A Comprehensive Guide on Thyroid Removal Surgery in Singapore

Located at the base of your neck, the thyroid gland is a butterfly-shaped gland that plays a critical role in regulating overall hormonal balance, metabolism, heart rate, body temperature, and overall hormonal balance.

Thyroid removal surgery, or a thyroidectomy, refers to the surgical removal of the thyroid. This safe procedure is often performed to treat various conditions, such as thyroid cancer, large goitres or hypothyroidism that does not respond to other conservative forms of treatment. 

If you ever need to undergo thyroid removal surgery, this article will guide you through everything you need to know and what to expect. Fret not! With proper management and the right follow-up care, it is possible to lead healthy lives post-surgery.

Understanding thyroid disorders

Your thyroid may be small, but it plays an important role in your body. This little gland produces hormones that keep our vital bodily functions running [1], such as your metabolism, energy levels, body temperature, and even your heartbeat. When something’s not quite right with your thyroid gland, it can throw your body out of balance.

In most cases, doctors aim to preserve as much of the thyroid as possible. Sometimes, partial removal is preferred when feasible to reduce the need for lifelong hormone replacement.Here’s a closer look at the thyroid problems that might lead to surgery, what signs to look out for, and when to talk to your doctor.

Common thyroid disorders that may need thyroid removal surgery

• Hyperthyroidism — This condition develops when your thyroid goes into overdrive and pumps out too many hormones. One of the usual causes of this condition is Graves’ disease. While many people can effectively manage it with medication, surgery may be recommended if the condition is severe, keeps coming back, or isn’t responding well to other treatments.
  
• Thyroid nodules — These lumps or bumps that form in the thyroid are usually harmless, but can sometimes become cancerous. If a nodule is large, keeps growing, or looks suspicious on scans or biopsy, your doctor may suggest surgical removal.
  
• Goitre — A goitre is an enlarged thyroid that can develop due to reasons such as iodine deficiency, hormone imbalances, or multiple nodules forming together. If a goitre grows too big, it may press on the windpipe or esophagus, making it difficult to breathe or swallow. That’s when thyroid removal surgery may be recommended.
  
• Thyroid cancer — Thyroid cancer is one of the more treatable cancers if caught early, and the first step is usually removing all or part of the thyroid. In many instances, it’s caught during a routine scan or check-up. If cancer is confirmed, surgery is usually the recommended treatment, followed by others if needed.

Symptoms of thyroid conditions to look out for

As the thyroid is heavily involved in homeostasis of the body, dysfunction can lead to symptoms affecting various systems — from our energy levels, menstrual cycles, and even temperature regulation. Keep an eye out for symptoms such as:

• A visible or growing lump in your neck
  
• Difficulty swallowing or breathing
  
• Unexplained weight changes
  
• Feeling tired, anxious, or shaky
  
• Irregular or heavy periods
  
• Changes in your voice, such as hoarseness
  

Risk Factors 

You’re more likely to develop thyroid issues if:

• Someone in your family has had thyroid problems
  
• You’ve had radiation exposure [2], especially to your neck or head area
  
• Your iodine intake is too low or too high
  
• You are female, as women are more prone to thyroid disorders, especially during pregnancy or menopause
  

Types of Thyroid Removal Surgery

If your doctor has recommended thyroid surgery, the type of surgery you’ll need depends on your specific condition. Thyroid removal surgery is done under general anaesthesia, putting you to sleep throughout the entire procedure. 

A conventional surgery involves an incision at the lower front of your neck, while modern options like endoscopic or robotic-assisted surgery utilise smaller incisions, reducing scarring significantly. A transoral approach (through the mouth) leaves no visible external scar at all. 

Here’s a look at different types of thyroid surgeries:

Total Thyroidectomy

This involves removing the entire thyroid gland, and is often recommended for thyroid cancer, or in cases where both lobes of the thyroid are affected, like in Graves’ disease. After a total thyroidectomy, you’ll be required to take thyroid hormone replacement for life to maintain normal bodily functions.

Partial Thyroidectomy

A partial thyroidectomy (also called a thyroid lobectomy or hemithyroidectomy) involves removing just one lobe of the thyroid gland. It’s usually done when there is a nodule or tumour on one side of the thyroid.

