually fades over time – Expected
Your surgeon will take every precaution to minimise these risks.
This includes careful dissection, nerve monitoring, and preserving the parathyroid glands wherever possible.
Final Thoughts
Thyroid surgery is a safe and effective treatment for most types of thyroid cancer.
Understanding what to expect at each stage of the journey can help you feel more confident and prepared.
If you have any questions about your surgery or whether further treatment such as radioactive iodine is needed, please don’t hesitate to contact us.
Every case is unique, and your care will be tailored to your individual needs.