A tonsillectomy is a surgical procedure involving the complete removal of the tonsils, oval-shaped pads of tissue at the back of the throat. This surgery is commonly performed to address recurrent throat infections, such as tonsillitis, and to alleviate breathing difficulties during sleep, specifically obstructive sleep apnea. While once common, particularly in children, it remains a frequently performed outpatient surgery today.
The Scab Formation and Falling Off Process
Following a tonsillectomy, the surgical sites will develop scabs. These scabs are a normal part of healing, forming a protective layer over the raw tissue. They appear as thick, white or grayish patches in the back of the throat.
The formation of these scabs begins shortly after surgery. These scabs remain in place for about 5 to 10 days after surgery. As the underlying tissue heals, the scabs will gradually loosen and fall off in small pieces.
Many swallow these small pieces without noticing. While some minor bleeding, as small flecks or streaks of dark blood, can occur as the scabs separate, significant bright red bleeding is not typical and requires medical attention.
What to Expect During Scab Separation
As the scabs begin to separate, between days 5 and 10 after surgery, patients often experience an increase in throat pain. This discomfort can peak around day 5 to 7 of recovery. The pain may radiate to the ears, neck, and jaw due to nerve pathways.
Bad breath is also a common symptom during this healing phase, due to the scabs and healing tissue. A temporary voice change may also occur. Maintaining adequate pain management with prescribed medications helps manage this increased discomfort.
Staying well-hydrated is important during this period, as dehydration can cause scabs to fall off too early. Consuming soft, cool foods like ice chips, popsicles, clear broths, and applesauce can help soothe the throat and aid swallowing.
When to Seek Medical Attention
While some minor symptoms are normal during tonsillectomy recovery, certain signs require immediate medical attention. Any amount of bright red bleeding from the mouth or nose is a serious concern and requires immediate evaluation. This includes spitting bright red blood or clots, or vomiting bright red, black, or brown material.
A persistent high fever, over 101°F (38°C), that does not respond to fever-reducing medication warrants a call to your doctor. If you are unable to drink fluids for over 24 hours, or experience severe vomiting preventing liquid intake, medical consultation is necessary to prevent dehydration.