title: Cosmetic thyroid surgery: defining the essential principles.
abstract: OBJECTIVE
  Minimally invasive thyroid surgery is rapidly becoming a common approach in busy endocrine surgery practices. The surgical concepts necessarily include a number of principles found within the realm of plastic surgery.
  
  
  METHODS
  The study was a prospective, nonrandomized analysis of a consecutive series of thyroid surgical patients.
  
  
  METHODS
  All patients who underwent thyroid surgery at the Medical College of Georgia in the Department of Otolaryngology were prospectively evaluated. Recommendations for endoscopic thyroidectomy, minimally invasive nonendoscopic thyroidectomy (MINET), or conventional thyroid surgery were based on patient and disease parameters as previously described. Specific factors contributing to improved cosmetic outcomes were sought.
  
  
  RESULTS
  Two hundred forty-eight patients underwent thyroidectomy between September 2003 and June 2006. There were 50 males and 198 females, with a mean age of 44.9 +/- 14.6 years. Seventy-seven (31.0%) patients underwent conventional thyroidectomy (group A), 120 (48.4%) patients had MINET (group B), and the remaining 51 (20.6%) patients underwent thyroidectomy with an endoscopic technique (Group C). Incision lengths were 92.4 +/- 22.3 mm in Group A, 46.4 +/- 9.9 mm in Group B, and 24.3 +/- 5.9 mm in Group C. The factors that contributed most to an optimal cosmetic result were marking the patient while he or she was sitting up prior to surgery, resecting skin edges during closure, avoidance of subplatysmal flap elevation and drains, and use of Dermabond.
  
  
  CONCLUSIONS
  Achieving an optimal cosmetic result when performing thyroid surgery is easiest when oneapplies a number of principles, including elements normally associated with plastic surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912-4060, USA. dterris@mcg.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Terris
authors.forename: Melanie W
authors.initials: MW
authors.lastname: Seybt
authors.forename: Mayssoun
authors.initials: M
authors.lastname: Elchoufi
authors.forename: Edward
authors.initials: E
authors.lastname: Chin
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D013518:Surgery, Plastic / Q000379:methods*; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*