The type of surgery that you undergo will depend on your consulting surgeon. At NC Tan Surgery in Singapore, we take the time to understand your condition thoroughly, whether it's a thyroid nodule, goitre, or abnormal hormone levels. With personalised assessments and diagnostics, along with a patient-first approach, we’ll help you make the right decision for your health. Book a consultation today and find out if surgery is the right step for you.

When is thyroid removal surgery recommended?

Thyroid surgery is generally considered one of the last treatment options recommended — when less invasive methods aren’t effective or appropriate. 

Your doctor might recommend surgery due to the following reasons:

• Medications aren’t working or causing unwanted side effects
• Risk of or confirmed diagnosis of thyroid cancer
• A goitre or nodule pressing on your windpipe or esophagus
• Condition and symptoms keeps returning or worsening despite treatment

Before anything is decided, you will undergo a thorough assessment. This includes blood tests, ultrasound scans, and sometimes, a biopsy. These tests help your specialist decide whether surgery is truly needed and what type would be best for you.

How to prepare for thyroid removal surgery

Once surgery is confirmed, preparation is key. Your surgeon will walk you through the steps required. Generally, before any procedure is undertaken, the following diagnostic tests are conducted:

• Blood tests — To check thyroid function and calcium levels
  
• An ECG or imaging scans — Especially if there are other health concerns
  
• Medication review — You may need to pause or adjust some prescriptions temporarily

How much does thyroid removal surgery cost in Singapore?

You will also need to prepare financially for thyroid removal surgery. In Singapore, thyroid surgery itself can cost anywhere from SGD 8,000 to 15,000. Most procedures are MediSave-claimable, and insurance often covers a significant portion. It’s always worth checking your coverage ahead of time to stay well-informed of costs and payments. 

The thyroid removal surgery process: what to expect

Knowing what to expect for thyroid removal surgery can help ease anxieties and prepare for recovery afterwards. The surgery is done under general anaesthesia, and most procedures take about 1.5 to 3 hours. You may need to stay in the hospital for a night or two, depending on the type of surgery and to make sure you are healing well.

After the procedure, you might feel a bit sore in the neck area and have a drain placed temporarily to manage fluid. Some people notice a hoarse voice, but this usually improves over time. You should be back on your feet within a few days and can return to your usual activities, such as work, in one to two weeks. A full recovery usually takes approximately three weeks. 

As with any surgery, there are some risks. These include temporary or long-term voice changes, low calcium levels if parathyroid glands are affected, and infection or bleeding. Your surgeon should discuss these with you based on your risk profile.

Life after thyroid removal

If your entire thyroid is removed, you will need to take daily thyroid hormone replacement tablets. This keeps your body functioning normally. Your doctor may recommend taking calcium and vitamin D supplements, staying well-hydrated, and avoiding high-iodine foods unless advised otherwise. 

Regular follow-up appointments will also be scheduled, along with blood tests to monitor your hormone levels and adjust medication as needed. If cancer was involved, your follow-up plan may also include imaging or further treatment.

Summary

Thyroid issues can feel overwhelming, and symptoms can impact your quality of life. However, with the right care and early intervention, such as thyroid removal surgery, most people go on to live full and healthy lives. 

If you’re experiencing symptoms or facing a diagnosis, understand that there are options and treatments available to you. We suggest you speak with a specialist, ask questions, and explore your options, as early treatment can make all the difference. Schedule a consultation for a detailed diagnosis and personalised treatment plan.

Frequently Asked Questions

Will I need medication for life after thyroid surgery?
Yes, if your entire thyroid is removed. However, if part of it remains, you may not need lifelong medication, but will need to monitor your hormone levels through regular blood tests.

Is thyroid removal surgery painful?
You will be under anaesthesia during the surgery, so you will not feel any pain during the procedure. Afterwards, some people experience mild discomfort, which can be managed with painkillers.

Will I have a scar after thyroid removal surgery?
Yes, but it usually fades over time. Minimally invasive techniques can help reduce visible scarring.

References

1. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. In brief: How does the thyroid gland work? [Updated 2024 May 28]. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK279388/

2. Iglesias, M. L., Schmidt, A., Ghuzlan, A. A., Lacroix, L., Vathaire, F., Chevillard, S., & Schlumberger, M. (2017). Radiation exposure and thyroid cancer: a review. Archives of endocrinology and metabolism, 61(2), 180–187. Retrieved from: https://doi.org/10.1590/2359-3997000000257