Thyroidectomy Melbourne – Also Known As Thyroid Cancer Surgery

Thyroidectomy is an operation to remove part or all of the thyroid gland. At Melbourne ENT in St Kilda East, Victoria, Dr Stephen Kleid (MBBS, FRACS), ENT and Head & Neck Surgeon in Melbourne, performs thyroidectomy as part of his work in head and neck cancer surgery, including thyroid cancer surgery.

For most patients, thyroidectomy is a surgical procedure, not a cosmetic one. It is usually performed for thyroid lumps (benign and malignant), troublesome nodules, overactive thyroid glands (producing too much Thyroid hormone), large thyroids (called goitres) and for Thyroid cancers.

This page provides general information only. It does not replace advice from your GP, endocrinologist or treating specialist.

What is Thyroidectomy

The thyroid is a small, butterfly shaped gland low in the front of the neck. It produces hormones that help regulate metabolism, body temperature, heart rate and energy levels.

A thyroidectomy is an operation to remove:

• Part of the thyroid – a hemithyroidectomy or thyroid lobectomy, where one lobe is removed (left or right side).
• Most or all of the thyroid – a total thyroidectomy, where all of the thyroid tissue is removed

Thyroidectomy is commonly performed for:

• Thyroid cancer
• Thyroid nodules that are cancerous, suspicious or causing symptoms
• Multinodular goitre – an enlarged, lumpy thyroid
• Overactive thyroid (hyperthyroidism) when other treatments are not suitable or not effective

Because it is usually done to manage significant disease, thyroidectomy is considered a functional operation and cancer surgery, not a cosmetic procedure.

Who Needs It (Candidates for Thyroidectomy)

You may be referred to Dr Stephen Kleid for assessment if one or more of the following apply.

✓ Confirmed thyroid cancer

Thyroid cancer may be found on:

• Fine needle aspiration (FNA) biopsy
• Pathology from previous surgery
• A combination of imaging, examination and biopsy

For many patients, thyroid cancer surgery with total thyroidectomy is the main treatment, sometimes combined with radioactive iodine and thyroid hormone therapy.

✓ Suspicious or indeterminate thyroid nodules

Not all nodules are clearly benign. Surgery may be discussed if:

• Biopsy results are indeterminate or suspicious
• A nodule grows or changes on ultrasound
• Imaging features or personal or family history increase concern for malignancy

In these situations, thyroidectomy can remove a possible cancer and provide a definite diagnosis.

✓ Multinodular goitre or large thyroid

An enlarged thyroid can cause:

• Visible neck fullness
• Tightness or pressure in the neck
• Difficulty swallowing, especially solids
• Shortness of breath or noisy breathing when lying flat

If the thyroid is large and causing symptoms or structural problems, surgery may be recommended.

✓ Overactive thyroid (hyperthyroidism)

Thyroidectomy may be considered if:

• Medication is not tolerated, unsuitable or ineffective
• Radioactive iodine is not appropriate
• There is a large goitre or significant nodular disease

In these cases, removing the thyroid can provide a more definitive solution, followed by thyroid hormone replacement.

Recurrent or persistent thyroid disease

Some people develop:

• Recurrent thyroid cancer after previous therapy
• Persistent nodules causing concern or symptoms

Further surgery may be considered as part of the long term management plan.

✓ Diagnostic uncertainty

Sometimes, even after several tests, there is still uncertainty about whether a nodule is benign or malignant. After careful discussion, some patients choose surgery to:

• Obtain a clear diagnosis
• Remove tissue with a small but real cancer risk
• Reduce the need for repeated scans and biopsies

Not everyone with a thyroid nodule requires surgery. Many can be monitored or treated medically. Decisions are usually made together with your GP, endocrinologist and surgeon, and in cancer cases often within a multidisciplinary team.

Benefits of Thyroidectomy

The expected benefits depend on your diagnosis. Dr Stephen Kleid will discuss how these apply in your case.

✓ Cancer control as part of thyroid cancer surgery

For thyroid cancer, thyroidectomy can:

• Remove the primary tumour and affected thyroid tissue
• Allow assessment and removal of neck lymph nodes, when indicated
• Provide detailed pathology to guide further treatment
• Support the use of radioactive iodine in selected patients
• Facilitate tailored thyroid hormone therapy as part of ongoing cancer care

Many people with differentiated thyroid cancer do well long term with appropriate management, although no treatment can guarantee a cure.

✓ Symptom relief from goitre or nodules

For patients with large goitres or nodules, surgery may:

• Improve breathing, especially when lying flat
• Make swallowing more comfortable
• Reduce tightness or pressure in the neck
• Reduce visible neck bulk in some cases

Results vary between individuals and will be discussed with you beforehand.

