Select a procedure above to view detailed surgical information.
Tympanostomy (ear tube) placement is one of the most common childhood surgical procedures. Under brief general anesthesia, a tiny incision is made in each eardrum and a small ventilation tube is inserted to allow fluid to drain and air to enter the middle ear. The procedure typically takes 10–15 minutes and children go home the same day. Tubes fall out on their own, usually within 6–18 months.
- Ear drainage (otorrhea): Fluid or mucus may drain through the tube, especially with colds or water exposure. Usually treated with antibiotic ear drops.
- Tube blockage: Tubes can become clogged with dried fluid or wax and may need to be cleared.
- Tube displacement: A tube may fall out too early or migrate inward, occasionally requiring repeat placement.
- Persistent perforation: In rare cases (<1–2%), the eardrum does not heal fully after the tube falls out and may require a minor repair.
- Scarring (tympanosclerosis): White calcium deposits may appear on the eardrum; these rarely affect hearing.
- Anesthesia risks: General anesthesia in children is extremely safe with modern techniques. Our team works with experienced pediatric anesthesiologists.
- Infection: Mild ear infections may still occur; they are typically easier to treat with topical drops once tubes are in place.
- Children typically wake up quickly and are home within 1–2 hours after the procedure.
- Some fussiness, mild ear discomfort, or grogginess from anesthesia is normal for a few hours.
- A light diet is recommended until fully alert; normal diet resumes the same day.
- Water precautions: Ask your surgeon specifically about swimming and bathing restrictions — recommendations vary by patient.
- Follow-up is typically at 4–6 weeks after placement, then every 6 months to monitor tubes and hearing.
- Antibiotic ear drops may be prescribed for use immediately after surgery or during future drainage episodes.
- Thick, yellow, or green drainage lasting more than 3–4 days, or not improving with prescribed drops
- Fever above 101°F (38.3°C) persisting more than 24 hours after surgery
- Significant ear pain or your child pulling at their ear repeatedly
- A tube visibly displaced or seen outside the ear canal
- Any concerns about hearing after tube placement
In adults, ear tubes can often be placed right in the office without general anesthesia. Topical phenol is applied directly to the eardrum to numb the area. A small incision is made and a ventilation tube inserted — the entire procedure takes only a few minutes. No sedation or recovery time is required and you may drive yourself home.
- Discomfort during placement: Phenol provides good topical anesthesia but some patients feel brief pressure or a sharp sensation at the moment of insertion.
- Ear drainage (otorrhea): Drainage of retained middle ear fluid is expected and may continue for a few days.
- Tube blockage or early extrusion: Tubes may clog or fall out prematurely, occasionally requiring repeat placement.
- Persistent eardrum perforation: Rare risk that the eardrum does not close after the tube falls out.
- Temporary dizziness: Brief vertigo can occur immediately after placement due to cold fluid or air entering the middle ear.
- Infection: Uncommon; typically managed with antibiotic ear drops.
- You may return to normal activities immediately. No driving restrictions.
- Some crackling, popping, or muffled sounds in the treated ear are normal for the first day.
- Antibiotic ear drops are often prescribed for several days after placement.
- Water precautions: Use ear plugs during showering and avoid submersion until cleared by your surgeon.
- Follow-up at 4–6 weeks, then every 6 months while tubes are in place.
- Ear drainage that is thick, foul-smelling, or not improving within 3–4 days
- Significant ear pain or new hearing loss after the procedure
- Dizziness or vertigo persisting more than a few hours after placement
- Signs of infection: redness, swelling, warmth around the ear
- A tube that has clearly fallen out before your follow-up appointment
Tympanoplasty is surgery to repair a hole (perforation) in the eardrum, and sometimes to reconstruct the small hearing bones behind it. Eardrum perforations can result from chronic ear infections, prior ear tubes, trauma, or long-standing eustachian tube problems. A persistent perforation can cause recurrent drainage, infections, and hearing loss. The goals of surgery are to close the eardrum, create a safe and dry ear, and improve hearing.
The procedure is performed under general anesthesia, usually as an outpatient. Depending on the size and location of the perforation, your surgeon may work through the ear canal, or through a small incision behind or in front of the ear. The hole is patched using your own tissue — most often the covering of nearby muscle or cartilage (a graft) — which becomes a new, healthy eardrum as it heals. If a hearing bone is damaged, it may be repaired or reconstructed during the same surgery (ossiculoplasty). The ear canal is then packed with dissolvable and/or removable material to support the graft while it heals.
