One of the unfortunate consequences of surgery is a scar on the neck. However, there are a couple of options which can minimize or completely eliminate the scar from thyroidectomy. Certainly, one of the more exciting developments over the past couple of years has been the development of a transoral approach to thyroidectomy which leaves no visible scar on the neck. This is an excellent option for patients who scar badly, form keloids, or just want to avoid the cosmetic consequences of a neck scar. Not everyone is a candidate for a transoral approach, but for those that are, it is an excellent option to consider. In the traditional approach, there would always be a scar left on the neck. In recent years, there has been a move towards a minimally invasive approach that leaves a shorter scar, however, some of these shorter scars are highly visible. In my practice what I have found is patients typically want a less noticeable scar. Achieving a less noticeable scar that looks natural and appears like a neck crease would be far less noticeable to both patients and others. Achieving a good scar outcome involves multiple aspects all throughout the surgery. Stretching and injury of the incision edges leads to worse scarring postoperatively. And of course, the closure technique is extremely important as well. A natural looking scar looks like a neck crease and after just a few weeks of healing can appear nearly unnoticeable to the casual observer. There are multiple interventions that can improve scar outcome and we monitor our patients very carefully to see that their scars are healing well and will fade over time. When considering a thyroid surgeon, certainly the scar outcome is an easy thing to evaluate. We routinely provide patients pictures and examples of what to expect from our thyroid surgeries. If you Google thyroid scars, you will see some ghastly examples of poorly done surgery. Don’t be alarmed by these awful pictures! Outcomes can be much better if you choose your surgeon wisely. If a surgeon doesn’t have pictures to show you or refuses to show you pictures, then move on and find a better surgeon!