Tonsil removal (tonsillectomy)

What is tonsil removal (tonsillectomy)?

The tonsils are two small glands at the back of the throat. A tonsillectomy removes them, usually because they keep getting infected (recurrent tonsillitis) or because they are large enough to disturb breathing during sleep. In children, enlarged tonsils and adenoids are a common cause of snoring and pauses in breathing at night (obstructive sleep apnoea).

Most sore throats and bouts of tonsillitis get better on their own and do not need surgery. Tonsillectomy is usually only considered when infections are frequent and severe enough to disrupt life, or when breathing during sleep is affected. Removing the tonsils reduces throat infections, but you can still get sore throats and other throat infections afterwards.

It is a common operation, but it is not minor: the throat is very sore for one to two weeks afterwards, and bleeding is the main serious risk. Because of this, the decision should weigh up how much the infections or sleep problems are really affecting you or your child against the recovery and risks.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Surgery vs waiting and managing

For many people, especially milder cases, watchful waiting is reasonable because infections often become less frequent over time. Surgery makes most sense when episodes are frequent, severe and clearly disrupting life, or when sleep breathing is affected.

Preparing for your surgery

• See the ENT surgeon to confirm the criteria for surgery are met and discuss the balance of benefit and risk.
• Mention any bleeding tendency, family history of bleeding, or blood-thinning medicines.
• Tell the team about any recent throat infection; surgery may be postponed if you are currently unwell.
• Follow fasting instructions before the general anaesthetic.
• Stock up on soft foods, cold drinks and ice lollies, and recommended painkillers for the recovery.
• Arrange about 2 weeks off school or work and a lift home.
• For children, plan time off work to care for them and arrange childcare if needed.

What happens

The operation is done under general anaesthetic, so you or your child are asleep, and usually takes about 30 to 45 minutes. The surgeon works through the open mouth — there are no cuts to the skin or face. The tonsils are removed and any bleeding is sealed.

Many people go home the same day once they are awake, comfortable and able to drink; some stay one night, particularly younger children or those with sleep apnoea. The throat will be sore on waking. Before discharge the team gives clear painkilling advice, what to eat and drink, and what to do if bleeding happens.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

Bleeding is the key risk and the reason recovery needs to be taken seriously. It can be early (within 24 hours) or delayed (often around days 5–10 as the scab separates), and any significant bleeding needs urgent assessment. Eating normally and keeping well hydrated actually helps healing. Ask your surgeon about their bleeding (return-to-theatre) rate, which technique they use, and exactly what to do if bleeding occurs.

Published figures to discuss

Bleeding rates vary with surgical technique, age (adults bleed more often than children), and how bleeding is defined and recorded. The figures below are cautious ranges from systematic reviews and UK data; secondary (delayed) bleeding is more common than the rarer, more serious bleeding that needs a return to theatre. They are not guarantees for any one person.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery is genuinely uncomfortable: the throat is very sore for around 10 days to 2 weeks, often peaking mid-recovery, and good pain relief and fluids matter throughout.

• A very sore throat for about 10 days to 2 weeks
• Ear pain that is referred from the throat, not an ear infection
• A white or yellow coating over the tonsil area as it heals
• Bad breath while healing
• Reduced appetite and a few days of feeling washed out

Aftercare

• Take painkillers regularly as advised, often before meals to make eating easier.
• Encourage eating normal food — chewing helps keep the area clean and supports healing.
• Drink plenty of fluids to avoid dehydration and ease the throat.
• Avoid smoky environments and crowds with coughs and colds while healing.
• Keep away from anyone with a throat infection where possible.
• Stay off school or work for about 2 weeks and avoid strenuous activity.
• Know exactly what to do and who to call if bleeding occurs.
• Avoid aspirin in children, and use only the painkillers advised.

