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Surgical Scars

One thyroid health topic I rarely see acknowledged surrounds the trauma caused by the incision site of a partial or total thyroidectomy. There is both physical and emotional scarring that can occur as a result of thyroid surgery. Knowing what to expect during the healing process may help minimize some of the concerns.

To access the thyroid, the surgeon makes a one to four inch incision across the front of the neck, usually through the hollow in the lower portion of the throat. The skillful surgeon places the incision in the natural creases of the neck, to help disguise it as it heals. Initially, the wound will be covered with a bandage placed by the surgeon. Bathing and showering are allowed while the bandage remains for up to two weeks. The patient may want to use a blow dryer set on cool to help dry the bandage after showering. Of course, the doctor will give the patient instructions to follow for immediate care of the wound site following the surgery.

During the week following the surgery, the patient may notice difficulty swallowing, neck stiffness and just a bit of pain at the incision site. These issues are to be expected, but of course, contact your physician if anything seems abnormal.

Even before the bandage eventually falls off or is removed by the doctor, the patient may feel like the scar is going to have a negative impact on their appearance. It is natural to feel scared, anxious or even sad about the thought of having a scar running across the front of the neck. One factor that may even amplify those feelings is that the disruption of the thyroid function also severely impacts hormones. Until the body and hormones return to a balanced state, emotions may be even stronger. Hormone disruption may also impact the physical healing of the incision.

It is normal to feel self conscious about one’s appearance – especially if the bandage is still visible. People are curious and it is likely they will notice the bandage or scar when it is new, and, possibly even make a comment. Wearing a scarf, bandana or turtleneck are good options. Personally, I wore scarves and bandanas after my surgery, and actually found the scarves really added an elegant touch to my wardrobe. Wearing a bandana while spending time outside is a good idea to protect the scar from the damaging rays of the sun. Actually, keeping protected from the sun is just a good idea anytime.

Surgeons use dissolving stitches that are artfully placed on the inside of the incision and eventually “melt” away. The patient may notice very fine bits of the material used to create the stitches on each end of the incision. Within a couple of months those barely noticeable pieces of suture material will also vanish.

Whether or not to use a cream or ointment to help minimize the scar is based on personal preference. There are many treatments available to help heal the scar. At a minimum, keep the scar covered with a sunscreen. Aloe, castor oil, vitamin E, cocoa butter and Mederma are common treatments to help the scar heal and disappear. Iodine is beneficial, especially to keep the scar sanitized. Stretching the neck and gently massaging the scar is also helpful to keep the skin supple. I used Mederma and vitamin E cream on my scar and continue to moisturize it daily.

People who are prone to keloid scaring, which are raised, thickened scars, may want to treat the scar more aggressively from the start. Doctors have special injections and treatments that may help patients who have a history of developing keloids.

Time may be the best medicine. A year after surgery, the scar should be barely visible. A little bit of makeup on the incision may conceal it completely.

Along with time, acceptance is also a wonderful healer. Recognizing that scars are badges of courage obtained throughout life is empowering. None of us get through life unscathed. Be proud of your battle scars and recognize that you are strong, resilient and amazing!
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