Common and usually minor:
- Ear fullness, muffled hearing, and mild discomfort during healing
- Bloody or watery drainage for the first several days
- Temporary altered taste on one side of the tongue
- Numbness of the outer ear that gradually resolves
Less common but important:
- Graft failure — the perforation does not fully close and may need revision
- Infection
- Incomplete hearing improvement, or rarely, worsened hearing
- Persistent ringing in the ear (tinnitus)
Rare but serious:
- Significant hearing loss in the operated ear
- Dizziness or balance disturbance
- Facial nerve weakness
- Persistent taste changes
- Adverse reaction to anesthesia
- Keep the ear dry. No water in the ear until your surgeon clears you — use a cotton ball coated in petroleum jelly when showering.
- Expect muffled or fluctuating hearing for several weeks; the ear canal packing must dissolve or be removed before hearing improves.
- Do not blow your nose forcefully and sneeze with your mouth open to protect the graft. Avoid air travel until cleared.
- Avoid heavy lifting, straining, and strenuous activity for about 2–3 weeks.
- Use prescribed ear drops and take medications as directed.
- Some popping, clicking, or crackling in the ear is normal during healing.
- Follow-up visits are important — packing removal and a hearing test are usually done several weeks after surgery to check the result.
- Significant or increasing ear pain not controlled by medication
- Fever greater than 101°F (38.3°C)
- Foul-smelling or pus-like drainage from the ear
- Sudden hearing loss, severe dizziness, or spinning
- Facial weakness or difficulty moving one side of the face — seek prompt evaluation
- Any other concerning symptoms
A cochlear implant is a device that restores access to sound for people with significant hearing loss who no longer benefit enough from hearing aids. Unlike a hearing aid, which makes sounds louder, a cochlear implant bypasses the damaged parts of the inner ear and stimulates the hearing nerve directly. It has two parts: an internal portion placed during surgery, and an external sound processor worn on the ear that sends signals across the skin to the implant.
The surgery is performed under general anesthesia, usually as an outpatient or with a single overnight stay. Through an incision behind the ear, the surgeon places the internal receiver under the scalp and gently threads a thin electrode array into the cochlea (the inner ear's hearing organ). The implant is not activated at surgery — the external processor is fitted and "turned on" about 2–4 weeks later, once the incision has healed.
Who is a candidate? Cochlear implants are for adults and children with moderate-to-profound or severe-to-profound sensorineural hearing loss who get limited benefit from hearing aids. Candidacy has broadened significantly in recent years: since 2019 the FDA has also approved implantation for single-sided deafness (profound loss in one ear with a normal-hearing other ear). A common referral guide is the "60/60 rule" — if hearing is poor enough and word understanding is below about 60%, an implant evaluation is worthwhile. Candidacy is confirmed with specialized hearing testing and imaging.
Common and usually temporary:
- Swelling, numbness, or discomfort around the incision and ear
- Altered taste on one side of the tongue
- Temporary dizziness or imbalance
Less common but important:
- Loss of any remaining natural hearing in the implanted ear
- Infection, occasionally requiring treatment or device removal
- Persistent tinnitus or dizziness
- Device failure requiring reimplantation
Rare but serious:
- Facial nerve weakness
- Cerebrospinal fluid leak or meningitis (vaccination beforehand reduces this risk)
- Adverse reaction to anesthesia
- Keep the incision clean and dry per your surgeon's instructions; expect some swelling and numbness behind the ear that improves over weeks.
- Manage discomfort with prescribed or over-the-counter pain medication.
- Avoid heavy lifting and strenuous activity for about 1–2 weeks.
- The device is not turned on right away — activation occurs about 2–4 weeks after surgery at your audiology appointment.
- Hearing takes time. Sound is unusual at first and improves gradually. Success depends heavily on consistent daily use and follow-up programming ("mapping") sessions, and often aural rehabilitation.
- Tell future clinicians you have a cochlear implant — it affects certain MRI scans.
- Ongoing audiology follow-up is an essential part of a good outcome.
- Increasing redness, swelling, warmth, or drainage at the incision
- Fever greater than 101°F (38.3°C), severe headache, or stiff neck
- Severe or worsening pain not controlled by medication
- Facial weakness or difficulty moving one side of the face
- Persistent severe dizziness or vomiting
- Clear fluid draining from the ear or incision
- Any other concerning symptoms
Septoplasty with turbinate reduction is performed to improve nasal breathing when a deviated nasal septum and/or enlarged turbinates cause nasal obstruction. Common symptoms include chronic nasal congestion, mouth breathing, snoring, difficulty sleeping, and impaired airflow. The goal is to create a more open nasal passage and improve airflow through the nose.
