Many surgeon in rural fear about their shortcomings when facing with bloody procedures, but with meticulous hemostatic and operating step that situation can be avoided. It seems impossible to send a poor socio-economic patients to the higher healthcare facility because long queue list to get the procedure and living cost are higher. When you can do it in rural you already help them in many aspect. In this photo : This is the plane after platysma flap done and note the midline to divide the strap muscles to reach the true capsule of thyroid in thyroidectomy procedure.