• Recommended painkillers in stock (and a dosing plan)
• Soft and normal foods, cold drinks and ice lollies ready
• About 2 weeks off school or work booked
• A carer available for a child during recovery
• The hospital/ENT emergency number saved
• A clear plan for what to do if bleeding happens
• A thermometer to check for fever

⚠ Get urgent help if…

• Any bleeding from the mouth or throat — even a small amount needs urgent assessment; heavy bleeding is an emergency (call 999)
• Coughing or spitting up blood, or vomiting blood (which may look dark)
• Not being able to drink, or signs of dehydration (little urine, dizziness, very dry mouth)
• A high temperature that does not settle, or feeling very unwell
• Increasing pain not controlled by the painkillers advised
• Difficulty breathing (call 999)

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

For people who had frequent, severe tonsillitis, surgery usually reduces how often they get tonsil infections, and for those with sleep-related breathing problems it can improve sleep and breathing. The benefit is judged over the months that follow.

It does not make you immune to sore throats — you can still get throat infections from other causes. A good ENT surgeon is honest that surgery reduces, rather than removes, the problem, and that many milder cases improve with time without an operation.

Once removed, tonsils do not normally grow back, so the reduction in tonsil infections is lasting. After partial removal (tonsillotomy) in children, a small amount of tonsil tissue can regrow and occasionally cause symptoms again. Sleep and breathing improvements are usually durable, though weight and other factors also affect sleep over time.

Combining with other procedures

In children, the adenoids are often removed at the same time (adenotonsillectomy), especially for sleep or breathing problems. Grommets for glue ear are sometimes done in the same anaesthetic. Combining procedures should be based on clinical need, not convenience.

Follow-up & long-term care

Many tonsillectomies need little routine follow-up, but you should be told who to contact and when, and have a clear plan for bleeding or other problems. If a child had sleep apnoea, breathing and sleep should be reviewed. Removed tonsils are sometimes sent for testing in adults, and any results should be explained.

Revision and secondary surgery reality

• Removed tonsils do not normally grow back, so reoperation for the tonsils themselves is unusual.
• After partial removal (tonsillotomy), tonsil tissue can regrow and occasionally need further treatment.
• A return to theatre is sometimes needed to control bleeding rather than to redo the operation.
• If symptoms persist, the cause may not have been the tonsils, prompting reassessment.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear written pain-relief and eating/drinking advice, with painkillers timed before meals.
• Specific, written instructions on what to do and who to call if bleeding occurs.
• A named contact and 24-hour emergency route during the 2-week bleeding-risk window.
• Review of sleep and breathing if the operation was for obstructive sleep apnoea.
• Honest explanation that benefit is judged over the following months.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Surgical technique used (for example cold steel, diathermy or coblation)
• Surgeon's and anaesthetist's fees
• Theatre/facility time and whether an overnight stay is needed
• Whether the adenoids are removed at the same time
• Whether it is for a child or an adult, which can affect monitoring needs
• Follow-up appointments and the policy if a complication such as bleeding occurs

• The surgeon's fee and the anaesthetist's fee
• The hospital/facility and theatre fee, and any overnight stay
• Whether adenoid removal is included if planned
• Follow-up appointments
• The cancellation policy
• What happens, and who pays, if bleeding or another complication needs readmission or a return to theatre
• Any charge for testing removed tissue

On the NHS? Tonsillectomy is available on the NHS when strict criteria for recurrent severe infection or sleep-disordered breathing are met; private care may be used for speed or choice, but the same careful balance of benefit and risk applies.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Do we clearly meet the criteria for surgery, or could we reasonably wait?
• Which surgical technique will you use, and why?
• What is your rate of bleeding and of returning to theatre for bleeding?
• Exactly what should we do, and who do we call, if bleeding happens?
• Will the adenoids be removed at the same time, and is that needed?
• How and when will we know if the surgery has helped?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for tonsil removal (tonsillectomy)

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Tonsillitis (treatment and surgery) ENT UK — Tonsillectomy commissioning guide (2016) ENT UK — Revised tonsillectomy commissioning guide EBI / GIRFT — Tonsillectomy for recurrent tonsillitis Post-tonsillectomy haemorrhage by technique — systematic review and meta-analysis (PMC) Return to theatre for post-tonsillectomy haemorrhage — 359,241 UK tonsillectomies, 15 years of Hospital Episode Statistics (PMC) Hemorrhage rate after coblation tonsillectomy — meta-analysis (PMC)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.