The procedure is usually performed under general anesthesia. During septoplasty, the surgeon straightens the nasal septum by reshaping or removing portions of cartilage and bone that are blocking airflow. Turbinate reduction decreases the size of enlarged turbinates while preserving their normal function. In many cases, thin silicone splints are placed on both sides of the septum to support healing and minimize scar formation. These splints remain in place until the first postoperative visit and are then removed in the office.
Common and usually minor:
- Mild bleeding or bloody drainage
- Nasal congestion and crusting during healing
- Facial pressure or discomfort
- Temporary decrease in sense of smell
Less common but important:
- Infection
- Persistent nasal obstruction or incomplete improvement
- Scar tissue formation inside the nose
- Need for additional treatment or revision surgery
Rare but serious:
- Septal perforation (hole in the septum)
- Change in nasal appearance
- Significant bleeding requiring intervention
- Cerebrospinal fluid leak
- Adverse reaction to anesthesia
- Expect nasal congestion, pressure, and mild bloody drainage for several days.
- If splints are placed, your nose will feel congested until they are removed at your first follow-up appointment.
- Begin NeilMed saline sinus rinses 3 times daily unless instructed otherwise. Continue until your follow-up visit.
- Sleep with your head elevated for the first several nights.
- Do NOT blow your nose until cleared by your surgeon.
- Avoid strenuous activity, heavy lifting, bending, and exercise until cleared by your surgeon.
- Afrin (oxymetazoline) nasal spray may be used for bothersome oozing or mild bleeding during the first 48 hours after surgery.
- Take prescribed medications as directed.
- Most patients return to work within several days, depending on their recovery and job requirements.
- Heavy bleeding that does not improve with gentle pressure or Afrin
- Fever greater than 101°F (38.3°C)
- Increasing pain not controlled with prescribed medication
- Increasing swelling, redness, or foul-smelling drainage
- Difficulty breathing
- Vision changes, severe headache, or clear watery drainage from the nose
- Any other concerning symptoms
This combined procedure corrects a deviated septum and opens blocked sinuses simultaneously. FESS uses a small endoscope inserted through the nostrils to open sinus drainage pathways and remove diseased tissue — no external cuts. Image guidance (CT-based navigation, similar to GPS) precisely maps sinus anatomy for maximum safety in complex cases. Typically 2–3 hours as an outpatient.
- Bleeding: Blood-tinged discharge is expected. Significant bleeding requiring return to surgery is rare.
- Infection / sinusitis recurrence: Surgery improves drainage but does not eliminate the underlying tendency toward sinus inflammation.
- Orbital (eye) complications: The sinuses lie immediately adjacent to the eye socket. Injury to orbital fat, muscles, or the eye is very rare (<0.5%).
- CSF leak: An unintended opening at the skull base causing cerebrospinal fluid leakage is rare (<0.5%) and typically repaired at the time of surgery.
- Loss of smell: Temporary or, rarely, permanent changes in smell can occur.
- Nasal scarring / adhesions: Scar tissue may form between nasal structures and require in-office release.
- Septal-related risks: Same as listed under Septoplasty.
- Expect significant nasal congestion, bloody discharge, and fatigue for 1–2 weeks.
- Splints or packing removed at first follow-up within 5–7 days.
- Saline rinses are critical — begin as directed (often twice daily) and continue for several weeks.
- Avoid blowing your nose forcefully for 2 weeks. Sneeze with your mouth open.
- No strenuous exercise or heavy lifting for 2–3 weeks.
- In-office sinus debridement (cleaning) at 1 week, 3 weeks, and 6 weeks — these visits are an essential part of healing.
- Continue prescribed nasal steroid sprays and allergy management post-operatively.
- Heavy or uncontrolled nasal bleeding
- Clear watery fluid dripping from the nose when leaning forward — may indicate a CSF leak
- Swelling, redness, or pain around the eye or forehead
- Vision changes of any kind
- Fever above 101.5°F or severe headache and stiff neck
Septorhinoplasty is surgery that reshapes the nose and corrects the internal structures that affect breathing. It can be done for functional reasons (to improve airflow through a blocked or collapsed nose), for cosmetic reasons (to change the shape or appearance of the nose), or — very commonly — for both at the same time. The nose is a single structure, so how it looks and how it works are closely linked; straightening a crooked nose often improves both.
What "open" means. In the open approach, a small incision is made across the columella — the strip of skin between the nostrils — which allows the skin to be lifted and the underlying cartilage and bone to be seen directly. This gives the surgeon the clearest view and the most precise control, which is especially valuable in complex, revision, or significantly crooked noses. The columellar incision typically heals into a fine, well-hidden scar. All other incisions are inside the nose.
