Tonsillectomy: Having Your Tonsils Removed


Having your tonsils removed is a surgical procedure called a tonsillectomy. Reasons you may need to have your tonsils removed include frequent infections (episodes of tonsillitis, usually seven or more in one year), difficulty breathing or swallowing, sleep apnea, or any growths on the tonsils.

Before Having Your Tonsils Removed

Tonsillectomies are performed under general anesthesia. You will be completely asleep and will not be able to feel pain during the procedure. To reduce the risk of vomiting with anesthesia, you will not be able to eat before surgery. Your physician or nurse will give you exact instructions about when to stop eating and drinking. In addition to not eating or drinking, you should not smoke, chew gum, or suck on mints or candy.

Tonsillectomies are mostly performed in same-day surgery settings. This means that you will go home the same day that you have your tonsils removed. You should wear loose comfortable clothing to the surgical center. Arrive on time. In some cases, a medication called Versed can be given prior to the procedure to reduce anxiety, especially in small children. If you have other health problems, your doctor may order blood work or other tests before the surgery. If you are a woman of childbearing age (usually age 12 to 55 unless you have had a hysterectomy), it is mandatory that you have a pregnancy test before the surgery. This requires a small amount of urine.

If the patient is a child and has a comfort item, such as a blanket or a favorite toy, bring it with you. Also, if your child drinks from a bottle or special cup, bring it along so your child can drink after the surgery. Make sure you bring comfortable clothing and extra diapers or underwear.

Before having your tonsils removed, you will need to remove any metal from your body, including jewelry, retainers, or body piercings. You will also need to remove contact lenses, dentures, and hearing aids.

You will also need to refrain from medications that can thin your blood for one to two weeks before surgery. These medications include aspirin, ibuprofen, Coumadin, Plavix, and large doses of vitamin E. Follow your physician's instructions for taking any scheduled medications on the day of surgery, especially if you are on insulin or blood pressure medications.

Methods of Having Your Tonsils Removed

There are several types of procedures to remove the tonsils. Risks and benefits vary by each method. You will need to discuss which method is right for you with your surgeon.

  • Cold knife dissection: This is the traditional method of having your tonsils removed, using a scalpel. The tonsils are completely removed, and there is minimal bleeding.
  • Electrocauterization: This method burns the tonsils and surrounding tissue in a way that prevents a lot of bleeding. Unfortunately, this method can cause more pain during the post-operative period.
  • Harmonic scalpel (ultrasonography): This method uses energy from ultrasound to vibrate the blade. This results in a clean cut that also cauterizes the tissue. This method allegedly causes less damage to the tissue than electrocauterization.
  • Radiofrequency ablation: This procedure can be performed in a doctor's office under sedation. It is not a one-time procedure, but rather gradually shrinks the tonsils using radiation after several appointments. This procedure is only recommended for enlarged tonsils.
  • Carbon dioxide laser: This procedure can also be performed in a doctor's office under local anesthesia and only takes about 15 minutes. Post-operative bleeding can occur the first or second post-op day. The advantage of this procedure is decreased pain and morbidity. However, this procedure is not recommended for all patients, particularly children.
  • Bipolar radiofrequency ablation: This method must be performed in an operating room under general anesthesia. It uses a very complex method of action that disrupts the molecular bonds of the tonsilar tissue. It can be used to remove some or all of the tonsils. This method is associated with less pain and post-operative care.
  • Microdebrider: This procedure is used for partial tonsillectomies only. The enlarged or obstructive portion of the tonsil is shaved off. This procedure carries less risk of pain after surgery.

After Having Your Tonsils Removed

You will be monitored by a nurse for a few hours after having your tonsils removed. Before you leave the hospital or surgical center, you will be given exact instructions on how to care for yourself at home. Always follow your doctor's orders, but you will likely receive these instructions:

  • Remain in the care of a responsible adult for at least 24 hours following surgery.
  • Do not drive, sign legal papers, or participate in activities that require you to be awake and alert for at least 24 hours after surgery.
  • Eat and drink clear liquids if you are experiencing post-op nausea and vomiting (clear liquids include apple juice, soda, soup broth, jello, and black coffee).
  • Eat food that is easy to chew and swallow.
  • Elevate the upper body.

You should call your physician or go to the emergency room if you experience the following:

  • Fever or chills
  • Excessive nausea and vomiting
  • Excessive pain
  • Unable to urinate within eight to 12 hours of surgery
  • Notice any bright red bleeding
  • Difficulty breathing or swallowing

You will likely be prescribed oral pain medication to take following surgery. Typical medications used include oxycodone and hydrocodone. Often combination medications like Percocet (oxycodone and acetaminophen combined) and Lortab (hydrocodone and acetaminophen) are prescribed. You should refrain from taking acetaminophen while on a combination pain medication to avoid an acetaminophen overdose.

You should not drive while taking these medications. Make sure you follow the directions and talk to your pharmacist before combining medications. Your pain should gradually decrease and most people start feeling better within a few days after surgery. Make sure to schedule a follow-up appointment with your surgeon.

Was this page helpful?
View Article Sources
  • Tonsillectomy. MedlinePlus.
  • Tonsillectomy and Adenoids Post-op. American Academy of Otolaryngology - Head and Neck Surgery.
  • Tonsils and Adenoids. American Academy of Otolaryngology - Head and Neck Surgery.