Lorraine, I can so relate the concerns about appearance. I was never one who fussed much about looks but when I saw that neck dissection incision plus the scar from the trach I was very self-conscious. I was only 32 at the time. Right after the surgery some people tended to look at me as if they were trying to figure out what happened but either that went away as the scar faded or my attitude changed so that I didn't notice. I wore scarves for a while and then decided they were more trouble than they were work. I wasn't too concerned with my speech then as it came back fairly quickly. However a second surgery and radiation have greatly changed my voice and I am uncomfortable with the raspy voice and my difficulty pronouncing some words. My current job doesn't require much speech but I was a university professor for several years and was always proud of my ability to speak in front of large groups. I think others are less bothered about my voice than I am.
My local ENT also does some plastic surgery and really discouraged me from that route saying he didn't think it would make much difference but we could explore it further if I felt strongly about it.
Keep asking questions!