What's done. Depending on your goals, the surgery may include straightening the septum (septoplasty), reshaping the nasal bones and cartilage, placing cartilage grafts to support and open the airway, refining the tip or bridge, and reducing the turbinates. Cartilage is usually borrowed from your own septum, and occasionally from an ear or rib. The procedure is performed under general anesthesia and typically takes 2–4 hours as an outpatient. A splint is placed on the outside of the nose, and internal splints or soft packing may be used.
A note on insurance. The functional (breathing) portion of the surgery is often covered by insurance when there is documented obstruction, while purely cosmetic changes are generally not. Our staff will help you understand your specific coverage before surgery.
Common and expected during healing:
- Swelling and bruising around the nose and eyes (often significant for the first 1–2 weeks)
- Nasal congestion and difficulty breathing through the nose for several weeks
- Numbness of the nasal tip and upper front teeth, which gradually resolves
- Mild bloody drainage in the first several days
Less common but important:
- Persistent asymmetry or a result that differs from expectations
- Incomplete improvement in breathing
- Infection
- Scar tissue formation inside the nose
- Visible or thickened scar at the columellar incision
- Need for revision surgery. Rhinoplasty is one of the most technically demanding operations in surgery, and a meaningful minority of patients ultimately choose or need a revision. This is not considered a complication so much as a recognized possibility.
Rare but serious:
- Septal perforation (hole in the septum)
- Significant bleeding requiring intervention
- Collapse or warping of cartilage over time, affecting shape or airflow
- Prolonged or permanent change in sense of smell
- Adverse reaction to anesthesia
- Sleep with your head elevated (2–3 pillows or a recliner) for the first 1–2 weeks to reduce swelling.
- Use cool compresses around — not directly on — the nose for the first 48 hours to limit bruising.
- The external splint is typically removed at about 1 week. Internal splints, if placed, are usually removed at the same visit.
- Do NOT blow your nose for 2 weeks. Sneeze with your mouth open.
- Begin saline sprays or gentle rinses as directed to clear crusting.
- Avoid strenuous activity, heavy lifting, and bending for 2–3 weeks; no contact sports or any activity risking a blow to the nose for 6 weeks or longer.
- Do not rest glasses or sunglasses on the bridge of your nose for about 4–6 weeks — tape them to your forehead or use contacts.
- Avoid aspirin and NSAIDs before and after surgery unless approved by your surgeon.
- Protect your nose from the sun; healing skin sunburns easily.
- Be patient with the result. Most bruising fades in 2 weeks and you'll look presentable in public, but swelling resolves slowly. Roughly 80–90% of swelling is gone by 2–3 months, while the final refined result — especially at the tip — can take a full year or longer to appear. Judging your nose too early is the most common source of unnecessary worry.
- Heavy bleeding that does not stop with gentle pressure or Afrin
- Fever greater than 101°F (38.3°C)
- Increasing pain not controlled by prescribed medication
- Increasing redness, swelling, warmth, or foul-smelling drainage
- Rapidly worsening swelling of the septum, or a sensation of increasing pressure inside the nose
- Vision changes or severe headache
- Any other concerning symptoms
Powered inferior turbinate reduction with therapeutic turbinate outfracture is performed to improve nasal breathing in patients with enlarged inferior turbinates that contribute to chronic nasal congestion. The goal is to reduce turbinate size while preserving their important function of warming, humidifying, and filtering air. This procedure is commonly recommended when medications have not provided adequate relief.
This is typically an office-based procedure performed under local anesthesia. Because you will remain awake, it is acceptable to eat a light meal beforehand unless instructed otherwise. Your provider may prescribe a mild sedative medication, such as triazolam, before the procedure and may also provide a small quantity of postoperative pain medication.
Anesthesia is obtained in several steps. First, topical anesthetic and decongestant sprays are applied inside the nose. This is followed by placement of medicated nasal packing to further numb the tissues. Finally, a small amount of local anesthetic is injected directly into the inferior turbinates. Once the area is fully numb, a powered microdebrider with a specialized turbinate blade is used to remove excess tissue from within the turbinate while preserving the outer lining. The turbinate is then gently outfractured (repositioned laterally) to create additional airflow through the nose.
This procedure is done while you are awake, in the office, using numbing medication rather than general anesthesia. Our goal is for you to be comfortable throughout.
- You may eat before your appointment. Because you will not be put to sleep, there is no need to fast unless we tell you otherwise.
- A mild anti-anxiety medication is optional. Many patients choose to take a low dose beforehand to help them relax. If you take one, you will need someone to drive you home.
