Tonsillectomy

Table of Contents

Tonsillectomy Introduction

A tonsillectomy is a surgical procedure to remove the tonsils, which are two small glands located at the back of the throat. The tonsils are part of the immune system and help fight infections, particularly in early childhood. However, in some adults, the tonsils can become chronically infected, enlarged, or contribute to other health problems.

Tonsillectomy in adults is less common than in children but may be recommended by Dr Phillips if tonsil-related symptoms are affecting your quality of life. The surgery is performed under general anaesthetic as a day procedure or with an overnight hospital stay.

Reasons for surgery

Adult tonsillectomy is most commonly performed for:

  • Recurrent tonsillitis (multiple episodes of sore throat or infection each year)
  • Chronic tonsillitis & tonsil stones (tonsilloliths) causing persistent sore throat, bad breath, or discomfort)
  • Obstructive sleep apnoea (OSA) or snoring due to enlarged tonsils
  • Asymmetrical tonsils or suspicion of tumour
  • Peritonsillar abscess (quinsy) that recurs or doesn’t respond to treatment

Tonsillectomy may be done alone or with other procedures such as uvulopalatopharyngoplasty (UPPP) or nasal surgery, depending on your symptoms.

Benefits of the procedure

  • Fewer or no sore throats
  • Relief from chronic tonsil-related discomfort or infection
  • Improved breathing and sleep quality (especially in OSA)
  • Reduced bad breath from tonsil stones or infection
  • Less time off work and fewer doctor visits

Risks & complications

Tonsillectomy is a common and generally safe procedure, but it does involve some risks:

  • General anaesthesia risks (low in healthy adults)
  • Pain, particularly throat and referred ear pain for 10–14 days
  • Bleeding, which can occur up to 2 weeks after surgery
  • Infection although this is uncommon
  • Dehydration, due to reduced fluid intake from pain
  • Voice changes or altered sensation when swallowing (usually temporary)

The most serious potential complication is post-operative bleeding, occurring in around 2–5% of adult patients. Bleeding may be minor or, in rare cases, require emergency treatment or return to theatre. Dr Phillips will discuss your individual risks in detail before surgery.

Alternative treatments

If your symptoms are not severe, alternative treatments may include:

  • Antibiotics during infections
  • Pain relief and throat lozenges
  • Good oral hygiene and saltwater gargles
  • Observation (some symptoms improve over time)

However, if symptoms are persistent, recurrent, or impacting your life, surgery is often the most effective long-term solution.

Pre-operative instructions

Fasting

You must fast before surgery – typically no food for 6 hours and clear fluids only for 2 hours prior. You’ll receive detailed instructions from the hospital or anaesthetist.

Medications

Inform Dr Phillips of any medications you are taking, especially blood thinners, supplements, or herbal remedies, as some may need to be stopped before surgery.

Illness

If you are unwell (with a cold, cough, or fever) prior to surgery, please contact our clinic. The operation may need to be delayed for safety reasons.

Procedure details

  • The procedure is done under general anaesthetic and takes about 30 minutes.
  • The tonsils are removed through the mouth using modern surgical instruments (no external cuts or stitches are required).
  • You will be monitored in the recovery unit before returning to the ward.
  • Most adults can be discharged the same day however some may require overnight stay and go home the following morning

Post-operative care & recovery

Pain

  • Expect significant throat and ear pain for up to 2 weeks.
  • Take regular pain relief as directed, not just when pain is severe
    • Paracetamol 4 times a day
    • Ibuprofen 3 times per day
  • Tapentadol or Oxycodone pain medications are provided for breakthrough pain.
  • Pain typically worsens around day 5–7, as the scabs over the tonsil sites begin to slough off.

Diet

  • Eat and drink as normally as possible – this helps reduce pain and the risk of infection.
  • Focus on soft foods like pasta, rice, yoghurt, scrambled eggs, smoothies.
  • Drink plenty of fluids to avoid dehydration.
  • Avoid hot, spicy, or sharp foods for the first week.

Activity

  • Rest at home for 10–14 days.
  • Avoid strenuous activity, sports, or heavy lifting for 2 weeks.
  • Do not travel far from medical care during the first 2 weeks, in case of delayed bleeding.

Bleeding

  • A small amount of blood-stained saliva is normal.
  • If you experience fresh red bleeding, particularly with clots or coughing up blood, seek urgent medical attention at the nearest emergency department.
  • This risk is highest between days 5 and 10 after surgery.

What to watch for

Contact our clinic or seek urgent care if you experience:

  • Bright red bleeding from the throat
  • Fever above 38.5°C lasting more than 48 hours
  • Inability to drink fluids due to pain
  • Signs of dehydration (dry mouth, dark urine, dizziness)
  • Severe or worsening pain not relieved by medication

Frequently asked questions (FAQ)

  • Is recovery worse in adults than children?

    Yes, adults generally experience more pain and longer recovery than children after tonsillectomy. However, most patients recover well with appropriate care and pain relief.

  • Will I still get sore throats?

    The tonsils are removed, so you won’t get tonsillitis, but you may still get occasional viral sore throats like the general population.

  • Will my voice change?

    Some people notice a temporary change in voice tone or sensation – this usually settles within weeks.

  • When can I return to work?

    Most adults return to work or study after 10–14 days, depending on pain and recovery.

Book a consultation

If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.