Parathyroidectomy is the procedure to treat hyperparathyroidism, a condition in which there is an over production of parathyroid hormone by one or more of the parathyroid glands. These glands help keep the calcium level in our blood at the appropriate point. The only treatment for primary hyperparathyroidism is surgery to remove the abnormal glands.

Many people worry about their scar after surgery. This is especially true for parathyroid surgery. While the most important aspect of parathyroid surgery is getting a cure, we frequently get asked as many questions about the incision and scar as we do about the surgery.

Here are five of the the most frequently asked questions about a parathyroidectomy scar and the answers.

Top 5 Questions About Parathyroidectomy Scar

1) How big will my parathyroidectomy scar be?

2) How long does it take for my parathyroidectomy scar to heal?

3) Will my parathyroidectomy scar be visible?

4) What do I need to do to care for my parathyroidectomy scar after surgery?

5) Will I have stitches that need to be removed from my parathyroidectomy scar?

1) How big will my parathyroidectomy scar be?

This is the easiest question to answer, and likely the biggest difference between very experienced and high-volume surgeons and those surgeons who do not specialize in parathyroid surgery. In our high-volume practice (about 75 per week), our patients will have a parathyroidectomy scar about 1 inch long. That’s it. For many patients, the incision is even smaller than an inch. It doesn’t take much to be able to see the glands and remove the problem glands. A big part of this is our approach to surgery, which involves knowing were parathyroid glands may be and where they will not be.

When you visit with a surgeon regarding your parathyroid operation, you must ask them how big their incision will be. If you don’t, your parathyroidectomy scar may be 5-6 inches in length! Surgeons made these large incisions for parathyroid surgery for 75 years, but sadly many of surgeons still do this. The operation used to involve exposing almost every structure in the neck to find the parathyroid glands.

Once again, this is where our approach makes the difference. Our preoperative scans are conducted in a fashion that they can tell us where the problem glands are NOT located, so we don’t need to expose or look in areas that will be of no benefit. Through our experience in parathyroid surgery, we have learned where parathyroid glands will never be located. If the gland won’t be there, then we don’t need to expose or look there. Eliminating unnecessary surgery reduces risk, and the length of the incision. (You can read about the standard approach here and the mini-surgery here)

2) How long does it take for my parathyroidectomy scar to heal?

All scars heal, and parathyroid surgery scars are no different. As it heals, your parathyroidectomy scar will change from week to week, and month to month. No incision looks great immediately after surgery.

There are two different questions people are actually asking with this question: when will it look better, and when will it be truly healed. By about two weeks after surgery, the redness that happens right after surgery will fade significantly. The color of the skin at the incision will be slightly more pink, but usually not noticeable. By one month, the color should match the skin around it. At six months, a well placed incision won’t be noticed by someone unless they look for it.

Less people ask about the actual healing process of their parathyroidectomy scar, but it is still important. Within a few hours, the edges of the incision will start to “stick” together. That means even if the dressing falls off, the skin will remain closed. Usually by about 48 hours after surgery, the incision is sealed so that it is water tight. Between 1-2 weeks, the incision will have a majority of its final strength. At this point, there shouldn’t be any issues or concerns about your incision with normal activities. Even so, the incision is continuously remodeling to get to the final strength until about six months after surgery.

3) Will my parathyroidectomy scar be visible?

Probably the aspect people care more about than the length or what their scar will look like in the weeks after surgery is whether their parathyroidectomy scar will be visible. As I said above, after six months, your incision shouldn’t be visible unless someone is deliberately looking for it. There are many things that determine how visible a scar is, from length and direction to tension to skin tone. You should ask your surgeon about your incision, because many surgeons aren’t worried about how the incision will look.

We place our incision in a skin crease when one is available. After the early stages of healing, these incisions are hard to find even when you are looking for them. If there isn’t a crease available, our incision is placed along the skin lines. As you age, the skin usually form a crease along the incision. It’s like the body wants to hide the incision!

4) What do I need to do to care for my parathyroidectomy scar after surgery?

This is my favorite question about parathyroidectomy scars that I get from people because it has the simplest answer: nothing. There is essentially nothing that needs to be done with the incision after surgery. There are no sutures to remove. We place a Steri-Strip, a small white bandage, that will fall off around 10-14 days. We recommend you take it off at 7 days following the operation.  You can shower the day after surgery, and you don’t need to cover your incision or keep it dry.

One question people ask about their parathyroidectomy scar is whether they can or should put some type of cream or ointment on it. These range from an antibiotic ointment like polysporin to vitamin E oil to scar reduction creams like Mederma. All of these have been shown in some studies to reduce the visibility of scars. The only thing we would recommend is Vitamin E, but even then it is hard to tell which patients used Vitamin E and which ones did not.  One problem is that they don’t work on every scar for every patient. But more importantly, there isn’t much room for improvement for our parathyroid incisions.

5) Will I have stitches that need to be removed from my parathyroidectomy scar?

There are many options available for closing and covering incisions that can impact what your parathyroidectomy scar will look like. To close the skin, we use a dissolvable suture that does not need to be removed. The suture is placed entirely under the skin, so that no suture is ever visible. This is fairly standard practice. Occasionally, we will hear from someone who had external sutures (which leaves marks on the skin) or staples. Staples! If your surgeon uses anything other than dissolvable sutures, run out of their office!

After the incision is closed, there are different options for covering the incision. Our practice is to use a Steri-Strip that goes over the incision. They reduce the tension on the skin, which helps keep the scar small. The most important reason we chose this is the same reason we don’t use glue. During that first week, almost any incision is unattractive and draws attention. Glue allows people to see the incision during this phase, and often increases how noticeable the incision is. After that first week, you take the dressing off. As discussed above, the incision will be near invisible after only a couple of weeks.

Additional Resources:

• Learn more about the Norman Parathyroid Center.
• Read more on the Parathyroid blog.
• Become our patient.
• Check out our sister surgeons at the Clayman Thyroid Center, the Scarless Thyroid Surgery Center and the Carling Adrenal Center. We are now united under one roof, operating at the Hospital for Endocrine Surgery.