Tonsillectomy Surgery: Everything You Need to Know

Tonsillectomy is a surgery to remove the tonsils, lymphatic organs in the throat that protect your body from infection. Healthcare providers may consider removing the tonsils in the following circumstances:

  • They are large and cause trouble with breathing at night
  • They lead to frequent infections (such as strep throat)
  • You have recurrent, painful sore throats

Your adenoids sit behind the nose in the throat. Like tonsils, they are part of the lymphatic and immune systems. In some cases—most often in children—a tonsillectomy and adenoidectomy (surgical removal of the adenoids) are performed simultaneously. This surgery is dubbed a T&A.

This article explains when doctors advise tonsillectomy and what to expect from the procedure and recovery.

should i have my tonsils removed
Illustration by Emily Roberts, Verywell

What Is Tonsillectomy?

A tonsillectomy is performed under general anesthesia, which means you will be asleep during the procedure. The surgeon removes the tonsils through an open mouth, so there’s minimal cutting and no scarring.

There are two types of tonsillectomies:

  • Traditional (extracapsular) tonsillectomy: The surgeon completely removes both tonsils.
  • Intracapsular tonsillectomy (also called tonsillotomy): The surgeon removes the affected tonsil tissue but leaves a small layer to protect the throat muscles underneath.

A tonsillectomy is usually a scheduled surgery and is rarely performed on an emergency basis. Most tonsillectomies are outpatient procedures in a hospital. However, in some cases, you may need to stay overnight.

Why Is It Done?

The tonsils are glands on both sides of the back of the throat that help protect against infections.

Your healthcare provider may suggest a tonsillectomy for one of the following reasons:

  • Enlarged tonsils and trouble breathing at night: Swollen tonsils can cause snoring and obstructive sleep apnea, a condition where you stop breathing during sleep.
  • Frequent infections: If you have had seven or more infections in a year or five or more infections a year for the past two years, your doctor might suggest tonsillectomy.

The American Academy of Otolaryngology-Head and Neck Surgery Foundation strongly recommends watchful waiting for recurrent throat infections before having a tonsillectomy.

Call your healthcare provider if you or your child has had a sore throat for more than two days, pain when swallowing, or feels very sick or weak. Also, call 911 if you have trouble breathing, start drooling, or have significant difficulty swallowing.

Contraindications

Both adults and children have tonsillectomies. But children younger than 2 years old may have a higher risk of respiratory complications with this surgery. To assess the risks, your child's doctor may order testing before surgery, such as polysomnography (sleep study).

Since bleeding is a potential complication of this surgery, patients with certain risk factors may require an additional evaluation before the surgery. Risk factors that may need extra caution include:

  • Bleeding disorders
  • Malignant hyperthermia (a high body temperature as a severe reaction to anesthesia)

In addition, atypical uvulas, such as a bifid uvula (a uvula that is split in two) or double uvula, require special consideration. The uvula is the flesh that hangs down in the back of the throat

Recap

Children under 2, people with bleeding disorders, those with a history of anesthesia complications, and those with atypical uvulas may be at increased risk for tonsillectomy complications.

Potential Risks

Complications of tonsillectomy are rare, but when they occur, they can include:

  • Bleeding, which can be severe and occur up to 14 days after surgery
  • Dehydration
  • Prolonged pain
  • Infection

Removing the tonsils doesn't affect your body's overall ability to fight infections because your immune system can do that in other ways. Still, infection post-surgery can occur.

In addition, general surgical risks include:

  • Anesthesia complications
  • Blood clots
  • Respiratory problems
  • Injury
  • Scarring

Recap

Most people tolerate tonsillectomy well. However, as with any surgery, there are some risks, including bleeding, dehydration, prolonged pain, and infection. In addition, some people experience complications associated with anesthesia.

How to Prepare

Before a tonsillectomy, your surgeon may recommend a physical exam and blood tests (including complete blood count, electrolytes, and clotting factors) to ensure that you will tolerate surgery.

Both kids and adults may feel anxious about this surgery. Your surgeon can help answer any questions you or your child may have. Often, talking with your doctor can ease your concerns.

If your child is having a tonsillectomy, talk to them about any worries. Reassure them that the procedure will make them better and that they won’t look any different afterward. You might tell them that their throat will be sore for a little while post-surgery, but they will be able to take medicine later to help it feel better.

Location

A tonsillectomy usually occurs in an operating room at a hospital or a surgical center. In either case, you’ll likely go home the same day.

What to Wear

Comfortable, loose-fitting clothes that are easy to change are ideal since you'll need to wear a hospital gown for the procedure. Leave any jewelry at home, so you don't worry about losing it at the hospital or surgical center.

Food and Drink

Surgeons usually instruct people to refrain from eating or drinking anything after midnight the night before the surgery. Follow your healthcare provider's instructions to make sure your stomach is empty.