- Numbing sprays. We begin with topical anesthetic and decongestant sprays in the nose, which numb the tissue and shrink the lining to open up the nasal passages.
- Numbing packs. Small soft packs with additional numbing medication are then placed in the nose and left in place for several minutes to deepen the numbness.
- Local anesthetic injection. Finally, a small amount of numbing medication is injected to make sure the area is fully anesthetized. You may feel brief pressure or a pinch.
We do not begin until the area is completely numb. You may still feel pressure or movement during the procedure — that is normal — but it should not be painful. Tell us at any point if you are uncomfortable.
Common and usually minor:
- Mild bleeding or bloody drainage
- Nasal congestion and crusting
- Temporary tenderness or pressure inside the nose
- Temporary increase in nasal drainage
Less common but important:
- Infection
- Persistent nasal obstruction or incomplete improvement
- Need for additional treatment or revision procedure
- Scar tissue formation inside the nose
Rare but serious:
- Significant bleeding requiring intervention
- Excessive turbinate reduction resulting in dryness or crusting
- Adverse reaction to medications or local anesthetic
- Vasovagal reaction (lightheadedness or fainting)
- Persistent pain or discomfort
- Mild bleeding, drainage, congestion, and crusting are expected during the first several days.
- Begin NeilMed saline sinus rinses 3 times daily unless instructed otherwise and continue until your follow-up visit.
- Avoid blowing your nose until instructed otherwise.
- Avoid strenuous activity, heavy lifting, bending, and vigorous exercise for approximately one week.
- Sleep with your head elevated for the first several nights.
- Afrin (oxymetazoline) nasal spray may be used for bothersome oozing or mild bleeding during the first 48 hours.
- Take prescribed medications as directed.
- Most patients return to normal daily activities within 1–2 days.
- Heavy bleeding that does not improve with Afrin
- Fever greater than 101°F (38.3°C)
- Increasing pain not controlled by medication
- Increasing swelling, redness, or foul-smelling drainage
- Difficulty breathing
- Severe dizziness, fainting, or medication reaction
- Any other concerning symptoms
Balloon sinuplasty opens blocked sinus drainage pathways without removing tissue. A small flexible catheter with a balloon tip is guided into the blocked sinus opening, inflated to widen the passageway, then removed — leaving the opening enlarged. Performed in-office under local anesthesia (with optional oral sedation). Well suited for patients with recurrent sinusitis who have not responded to medications. Recovery is significantly faster than traditional FESS.
This procedure is done while you are awake, in the office, using numbing medication rather than general anesthesia. Our goal is for you to be comfortable throughout.
- You may eat before your appointment. Because you will not be put to sleep, there is no need to fast unless we tell you otherwise.
- A mild anti-anxiety medication is optional. Many patients choose to take a low dose beforehand to help them relax. If you take one, you will need someone to drive you home.
- Numbing sprays. We begin with topical anesthetic and decongestant sprays in the nose, which numb the tissue and shrink the lining to open up the nasal passages.
- Numbing packs. Small soft packs with additional numbing medication are then placed in the nose and left in place for several minutes to deepen the numbness.
- Local anesthetic injection. Finally, a small amount of numbing medication is injected to make sure the area is fully anesthetized. You may feel brief pressure or a pinch.
We do not begin until the area is completely numb. You may still feel pressure or movement during the procedure — that is normal — but it should not be painful. Tell us at any point if you are uncomfortable.
- Bleeding: Mild bloody discharge for a few days is expected; significant bleeding is uncommon.
- Incomplete dilation: Dense scar tissue or anatomic variations may prevent full balloon dilation.
- Restenosis: The dilated opening may gradually narrow again if underlying inflammation is not controlled.
- Orbital or skull base injury: Extremely rare with the balloon technique compared to traditional FESS.
- Need for revision/OR surgery: Complex sinus disease may require traditional FESS at a later time.
- Return to work within 1–2 days in most cases.
- Saline irrigation (NeilMed rinses) beginning the day after is strongly encouraged.
- Expect mild congestion, pressure, and bloody discharge for 3–5 days.
- Avoid blowing your nose forcefully for the first week.
- Avoid strenuous exercise for 1 week.
- Follow-up at 3–4 weeks to evaluate sinus openings.
- Continue prescribed nasal steroid spray and allergy treatment long-term.
