Parathyroid Surgery Frequently Asked Questions

If you need parathyroid surgery, it is important to know what to expect. The following are some of the most frequently asked questions:

How long will I be hospitalized?

Most patients come to the hospital on the morning of their surgery and the majority of patients go home the same day after a 4-hour observation period in the recovery room.

What type of anesthesia will I have?

You are given the option of either general anesthesia or local anesthesia. With both techniques your surgeon will perform a nerve block so your neck area is numbed. With local anesthesia, mild sedatives will be given so that you are essentially taking a nap during the operation. This is like the "twilight" anesthesia given during colonoscopy. With general anesthesia, the anesthesiologist gives a slightly bigger dose of anesthetic and places an endotracheal tube to maintain your breathing. The amount of post-op nausea and grogginess is about the same for both local and general anesthesia. Ultimately, you will have a discussion with your anesthesiologist and surgeon about what is the safest and best type of anesthesia for you.

Will I have a scar?

Yes. All surgery causes scarring, and how the patient heals the scar is very much dependent on the individual. However, there are some techniques that surgeons use to minimize scarring. These techniques include: smaller incision size, careful incision placement, and hypoallergenic suture material (to avoid inflammation). New York Parathyroid Center surgeons make every effort to place the incision in a natural skin line, which acts like camouflage. The incision will blend into the skin line and once the redness fades away it is essentially invisible. As a general rule, you should not have a noticeable scar after six months. See Scar Gallery ».

Will I have pain after the operation?

All operations involve some pain and discomfort. Our goal is to minimize this discomfort. At the time of operation, your surgeon will give you some numbing medicine which usually lasts about eight hours. Although you should be able to eat and drink normally, the main complaint is pain with swallowing. Most patients take Tylenol® or Motrin® to keep them comfortable at home. Your surgeon will send you home with a prescription for a mild narcotic medication, but patients generally do not need to take it.

When will I know the final pathology from the surgery?

The final pathology report requires careful study and occasionally special processing. For this reason, the final report is typically complete by 7 business days after the operation. During the operation, your surgeon may send a frozen section biopsy and the pathologist who will provide a preliminary diagnosis. Your surgeon will discuss with you if the frozen section is necessary.

Will I have stitches?

The incision is covered with a clear plastic glue called collodion, which is airtight and waterproof. There is a temporary stitch which will be removed 1 to 5 hours after the operation. You can shower the day after your operation, but we ask you not to swim or soak in a bathtub for a week after. The collodion will fall off on its own in 1 to 2 weeks and at that time, a moisturizer can be applied to the wound to improve healing.

Will I have any physical restrictions after my surgery?

In general, you should be eating, drinking, and doing your normal activities the night of the operation. We ask you to avoid heavy lifting and vigorous activity for 1 week after the operation. Most patients are able to return to work within the first or second week of surgery. You should be able to drive as soon as you can turn your head comfortably and if you are not taking narcotic pain medication. You must see your surgeon for a routine follow-up office visit approximately three weeks after surgery.

Do you have experience performing both unilateral and bilateral approaches for parathyroidectomy under local anesthesia?

There are two main approaches for parathyroid surgery: unilateral (one side of the neck) and bilateral (both sides). Bilateral surgery is best for the patients who are at risk for multi-glandular parathyroid disease, which occurs in about 10-20% of patients, or for the patients who have co-existing thyroid nodules, which occurs in about 20% of patients. If you choose to have your operation done under local anesthesia, it is important that your surgeon is experienced in performing the bilateral as well as the unilateral approach under local. Often surgeons who will perform thyroid or parathyroid surgery under local will only do so unilaterally because they lack experience with the bilateral technique under local or they believe it takes too long. If you have an experienced surgeon, there is very little difference between the bilateral and unilateral approaches in terms of recovery time, hospital stay, incision size, duration of operation and complications.