✓ Management of overactive thyroid

In selected cases of hyperthyroidism, thyroidectomy can:

• Remove overactive thyroid tissue
• Allow hormone levels to be stabilised using thyroid hormone tablets
• Reduce or avoid the long term use of anti thyroid medications and their side effects

✓ Diagnostic clarity

When test results remain inconclusive, thyroidectomy can:

• Provide full microscopic examination of the affected tissue
• Confirm whether a lesion is benign or malignant
• Allow clearer planning of future follow up and monitoring

Before and After Photos

Thyroidectomy is a medical and cancer surgery procedure, not a cosmetic operation.

For that reason:

• Before and after photos are not routinely used in the way they might be for cosmetic surgery
• Any images or diagrams are for education, for example to show incision position
• Scar appearance varies and no specific cosmetic result can be promised

During your consultation, Dr Kleid can explain where the incision is usually placed, how scars tend to mature over time and general scar care principles such as sun protection and simple skin care once healing allows.

Consultation for Thyroidectomy

A consultation with Dr Stephen Kleid at Melbourne ENT is designed to clarify your diagnosis and options.

✓ Medical history and examination

You will usually discuss:

• How the thyroid problem was first detected
• Symptoms such as neck swelling, tightness, swallowing issues, breathing changes or voice changes
• Possible signs of overactive or underactive thyroid
• Your medical history, medications, allergies and smoking history
• Any family history of thyroid disease or endocrine conditions

Dr Kleid will examine your neck, feel the thyroid gland and lymph nodes, and perform any additional ENT or head and neck examination required.

✓ Review of investigations

Where available, he will review:

• Thyroid ultrasound reports and images
• Thyroid function and other blood tests
• FNA biopsy reports
• CT, MRI or PET scans if they have been done

Additional tests may be arranged if needed before finalising a treatment plan.

Discussion of options

You will have the opportunity to discuss:

• Whether the current findings suggest benign disease, suspicious changes or cancer
• The potential roles of observation, medication, minimally invasive procedures and surgery
• The type of thyroidectomy being considered and whether lymph node surgery is advised
• Expected benefits, risks, recovery time and practical considerations for work and family life
• How surgery would fit into a broader cancer surgery plan if relevant

You are encouraged to bring a support person and a list of questions. A referral from your GP or endocrinologist helps ensure all relevant information is available.

How is Surgery for Thyroidectomy Performed

Thyroidectomy with Dr Stephen Kleid is performed in an accredited hospital under general anaesthetic.

✓ Pre operative preparation

Before surgery you may have:

• Blood tests and possibly further imaging
• A review of medications, especially blood thinners and certain supplements
• Fasting instructions
• A discussion with the anaesthetist about the anaesthetic and airway management

✓ Anaesthetic

You receive a general anaesthetic, so you are fully asleep and unaware. A breathing tube is placed into your windpipe to support breathing and protect your airway.

✓ Incision and exposure

A small horizontal incision is made low on the front of the neck, usually in a natural skin crease. Soft tissues and muscles are gently separated to expose the thyroid gland.

✓ Protecting key structures

During surgery, Dr Kleid carefully identifies and aims to preserve:

• The recurrent laryngeal nerves, which control the vocal cords
• The parathyroid glands, which help regulate calcium levels

In some complex cancer cases, complete removal of disease may increase the risk to these structures. This is discussed during the consent process where possible.

✓ Removal of thyroid and lymph nodes if required

Depending on your diagnosis:

• A hemithyroidectomy removes one lobe of the thyroid and often the central isthmus
• A total thyroidectomy removes most or all visible thyroid tissue
• If cancer involves neck lymph nodes, a selective neck dissection may be performed at the same time

All removed tissue is sent to a specialist pathologist for microscopic examination.

✓ Closure

Once the thyroid has been removed and bleeding is controlled:

• Muscles and tissues are gently repositioned
• The skin is closed, often with dissolving stitches under the surface
• A small dressing or tape is placed over the incision
• A drain may be used temporarily and is usually removed within a day or two

The length of surgery varies depending on the extent of the operation.

Recovery After Thyroidectomy

Recovery is individual, but some general patterns are common.

✓ In hospital

Most patients stay one to two nights. During this time:

• Pain is managed with tablets and usually feels like tightness or ache
• Breathing, calcium levels, voice and the wound are monitored
• After total thyroidectomy, thyroid hormone tablets are usually started in hospital
• You are encouraged to mobilise early to help reduce clot risk

✓ Early recovery at home

In the first one to two weeks you may notice:

• Neck stiffness and soreness
• Tightness or pulling at the incision
• Mild throat discomfort
• Tiredness while your body heals

You will receive guidance about wound care, showering, suitable activity levels and warning signs that need urgent review, such as rapidly increasing neck swelling, difficulty breathing, fever or marked tingling around the mouth and fingers.