- Heavy, uncontrolled nasal bleeding
- Clear watery drip from one nostril when leaning forward (possible CSF leak)
- Swelling or pain around the eyes
- Fever above 101.5°F or severe headache
Posterior nasal nerve ablation treats chronic rhinitis — persistent runny nose, nasal congestion, and postnasal drip that has not responded to medications. Using a small cryotherapy (freezing) or radiofrequency device guided through the nostrils, the posterior nasal nerves are disrupted, reducing signals that cause excess mucus production and nasal swelling. Performed in-office under local anesthesia in 15–30 minutes.
This procedure is done while you are awake, in the office, using numbing medication rather than general anesthesia. Our goal is for you to be comfortable throughout.
- You may eat before your appointment. Because you will not be put to sleep, there is no need to fast unless we tell you otherwise.
- A mild anti-anxiety medication is optional. Many patients choose to take a low dose beforehand to help them relax. If you take one, you will need someone to drive you home.
- Numbing sprays. We begin with topical anesthetic and decongestant sprays in the nose, which numb the tissue and shrink the lining to open up the nasal passages.
- Numbing packs. Small soft packs with additional numbing medication are then placed in the nose and left in place for several minutes to deepen the numbness.
- Local anesthetic injection. Finally, a small amount of numbing medication is injected to make sure the area is fully anesthetized. You may feel brief pressure or a pinch.
We do not begin until the area is completely numb. You may still feel pressure or movement during the procedure — that is normal — but it should not be painful. Tell us at any point if you are uncomfortable.
- Temporary increase in nasal congestion: Swelling may worsen congestion for 1–2 weeks before improving.
- Numbness of the palate: Temporary numbness of the roof of the mouth or upper teeth is common, resolving within weeks.
- Incomplete response: Approximately 80% of patients report significant improvement; some may require a second treatment.
- Bleeding: Minor bleeding at the treatment site; significant bleeding is rare.
- Dryness: Some patients note a drier nasal passage that typically self-resolves.
- Return to normal activities the same day or next day.
- Saline spray or rinses recommended for the first 2 weeks.
- Avoid strenuous activity for 24–48 hours.
- Maximum benefit typically seen at 2–3 months.
- Follow-up at 4–6 weeks to assess response.
- Nosebleed not controlled with 15–20 minutes of direct pressure
- Fever above 101°F
- Palate numbness lasting more than 4–6 weeks
- Severe nasal pain or swelling beyond the first week
This combined procedure examines the nasal passages and nasopharynx while treating eustachian tube dysfunction (ETD) — a common cause of ear fullness, pressure, muffled hearing, and chronic fluid in the ear. A small nasal endoscope is passed through the nose, and a small balloon catheter is guided to the eustachian tube opening and gently inflated to widen the tube. The procedure takes 20–30 minutes in-office.
This procedure is done while you are awake, in the office, using numbing medication rather than general anesthesia. Our goal is for you to be comfortable throughout.
- You may eat before your appointment. Because you will not be put to sleep, there is no need to fast unless we tell you otherwise.
- A mild anti-anxiety medication is optional. Many patients choose to take a low dose beforehand to help them relax. If you take one, you will need someone to drive you home.
- Numbing sprays. We begin with topical anesthetic and decongestant sprays in the nose, which numb the tissue and shrink the lining to open up the nasal passages.
- Numbing packs. Small soft packs with additional numbing medication are then placed in the nose and left in place for several minutes to deepen the numbness.
- Local anesthetic injection. Finally, a small amount of numbing medication is injected to make sure the area is fully anesthetized. You may feel brief pressure or a pinch.
We do not begin until the area is completely numb. You may still feel pressure or movement during the procedure — that is normal — but it should not be painful. Tell us at any point if you are uncomfortable.
- Discomfort: Local anesthetic spray reduces discomfort, but some pressure or mild pain may be felt.
- Bleeding: Minor nasal or nasopharyngeal bleeding is possible; significant bleeding is rare.
- Incomplete response: Not all patients respond; underlying causes (allergies, anatomy) may limit benefit.
- Temporary ear fullness: Symptoms may temporarily worsen for a few days after the procedure.
- Infection: Rare.
- Do NOT blow your nose for 1 week after the procedure. Sneeze with your mouth open. This protects the treated eustachian tube while it heals.
- Resume normal activities the same day. No driving restrictions.
- Mild nasal congestion or throat irritation for 1–2 days is normal.
- Ear popping and pressure changes may occur for a few days as the eustachian tube adjusts.
- Continue managing underlying allergies or reflux as directed.
- Improvement is often gradual over 4–8 weeks.
- Follow-up at 4–6 weeks with possible hearing testing.
