Abstract
INTRODUCTION: Thyroid surgery is a common procedure for managing benign and malignant conditions. While the primary focus is on treating the underlying pathology, visible neck scars can significantly impact patients' self-esteem and quality of life (QoL). A comprehensive assessment of scar cosmesis alongside functional outcomes is essential. Despite the availability of tools such as the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS), studies combining subjective and objective scar assessments with thyroid-specific and general QoL measures remain limited. METHODOLOGY: This retrospective study evaluated scar cosmesis and QoL in 100 thyroidectomy patients treated between January 2021 and December 2023. Subjective satisfaction was measured using the Visual Analog Scale (VAS), and objective assessments were performed using VSS and POSAS. QoL was assessed using validated instruments, ThyPRO and SF-36, to capture thyroid-specific and general QoL domains. Statistical analyses included t-tests, Pearson correlation, and multivariate regression. RESULTS: The mean VAS score was 7.8, with 85% of patients reporting satisfaction with their scars. Objective evaluations yielded mean VSS and POSAS scores of 5.2 and 6.8, respectively. Younger patients (VAS = 8.2 for ≤ 50 years) and females (VAS = 8.0) reported higher satisfaction with scar outcomes. QoL improved significantly, with physical functioning increasing from 65.3 to 76.8 (p < 0.01) and emotional well-being from 61.2 to 70.1 (p < 0.05). Significant correlations were observed between scar cosmesis scores and QoL domains, such as physical functioning (r = 0.42). Sensory changes, including numbness around the scar area, were reported in 12% of patients. CONCLUSION: Integrating subjective and objective measures, including ThyPRO and SF-36, provides a complete evaluation of scar cosmesis and QoL outcomes after thyroidectomy. Key predictors of higher satisfaction included younger age, female gender, and superior scar quality. These findings highlight the importance of addressing both aesthetic and functional outcomes in thyroid surgery to enhance patient satisfaction and QoL. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-025-05368-w.