Thyroid and parathyroid
surgery in Paris

Recovery time depends on the type of procedure. After a lobectomy (partial thyroid removal), same-day discharge is possible and most patients return to light activities within 7 to 10 days. After a total thyroidectomy, one night in hospital is usual, with a return to work after approximately 2 weeks. Strenuous physical activity is generally discouraged for 4 to 6 weeks. After a parathyroidectomy, the procedure is performed as day surgery and most patients resume normal activities within 1 to 2 weeks.

Before surgery, you will need to complete a mandatory preanaesthetic consultation with the anaesthesia team at Hôpital Privé des Peupliers (tel: 01 44 16 52 01). You will also receive a consent form and a surgical quotation to sign electronically via YouSign. Specific instructions regarding medications to stop or continue, fasting requirements and hygiene protocols will be given at the preoperative consultation. A detailed patient information booklet is provided at the time of the surgical decision.

After a total thyroidectomy, lifelong levothyroxine (thyroid hormone) replacement is always required. After a lobectomy, the remaining lobe usually produces enough hormone — treatment is only prescribed if the TSH level is above normal at the 6-week check, which occurs in approximately 30% of cases. After a parathyroidectomy, temporary calcium and vitamin D supplementation is often prescribed for a few weeks while the remaining parathyroid glands resume normal function.

The incision is placed in a natural skin crease at the base of the neck and typically measures between 3 and 6 cm, depending on the extent of surgery. It is closed with absorbable sutures and surgical glue — no visible stitches or traditional dressing. Showering is possible the day after surgery. After 15 days, a moisturising cream and gentle massage are recommended. With proper sun protection (SPF 50 for at least one year) and scar massage, the scar becomes fine and barely visible at 6 to 12 months for the vast majority of patients.

Surgery is the only curative treatment for primary hyperparathyroidism. In selected cases — older patients, surgical contraindication or patient preference — active surveillance or medical treatment (cinacalcet, bisphosphonates) may be proposed. These treatments control the effects of the disease but do not cure it. The decision is always made on a case-by-case basis, taking into account calcium levels, bone density, kidney function and symptoms.

Yes — the vast majority of patients return fully to normal life within 2 to 3 weeks. You may walk from the evening of surgery and resume driving after 7 days. Air travel is also possible after 7 days. Professional and sports activities typically resume after 3 weeks. For patients requiring levothyroxine after total thyroidectomy, once the dose is stabilised, a simple annual blood test is all that is needed.

Not all thyroid nodules require surgery. The main indications are: suspicious or malignant cytology (Bethesda IV, V or VI on fine-needle biopsy), a compressive goitre causing difficulty swallowing or breathing, hyperthyroidism (toxic nodule or Graves' disease) unresponsive to medical treatment, or a rapidly growing nodule. Dr Guian assesses each case individually based on ultrasound (EU-TIRADS classification), cytology results (Bethesda score) and clinical findings, in line with SFE 2022 and ATA 2025 guidelines.

The main risk is injury to the recurrent laryngeal nerve, which controls vocal cord movement. In specialist centres using routine intraoperative nerve monitoring (NIM), the risk of permanent vocal cord paralysis is below 1%. Temporary hoarseness in the first weeks after surgery is more common and resolves spontaneously in the vast majority of cases. Dr Guian uses NIM monitoring during every thyroid procedure, in line with SFE-AFCE-SFMN 2022 recommendations.