Aesthetic Perceptions Regarding a Thyroidectomy Scar and Transvestibular Approach in Brazil

Area of Science:

• Surgical Innovation
• Patient-Reported Outcomes
• Sociomedical Studies

Background:

• A significant portion of the general Brazilian population perceives cervical scars from thyroidectomy as detrimental to social and professional life.
• Younger women and childless individuals are particularly concerned about the aesthetic impact of cervical scarring.

Purpose of the Study:

• To investigate motivation levels and willingness to pay for scarless thyroid surgery among the general Brazilian population.
• To assess patient acceptance of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) as an alternative to traditional transcervical thyroidectomy.

Main Methods:

• A random-sample survey was conducted with 1250 participants in Brazil.
• A hypothetical thyroidectomy scenario comparing transcervical and transoral endoscopic thyroidectomy vestibular approach (TOETVA) was presented.
• The survey collected data on sociocultural factors, surgical preferences, and willingness to spend for TOETVA.

Main Results:

• All participants favored the transoral approach to avoid a cervical scar.
• Over 30% of respondents preferred TOETVA even with awareness of potential increased complications or unfavorable oncological outcomes.
• Nearly 99% associated TOETVA with greater postoperative pain, yet only 16.2% were unwilling to pay for it.
• Higher income (over 10 Brazilian minimum wages) and upper-class status significantly increased willingness to spend for TOETVA.

Conclusions:

• There is substantial patient interest and motivation for TOETVA in Brazil, driven by the desire to avoid cervical scarring.
• Patients demonstrate a willingness to accept a higher complication rate, poorer outcomes, and increased pain for scarless surgery.
• Societal subgroups, particularly younger women, show heightened concern regarding appearance, influencing surgical preference and willingness to pay for TOETVA.