- Sudden or significant change in hearing in either ear
- Severe ear pain following the procedure
- Nosebleed not controlled with pressure
- New dizziness or vertigo lasting more than a few hours
- Fever or signs of infection
Tonsillectomy removes the palatine tonsils at the back of the throat; adenoidectomy removes adenoid tissue at the top of the throat behind the nose. Performed together under general anesthesia in approximately 30–45 minutes as an outpatient. Common indications include recurrent strep throat infections, obstructive sleep-disordered breathing or sleep apnea, and tonsil stones. Recovery is more significant in adults than in children.
- Bleeding (primary): Occurs within the first 24 hours; risk is approximately 1–3%.
- Bleeding (secondary): Occurs 5–10 days after surgery as scabs in the throat separate — the most concerning complication. Requires immediate emergency evaluation.
- Dehydration: Pain limits swallowing; inadequate fluid intake is the leading cause of post-operative ER visits. Staying hydrated is critical.
- Infection: Uncommon; white scabs in the throat are normal and should not be confused with infection.
- Velopharyngeal insufficiency (VPI): Rare temporary nasal speech or nasal regurgitation, particularly if there is an underlying palate issue.
- Airway swelling: In children with severe sleep apnea, temporary worsening of breathing can occur in the immediate post-operative period.
- Throat pain is expected and typically worst between days 5–10. Pain often gets worse before it gets better — this is normal.
- Hydration is the single most important aftercare task. Drink cool, clear fluids constantly. Popsicles, ice chips, and water are encouraged.
- Soft, cool foods for the first 2 weeks. Avoid crunchy, sharp, or scratchy foods.
- Take prescribed pain medication on a schedule — don't wait for pain to become severe.
- No aspirin or ibuprofen — these increase bleeding risk. Use acetaminophen (Tylenol) only.
- Avoid strenuous activity and contact sports for 2 full weeks.
- Ear pain (referred pain) is very common and does NOT mean an ear infection.
- Follow-up at 2–3 weeks after surgery.
- Any bright red bleeding from the mouth — go to the nearest emergency room immediately
- Inability to swallow liquids or signs of dehydration (no urination for 8+ hours, dizziness)
- Fever above 102°F (38.9°C)
- Breathing difficulty or noisy breathing at rest
- Pain unresponsive to prescribed medications
Microlaryngoscopy is a direct surgical examination and treatment of the larynx (voice box) under general anesthesia using a rigid laryngoscope and operating microscope, allowing extreme precision on the vocal cords. Performed for vocal cord polyps, cysts, nodules, Reinke's edema, scar tissue, papillomas, or biopsy of suspicious lesions. No external incisions. Typically 30–60 minutes.
- Hoarseness / voice changes: Expected temporarily as vocal cords heal. Persistent hoarseness beyond several weeks warrants evaluation.
- Dental injury: The laryngoscope rests against the upper teeth; a tooth guard is placed, but loosening or chipping is possible.
- Tongue or lip numbness: Temporary compression of the tongue may cause transient numbness.
- Vocal fold scar: Aggressive surgery near the vocal cord surface can cause scar tissue affecting voice quality.
- Airway swelling: Rare mild stridor or breathing difficulty post-operatively is monitored during recovery.
- Incomplete removal: Some lesions (particularly papillomas) may require multiple procedures.
- Voice rest is critical. Your surgeon will specify duration — typically 3–7 days of complete voice rest. No speaking, whispering, or throat clearing.
- Whispering is NOT voice rest — it strains the cords more than soft speaking. Use a notepad or phone to communicate.
- Stay well hydrated. Use a humidifier. Avoid smoking, alcohol, and drying environments.
- Throat soreness and mild swallowing difficulty for 3–5 days is expected.
- Avoid forceful coughing; use cough suppressants if prescribed.
- Voice therapy may be recommended post-operatively.
- Follow-up with laryngoscopy at 2–4 weeks.
- Noisy breathing, stridor, or any sense of airway difficulty — go to the ER immediately
- Throat bleeding or spitting up blood
- Fever above 101.5°F (38.6°C)
- Hoarseness that significantly worsens after initial improvement
- Severe throat pain not managed by prescribed medications
Inspire is an implantable device that treats obstructive sleep apnea (OSA) for people who cannot tolerate or do not benefit from CPAP. Rather than using a mask and pressurized air, it works from inside the body: a small generator (similar to a pacemaker) is placed under the skin of the upper chest, with a lead that gently stimulates the hypoglossal nerve — the nerve that controls tongue movement. During sleep, the device senses your breathing and delivers mild stimulation with each breath, moving the tongue slightly forward to keep the airway open.
The device is implanted through one or two small incisions under general anesthesia, usually as an outpatient or with a single overnight stay. It is turned on about 4 weeks after surgery, once healing is complete, and you control it with a small handheld remote — turning it on at bedtime and off in the morning.
