A thyroidectomy is the surgical removal of part or all of the thyroid — the butterfly-shaped gland at the front of the neck that produces hormones controlling the body's metabolic rate. It is one of the most common endocrine operations, and the site's surgery library includes thyroidectomy videos showing the procedure, like the one embedded above.

Why the thyroid is removed

The main reasons are: thyroid cancer or a nodule that biopsy suggests could be cancer; a large goiter — an enlarged thyroid that presses on the windpipe or swallowing passage, or is cosmetically troublesome; overactive thyroid (hyperthyroidism), most often from Graves' disease, when medicines and radioactive iodine are unsuitable or have not worked; and suspicious nodules that cannot be cleared by biopsy alone. How much gland is removed depends on the reason.

Partial or total?

In a total thyroidectomy, the entire gland is removed — the usual choice for most thyroid cancers and for Graves' disease. In a lobectomy (partial thyroidectomy), only one of the two lobes is removed, which may be enough for a single suspicious nodule or a small, low-risk cancer — and leaves the remaining lobe to produce hormone. Your surgeon recommends the extent based on the diagnosis, and sometimes on what is found during surgery and final pathology.

How the surgery works

Under general anesthesia, the surgeon makes a short incision in a natural crease at the front of the neck. Working carefully around two structures that sit close to the gland — the recurrent laryngeal nerves, which control the vocal cords, and the four small parathyroid glands, which regulate calcium — the surgeon frees the thyroid from its blood supply and removes it. The incision is closed, usually leaving a thin scar that fades into the neck crease over time. The operation typically takes one to two hours, and many patients go home the same day or after one night.

Afterwards

After a total thyroidectomy, the body no longer makes thyroid hormone, so a daily hormone tablet (levothyroxine) replaces it for life — a routine, well-tolerated arrangement for most people, with blood tests to keep the dose right. After a lobectomy, the remaining lobe often produces enough hormone, though some people still need tablets. Voice changes and low calcium are the two issues teams watch for after surgery: both are usually temporary when they occur, because the nerves and parathyroids recover from the disturbance of surgery — and permanent problems are uncommon in experienced hands.

Educational only — this article is general information about thyroidectomy, not medical advice. Decisions about thyroid surgery belong with your own endocrinologist and surgeon.

Frequently Asked Questions

Will I need thyroid hormone tablets forever after a total thyroidectomy?

Yes — after total removal the body cannot make thyroid hormone, so daily levothyroxine is lifelong, with periodic blood tests to fine-tune the dose. It replaces exactly what the gland made.

Will thyroid surgery change my voice?

Temporary hoarseness is fairly common in the first days to weeks. Permanent voice change from nerve injury is uncommon; your surgeon may check the vocal cords before and after surgery.

How visible is the scar?

The incision is placed in a natural neck crease and is usually a few centimetres long. Most scars fade considerably over the first year.

Can thyroid cancer come back after removal?

It can, which is why follow-up — blood tests (including thyroglobulin after total removal for many cancer types) and sometimes ultrasound — continues afterwards. The follow-up plan depends on the cancer type and stage.