Many people in desk based roles return to work after about one to two weeks. More physical jobs usually require a longer or gradual return.

✓ Longer term recovery

Over the following weeks and months:

• The scar typically becomes less red and more flat
• Altered sensation around the incision often improves
• Thyroid hormone levels are monitored and medication doses adjusted as needed
• In cancer cases, further treatment such as radioactive iodine and structured follow up may be recommended

Follow up with Dr Kleid is arranged to review healing, pathology results and ongoing care.

Risks and Complications of Thyroidectomy

All operations carry risks. Most patients recover without major problems, but complications can still occur.

✓ General surgical and anaesthetic risks

These can include:

• Bleeding or haematoma in the neck, occasionally requiring urgent treatment
• Wound infection
• Blood clots in the legs or lungs
• Reactions to anaesthetic medicines

✓ Risks specific to thyroid surgery

Important specific risks include:

• Voice changes
  • Short term hoarseness or a tired voice is relatively common and often improves
  • Long term voice changes are less common but can occur if a vocal cord nerve is significantly affected
• Low calcium levels (hypocalcaemia)
  • If the parathyroid glands are affected, calcium levels may drop
  • Tingling around the lips or fingers and muscle cramps can occur
  • Many cases are temporary and treated with calcium and sometimes vitamin D. Some patients require longer term supplementation
• Scar related issues
  • Some people develop red, raised or thickened scars
  • Tightness or altered skin sensation around the incision may persist
• Need for thyroid hormone replacement
  • After total thyroidectomy, long term thyroid hormone tablets are usually required
  • After hemithyroidectomy, blood tests are used to determine whether hormone replacement is needed

Serious complications are uncommon, but they can occur with any operation. Understanding these risks is an important part of informed consent. Melbourne ENT can provide more general written information about surgical risks if required.

Cost of Thyroidectomy

The cost of thyroidectomy with Dr Stephen Kleid varies with:

• Whether you are treated as a public or private patient
• The type of surgery and hospital used
• Fees for the surgeon, anaesthetist, assistant and hospital
• Any additional tests, imaging and follow up

Public care for eligible patients is usually covered by the public system, but waiting times and choice of surgeon may be limited. Private care often provides more choice and flexibility, but there are usually out of pocket costs even when Medicare and private health insurance contribute.

Once a treatment plan is confirmed, Dr Kleid’s rooms can provide a written estimate of fees and the relevant item numbers so you can check rebates and health fund benefits.

Medicare Coverage and Insurance

Because thyroidectomy is generally performed for medical reasons, including cancer surgery, it usually attracts relevant Medicare item numbers.

In broad terms:

• A current referral from your GP or specialist is required to claim rebates
• Medicare usually pays a rebate toward the surgeon’s and anaesthetist’s fees under the appropriate item numbers
• If you have private hospital cover, your health fund may contribute to hospital and theatre costs and sometimes part of the gap

Your actual out of pocket cost depends on your fund, level of cover, any excess or co payments and whether the hospital and specialists have agreements with your insurer.

The Melbourne ENT team can assist by providing item numbers, a fee estimate and suggestions on what to ask your health fund.

Why Choose Your Surgeon – Dr Stephen Kleid

Dr Stephen Kleid is an ENT and Head & Neck Surgeon (MBBS, FRACS) with many years of experience in head and neck cancer surgery, including thyroid and parotid tumour surgery.

✓ Qualifications and experience

Dr Kleid:

• Graduated in medicine from the University of Melbourne
• Completed ENT and head and neck surgical training at major Melbourne hospitals
• Undertook a fellowship in ENT and head and neck tumours at the University of Florida
• Has held senior roles in head and neck tumour surgery at a major Australian cancer centre
• Teaches medical students and surgical trainees
• Has been involved in research on throat and mouth cancers, thyroid and parotid tumours and other ENT conditions

✓ Approach to care

Patients seeing Dr Kleid for thyroidectomy can expect:

• A careful review of history, examination findings and test results
• Clear explanations about diagnosis, treatment options and recovery
• Discussion of non surgical options where appropriate
• Encouragement to ask questions and, if desired, seek a second opinion
• Coordination of care with their GP, endocrinologist and oncology team when needed

The focus is on supporting informed, considered decisions that align with each person’s health needs and circumstances.

Next Steps

If you have been told you may need a thyroidectomy or thyroid cancer surgery, or would like another opinion about cancer surgery options for thyroid disease, the first step is to speak with your GP or endocrinologist. They can review your results and arrange a referral if specialist assessment is appropriate.

Contact details

• Dr Stephen Kleid – ENT & Head and Neck Surgeon
   Melbourne ENT – St Kilda East, Victoria
   Phone: (03) 9038 1630

This page is intended as general information only. It does not replace a personal consultation. For advice specific to your situation, please speak with your GP, endocrinologist or treating specialist.