The thyroid gland is a butterfly-shaped organ composed of two cone-like lobes or wings connected via the isthmus. The gland regulates metabolism by secreting hormones. When diseases affect the thyroid, its size or activity may become abnormal.

Anatomy Of Thyroid Gland - Winslow

Candidates for thyroid surgery often have concerns about the visible scarring that can result from standard open thyroidectomy. A  new technique pioneered by UCSF endocrine surgeon Insoo Suh, MD, endoscopic transoral thyroidectomy, leaves little to no trace at the skin level of the major operation performed underneath. Watch the Video

A thyroidectomy is a surgical procedure to remove all or part of the thyroid gland and used to treat diseases of the thyroid gland including:

  • Thyroid cancer
  • Hyperthyroidism (overactive thyroid gland)
  • Large goiters or thyroid nodules causing symptomatic obstruction such as swallowing or breathing difficulties.
  • Multi-nodular Goiter

Thyroid and parathyroid surgery is typically performed using a small horizontal incision in the front of the neck. This approach has been the standard for many decades, and usually results in a well-healed and thin scar. However, because the wound healing process is unique for each person, there are often variations in the visibility of the scar.  Many incisions heal well and fade with time while others may leave thicker lines and/or dimpling. Though relatively rare, some individuals may experience significant scarring issues such as keloids and hypertrophic scars. 

Endocrine Scar From Wikepedia
Traditional Thyroidectomy with Visible Neck Scar 

Scarless Thyroidectomy

Many patients are understandably concerned with the how incision and scar will look after healing, particularly because of the visibility of the neck area. An alternative surgical approach that UCSF endocrine surgeons helped pioneer, leaves virtually no visible scar in the neck. In this “scarless” approach, known as Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA), the surgeon operates on the thyroid or parathyroid gland using tiny instruments inside the mouth guided by thin endoscopic cameras. 

This technique is used in select patients with thyroid nodules, goiter, thyroid cancer, hyperthyroidism and hyperparathyroidism. 

UCSF Endocrine surgeons Insoo Suh, M.D. and Quan-Yang Duh, M.D. were the first in the western U.S. to perform a scarless endoscopic thyroidectomy.  As a leader in surgical innovation and research, UCSF is one of a very few centers in the country with expertise in this technique.

Scarless Thyroid Parathyroid Surgery Before       Scarless Thyroid Parathyroid Surgery After
Before Surgery   After Scarless Surgery

Thyroidectomy with Hidden Scar

A new hybrid procedure using a TransOral and Submental Technique (TOaST) technique offers patients an additional option, a refinement that pairs the transoral approach with a small easily hidden incision just under the chin, offering the following benefits:

  • Decrease in postoperative complications and patient discomfort
  • The ability to accommodate larger thyroid specimens
  • Maintaining virtually all of the cosmetic benefits of traditional scarless surgery
Toast
Before and after images using Transoral and submental thyroidectomy (TOaST) - Barely Visible Scar