Thyroid surgery, while a very safe procedure, is still surgery. It requires a trip to the hospital, general anesthesia, and the risks that come with both of those, to say nothing of the pain and recovery time. Additionally, you have the risks specific to thyroid surgery which include bleeding, scarring, hypothyroidism, damage to the vocal cord nerve, and calcium deficiency. Cosmetically, one often ends up trading a lump for a visible scar. Similarly, radioactive iodine therapy has its challenges. To begin with, special precautions must be taken to protect others from exposure to the radiation, especially children. If you have children, you may need to arrange childcare for several days after you have treatment.