A tonsillectomy is a surgical procedure to remove the tonsils, which are two small glands located at the back of the throat. Tonsils are part of the immune system and help fight infections, especially during early childhood. However, in some children, the tonsils can become chronically infected, enlarged, or cause breathing and sleep problems.
Tonsillectomy is one of the most common surgical procedures performed in children. It is performed under general anaesthetic as a day procedure or with an overnight stay, depending on your child’s age, health, and recovery.
Tonsillectomy is commonly performed for the treatment of:
Dr Phillips may recommend and perform tonsillectomy surgery in combination with other procedures such as adenoidectomy, cautery of inferior turbinates or grommet insertion, depending on your child’s symptoms.
In selected cases, a partial tonsillectomy (also known as tonsillotomy) may be considered. This technique removes most of the tonsil tissue while preserving a small layer. Dr Phillips may perform this as a coblation tonsillotomy, which uses coblation technology to reduce the tonsil tissue in a controlled way with evidence supporting less post operative pain and bleeding although a very small chance of tonsil regrowth. The most appropriate approach depends on the underlying condition and clinical assessment.
Tonsillectomy is a generally safe procedure, but as with any surgery, there are some risks:
Bleeding is the most serious potential complication but is uncommon occurring in less than 5% of children when surgery is performed by Dr Phillips. You will be provided with instructions on what to do if this occurs.
Dr Phillips will discuss these risks with you before surgery and answer any questions you may have.
If your child’s symptoms are mild or occasional, you may choose to delay surgery and manage the condition with:
Surgery is usually considered when symptoms are persistent or affecting quality of life.
Your child will need to stop eating and drinking for a certain period before surgery (usually 6 hours for food and 2 hours for clear fluids). The hospital or anaesthetist will give you specific instructions.
If your child is unwell before the surgery (with a fever, cough, or cold), please contact the clinic, as the procedure may need to be postponed.
Inform Dr Phillips if your child is on any medications, especially blood thinners, supplements or herbal remedies, as some of these may need to be stopped before surgery.
Most children go home the same day, though an overnight stay may be recommended in some cases.
Pain is expected for up to 10–14 days, especially in the throat and ears. Regular pain relief is essential:
A small amount of blood-stained saliva is normal in the first day or two. However, fresh red bleeding is not normal and should be treated as an emergency. Go to the nearest emergency department with ENT support if this occurs. Dr Phillips will outline your nearest suitable hospital before the surgery.
Call our clinic or seek urgent medical care if your child has:
A review appointment will be arranged 4-6 weeks after surgery to ensure your child is healing well. If there are any concerns before this, please contact the clinic. If at any stage you wish to see Dr Phillips, our staff will be happy to arrange an appointment.
Tonsils are part of the immune system, particularly in early childhood. However, their removal does not weaken the immune system or make children more prone to infections.
Many children who require tonsillectomy experience recurrent throat infections because the tonsils themselves have become chronically inflamed or infected. In these cases, surgical removal can actually reduce the frequency of infections over time.
Once the tonsils are removed, tonsillitis does not recur. However, children can still develop a sore throat due to viral or bacterial infections affecting the lining at the back of the throat, known as pharyngitis.
This type of infection may cause throat pain similar to a regular cold or flu, but it is different from recurrent tonsillitis. The aim of tonsillectomy is to reduce repeated, severe tonsil infections rather than prevent all sore throats entirely.
Most children return to school about 2 weeks after surgery, once they are eating and drinking normally.
The first week of tonsillectomy recovery is usually the most uncomfortable, with throat and ear pain common. During this time, children often feel tired and may require regular pain medication. Recovery can vary, but most children are ready to resume normal activities, including school, by the end of the second week.
If bleeding occurs at home, take your child to the nearest hospital emergency department with ENT support immediately. Postoperative bleeding, also known as postoperative haemorrhage, requires urgent medical assessment. Do not attempt to manage bleeding at home or wait for it to stop on its own.
A small amount of blood-stained saliva can be normal in the first day or two after surgery. However, fresh bleeding or bright red blood is not normal and should be treated as an emergency.
Note: If you are uncertain, take your child to the nearest emergency department for care from healthcare professionals; do not try to manage or treat the issue yourself.
For many children, the worst day of tonsillectomy recovery is typically between days 4 and 7 after surgery. During this period, throat pain often increases rather than improves, which can be unexpected for parents.
This happens as the healing tissue at the back of the throat changes and the protective scabs begin to loosen. Children may have a very sore throat, increased pain when swallowing, reduced appetite, and ear pain due to referred pain from shared nerve pathways. Fatigue is also common at this stage.
After a tonsillectomy, the areas where the tonsils were removed heal gradually over time. In the first few days, the back of the throat is inflamed and raw, which commonly causes a sore throat and discomfort when swallowing.
As healing progresses, a white or yellow coating forms over the surgical area. These are often referred to as scabs and are a normal part of recovery. During day-by-day tonsillectomy recovery, pain often increases between days 4 and 7, which is commonly the worst stage of recovery for many children. This occurs as the scabs dry and begin to separate from the underlying tissue.
At this stage, children may have a very sore throat, increased pain when eating or drinking, and ear pain due to shared nerve pathways between the throat and ears. By around 7 to 10 days, the scabs gradually fall away, and pain slowly improves. Most scabs have cleared by two weeks, although full healing may take a few weeks.
Fresh bleeding or bright red blood is not normal and should be assessed urgently at your nearest emergency department.
Pain after tonsillectomy is expected and can vary from day to day. Effective pain management is important to help children eat, drink, and recover comfortably.
Regular pain relief medicine, such as paracetamol and ibuprofen, is usually recommended and should be given consistently rather than waiting for pain to become severe. This approach helps relieve pain and supports better fluid intake. Pain may feel worse at certain times, particularly during the middle phase of recovery when scabs are separating.
Your child’s doctor will provide specific pain relief instructions tailored to your child’s age and needs.
Children should be encouraged to drink fluids and return to a normal diet as soon as they are able. Eating and drinking help keep the throat moving and can support healing.
Some children have trouble eating during the first week due to pain. Softer foods and cool drinks may be easier initially. Preventing dehydration is important, particularly when throat pain is at its peak. Small, frequent sips of fluid are often better tolerated than large amounts at once.
Many children go home the same day after surgery. However, an overnight hospital stay may be recommended for younger children or those with medical conditions such as sleep apnoea.
Children who have significantly enlarged tonsils, breathing difficulties during sleep, or other health concerns may be observed overnight to ensure they are breathing comfortably and maintaining safe oxygen levels after surgery.
In some children, tonsillectomy and adenoidectomy are performed together. This is common when children have tonsillar hypertrophy, persistent mouth breathing, or symptoms of sleep apnoea.
Removing both the tonsils and adenoids can improve airflow through the nose and throat, reduce snoring and mouth breathing, and improve sleep quality. This combined approach is often recommended when enlarged tonsils and adenoids are contributing to breathing problems during sleep.
You should contact your child’s doctor or an available local doctor or your if you are concerned about pain control, reduced fluid intake, or symptoms such as nausea and vomiting that interfere with eating or drinking.
Urgent medical care is required if there is fresh bleeding, difficulty breathing, or signs of dehydration. If bleeding occurs, attend the nearest emergency department immediately.
If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.
To book with Dr Phillips, you’ll need a referral from your GP or specialist. Questions? Call our team — we’re happy to help.