For children, you might try giving them their favorite foods the night before, so they fill up and aren't as hungry in the morning. In addition, you can ask for an early morning surgery to reduce the amount of time they have to go without food.

Medication

Your healthcare provider may recommend that you stop taking certain medicines a week or two before surgery. These medications may include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen)
  • Coumadin (warfarin)
  • Other drugs that may affect bleeding risk

Ask your healthcare provider if there are any drugs you or your child should keep taking before and on the day of the surgery.

To avoid complications, be sure your surgeon is aware of any medications or supplements you or your child uses before the procedure. Inform your doctor of any over-the-counter (OTC) products, prescriptions, vitamins, and herbs.

What to Bring

Be sure to bring your health insurance card and any paperwork you've filled out.

If you know that you'll be spending the night, bring a small suitcase for you or your child with a change of clothes and comfort items. For example, your child might like to bring a blanket, toy, or stuffed animal.

If you're the one having the tonsillectomy, remember to make arrangements for someone to take you back home.

What to Expect on the Day of Surgery

When you arrive, you will change into a gown, and the anesthesiologist and nursing staff will meet with you to go over important medical history and take your vitals. Then the anesthesiologist will administer general anesthesia. Parents can usually stay with their child until the child receives anesthesia, at which time you will go to the waiting room until the surgery is over.

During the Surgery

You will receive intravenous (IV) fluids during and after the surgery. The anesthesiologist will keep you or your child safely asleep while undergoing the procedure.

The surgeon will place a small tool in the mouth to hold it open. Then, they will remove the tonsils by cutting, burning, or shaving them away. These wounds heal naturally and don’t require stitches.

The tonsillectomy procedure will usually take about 20 to 30 minutes.

After the Surgery

You or your child will wake up in the recovery area. The staff will provide close observation for several hours. Easy breathing, coughing, and swallowing are all milestones you'll need to meet before discharge.

If your child has complications, like bleeding or slow recovery, they may need to spend the night.

Recap

On the day of the surgery, a nurse and an anesthesiologist will prep you for surgery by taking your vitals and administering anesthesia. The procedure typically takes only 20 to 30 minutes. During the process, the surgeon will remove your tonsils by cutting, burning, or shaving them. You usually go home within a few hours, but you might need to stay overnight if you have complications.

Recovery

Adults usually recover more slowly from tonsillectomies than kids. Children tend to have less pain a week after surgery, while adults might have pain for about two weeks. Children are also more likely to return to eating regular foods faster than adults.

Healing

Though pain and discomfort can make it hard to eat and drink, especially for kids, it's essential to avoid dehydration. Be sure to take in lots of fluids or offer your child a drink often. Good fluid choices after a tonsillectomy include:

  • Water
  • Grape juice
  • Apple juice
  • Sports drinks

Until your pain subsides, your healthcare provider will likely suggest sticking to soft foods, such as:

  • Lukewarm soup
  • Mashed potatoes
  • Pudding
  • Ice cream
  • Gelatin

Some kids find the sweet, soft treats a silver lining, so you might mention it even before surgery.

Allow for up to a week of rest after tonsillectomy. In addition, you or your child should avoid blowing your nose forcefully for two weeks after surgery.

Also, avoid any strenuous activities or sports for two weeks. The healthcare provider will let you know when light activities are OK.

Immediately let your healthcare provider know if there is any bleeding from the mouth or nose. Also, let them know if your child won’t drink any fluids after the surgery.

Coping

Pain in the throat will probably last for several to 10 days. Your healthcare provider may suggest taking Tylenol (acetaminophen) or will give a prescription for Tylenol with Codeine at the time of surgery.

Avoid taking any medication containing NSAIDs, including aspirin, ibuprofen, or other anti-inflammatory medicines to reduce the chance of bleeding.

Recap

It can take up to two weeks to recover from a tonsillectomy. Children tend to bounce back more quickly, while adults may experience pain longer. Eating soft foods and avoiding things like blowing your nose forcefully and avoiding strenuous activity for the first two weeks can help you heal faster. In addition, taking pain medications as advised by your doctor can help manage your pain.

Summary

You may need a tonsillectomy if you have recurrent infections or difficulty breathing while you sleep. Most people tolerate the procedure well; however, as with any surgical procedure, there are some risks, including bleeding, pain, infection, and complications with anesthesia. You will be asleep during the 20- to 30-minute procedure, and most people go home the same day. Recovery generally takes one to two weeks.

A Word From Verywell

After a tonsillectomy, you’ll likely deal with short-term throat pain, but it should lead to fewer sore throats and better breathing at night in the long term. Ask your healthcare provider if you have any questions about expectations before and after the tonsillectomy. They’ll discuss the risks and benefits and help you determine whether a tonsillectomy is the best treatment for you. 

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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