Cosmetic surgery techniques, such as having a patient sit or stand while incision sites are marked so they blend into natural lines of the body, can improve the aesthetic result of thyroid surgery as well, researchers say.
"We have found that while keeping the management of the underlying thyroid problem as the first priority, we can still achieve a maximal cosmetic result," says Dr. David Terris, a pioneer in minimally invasive techniques that have dramatically reduced the size of the hallmark base-of-the-neck incisions.
Dr. Terris, who chairs the Medical College of Georgia Department of Otolaryngology-Head and Neck Surgery, wanted to know if cosmetic surgery principles he learned in the facial plastic surgery part of his training could further improve results.
He did a prospective analysis of 248 patients who required varying approaches to thyroid surgery, from a standard, several-inch-long neck incision to remove huge thyroids to minimally invasive techniques that cut the incision size in half to endoscopic approaches that reduce incision size half again. Patients were operated on at MCG Medical Center between September 2003 and June 2006.
Most thyroid patients requiring surgery are women , 198 women compared to 50 men in this new study published in the July issue of The Laryngoscope , and many are concerned with the cosmetic result, says Dr. Terris. "It matters to them how big the scar is, if it's even, if it's hidden in a skin crease, if the edges are nicely aligned."
All patients sat up to have their incision sites marked. "You want the incision to be in a location that corresponds to a cosmetically favorable area when you are upright at a dinner party, not stretched out on an operating room table," says Dr. Terris.