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Thyroidectomy

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Thyroidectomy Introduction

A thyroidectomy is a surgical procedure to remove part or all of the thyroid gland, which is butterfly shaped and located at the front part of the neck just below the Adam’s apple. The thyroid plays an important role in regulating metabolism, energy levels, and body functions by producing thyroid hormones.

Thyroid surgery may be recommended for a variety of conditions, including thyroid nodules, goitre (enlargement), overactive thyroid (hyperthyroidism), or thyroid cancer. It is performed under general anaesthetic and usually involves a short hospital stay.

Reasons for surgery

Thyroidectomy is commonly performed for:

  • Thyroid nodules (non-cancerous or suspicious)
    • Some nodules can grow large, cause discomfort or affect swallowing
    • If there is a concern about cancer, surgery may be advised to remove the nodule for diagnosis and treatment
  • Thyroid cancer (confirmed or suspected)
    • Surgery is typically the first step in treating thyroid cancer, it may involve total thyroidectomy and sometimes removal of nearby lymph nodes
  • Overactive thyroid (hyperthyroidism) not responding to other treatments
    • In cases where the medication or radioactive iodine is not suitable or effective, surgery may be needed to control the overproduction of thyroid hormones. Often this indicated after a recommendation by an Endocrinologist
  • Large goitre causing pressure symptoms such as difficulty swallowing or breathing

Depending on the underlying condition, your surgeon may recommend:

  • Hemithyroidectomy – removal of one lobe of the thyroid
  • Total thyroidectomy – removal of the entire thyroid gland

Benefits of the procedure

  • Relief from pressure or discomfort in the neck
  • Removal of suspicious or cancerous thyroid tissue
  • Resolution of overactive thyroid symptoms
  • Definitive diagnosis of thyroid nodules
  • Prevention of future complications from thyroid enlargement

Risks & complications

Thyroidectomy is generally a safe procedure, but as with any surgery, there are some risks:

  • General anaesthesia risks (low in healthy individuals)
  • Bleeding or infection
  • Voice changes or hoarseness due to nerve injury
    • The nerves that control your voice are near the thyroid and may be bruised during surgery
    • Voice changes are usually temporary (<10%) but can be permanent (<1%)
  • Low calcium levels (hypocalcaemia) (temporary or rarely permanent, especially after total thyroidectomy)
    • If your parathyroid glands (which control calcium levels) are affected during a total thyroidectomy, you may develop low blood calcium
    • Symptoms include tingling in the hands, feet or lips. This is usually temporary and treatable with calcium supplements
  • Need for lifelong thyroid hormone replacement
    • If your entire thyroid is removed (total thyroidectomy) you will need to take a daily thyroxine tablet for life to replace missing hormone
    • If only half your thyroid is removed (Hemi thyroidectomy), most people do not need replacement, though some do
  • Scarring – the scar is typically low on the neck and fades over time

Dr Phillips will discuss these risks with you in detail and answer any questions you may have before the operation.

Alternative treatments

In some cases, surgery may not be immediately necessary. Alternatives may include:

  • Observation (active surveillance) for small, non-suspicious nodules
  • Medication for overactive thyroid (e.g., antithyroid drugs)
  • Fine-needle aspiration (FNA) biopsy for diagnosis and monitoring
    • Typically this is performed prior to surgery to investigate any nodules seen on USS and in some cases surgery may not be required if results are reassuring

Surgery is usually considered when symptoms persist, nodules grow, or there is concern about cancer.

Pre-operative instructions

Fasting

You will need to fast for a set period before surgery (usually no food for 6 hours and no clear fluids for 2 hours before). Specific instructions will be provided by the hospital or anaesthetist.

Illness

Please notify the clinic if you are unwell in the days before surgery (fever, cough, chest infection), as the procedure may need to be rescheduled.

Medications

Let Dr Phillips know about any medications you are taking, especially blood thinners, thyroid medications, vitamins, or supplements.

Procedure details

  • The operation is performed under general anaesthetic and usually takes 1–2 hours.
  • A small incision is made low in the front of the neck, following a natural skin crease.
  • The thyroid gland (or part of it) is carefully removed using specialised surgical instruments whilst identifying and preserving the thyroid nerves and parathyroid glands
  • A surgical drain may be placed and removed the next day, if needed.
  • The incision is closed with dissolvable stitches and covered with a surgical dressing.
  • Most patients stay in the hospital for 1 night, although same-day discharge may be possible.

Post-operative care & recovery

Pain

Mild to moderate discomfort around the neck and throat is common.

  • Use paracetamol and/or ibuprofen as advised.
  • Some patients may require stronger pain relief for a short period.

Scar

  • The scar will be firm at first and gradually soften and fade.
  • Sun protection is recommended during healing to reduce scar visibility.

Diet

  • Eat and drink as tolerated. Start with soft foods if your throat feels sore.

Activity

  • Light activity is encouraged.
  • Avoid strenuous exercise or heavy lifting for 1–2 weeks.
  • Most patients return to work or daily routines within 7–14 days.

Hormone Replacement

  • If your entire thyroid is removed, you will need lifelong thyroxine tablets to replace the thyroid hormone.
  • After a hemithyroidectomy, many people do not need hormone tablets, but blood tests may be needed to monitor your levels.

What to watch for

Seek urgent medical attention or contact the clinic if you experience:

  • Neck swelling or difficulty breathing
  • Voice changes or persistent hoarseness
  • Tingling in the hands, lips, or feet (may indicate low calcium)
  • Bleeding or discharge from the wound
  • Fever over 38.5°C
  • Severe pain not controlled with medication

Follow-up instructions

A follow-up appointment will be arranged 1-2 weeks after your operation to review your recovery and discuss any test results. Blood tests may be required to check thyroid function or calcium levels.

If you have any concerns before your scheduled appointment, please contact the clinic.

Frequently asked questions (FAQ)

  • Will I need thyroid medication after surgery?

    If you’ve had a total thyroidectomy, you will need lifelong thyroid hormone replacement. After hemithyroidectomy, around 1 in 4 people require thyroxine, depending on how the remaining lobe functions.

  • Will my voice be affected?

    Most people notice no long-term changes. Some mild hoarseness is common after surgery and usually improves within a few days or weeks. Permanent voice changes are rare.

  • Can I live a normal life without a thyroid?

    Yes. With proper thyroid hormone replacement, you can live a healthy and active life without a thyroid gland.

  • What happens if my calcium is low?

    If your calcium drops after surgery (more likely in total thyroidectomy), you may need calcium supplements temporarily or long-term. You will be monitored closely and advised accordingly.

Related conditions

Book a consultation

If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.

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Australian and New Zealand Rhinologic Society
Australian Society of Otolaryngology and Head and Neck Surgery
Royal Australasian College of Surgeons
International Surgical Sleep Society & Australasian Sleep Society
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