Who is a candidate? Inspire is a second-line treatment for adults with moderate-to-severe OSA who have failed or cannot tolerate CPAP. Current FDA criteria include an AHI (apnea-hypopnea index) in the range of about 15 to 100, a body mass index generally at or below 40, and mostly obstructive (not central) events. A brief scope procedure called a drug-induced sleep endoscopy is done beforehand to confirm the airway collapses in a pattern the device can treat — specifically, that there is no complete concentric collapse at the soft palate.
Common and usually temporary:
- Soreness, swelling, or bruising at the incision sites
- Temporary tongue soreness, weakness, or abrasion from stimulation
- Discomfort with stimulation that usually improves as settings are fine-tuned
Less common but important:
- Infection, sometimes requiring device removal
- Device or lead problems that may require a second procedure
- Incomplete improvement in sleep apnea
Rare but serious:
- Bleeding or injury to nearby nerves or structures
- Adverse reaction to anesthesia
- Need for future device revision or battery replacement (generator battery typically lasts about 11 years)
- Expect soreness and swelling at the chest and neck incisions for several days; most people manage well with over-the-counter pain medication.
- Avoid raising the arm on the surgery side above shoulder height and avoid heavy lifting for 1 week to protect the healing lead.
- Keep incisions clean and dry per your surgeon's instructions.
- The device stays off until your activation visit about 4 weeks after surgery.
- At activation, your provider programs the device and teaches you to use the remote. Settings are adjusted over several follow-up visits for comfort and effectiveness.
- A follow-up sleep study is usually done a few months after activation to confirm the device is controlling your apnea.
- Tell any future clinician you have an implanted stimulator — it matters for certain MRI scans (current Inspire models are MRI-conditional under specific settings).
- Increasing redness, swelling, warmth, or drainage at any incision
- Fever greater than 101°F (38.3°C)
- Severe or worsening pain not controlled by medication
- The device seems not to work, or stimulation is painful or intolerable
- Persistent tongue weakness or difficulty speaking or swallowing
- Any other concerning symptoms
Expansion sphincter pharyngoplasty (ESP) is a surgery to treat obstructive sleep apnea (OSA) by widening and stabilizing the throat at the level of the soft palate. In many people with OSA, the side walls of the throat (the lateral pharyngeal walls) are floppy and collapse inward during sleep, blocking airflow. ESP specifically addresses this side-wall collapse, which older palate surgeries did not treat as well.
The procedure is performed through the mouth under general anesthesia, with no external incisions. It typically includes removing the tonsils, then repositioning and anchoring a throat muscle (the palatopharyngeus) to create tension that holds the side walls open, along with trimming and reshaping part of the uvula and soft palate. The result is a firmer, more open airway that resists collapse during sleep.
Who is a candidate? ESP tends to work best for patients with lateral wall collapse confirmed on airway examination (often during drug-induced sleep endoscopy), relatively small tonsils, and a body weight in a healthy-to-moderate range. It may be done alone or combined with nasal or tongue-base procedures when obstruction occurs at more than one level.
Common and usually temporary:
- Significant throat pain for 1–2 weeks (similar to or greater than an adult tonsillectomy)
- Difficulty or discomfort swallowing during healing
- Ear-referred pain
- Temporary voice change or sensation of a lump in the throat
Less common but important:
- Bleeding from the tonsil/surgical beds (can occur up to about 2 weeks after surgery)
- Infection
- Temporary velopharyngeal insufficiency — liquids escaping into the nose when swallowing
- Incomplete improvement in sleep apnea
Rare but serious:
- Significant bleeding requiring a return to the operating room
- Persistent swallowing difficulty or nasal regurgitation
- Persistent voice change
- Adverse reaction to anesthesia
- Throat pain is expected and is often worst between days 5–10; it commonly gets worse before it gets better, which is normal.
- Stay well hydrated — regular swallowing of fluids actually speeds healing and reduces pain. Cool liquids and soft foods are best early on.
- Take pain medication as prescribed, ideally shortly before eating or drinking.
- Avoid strenuous activity, heavy lifting, and vigorous exercise for about 2 weeks to reduce bleeding risk.
- Avoid aspirin and NSAIDs unless your surgeon specifically approves them.
- Some noticeable throat scabbing (white/gray coating) is a normal part of healing and will resolve.
- Most patients take about 1–2 weeks off work depending on their recovery.
- A follow-up sleep study is typically done a few months after surgery to measure the effect on your apnea.
- Any bright red bleeding from the mouth or throat — this can be an emergency; call immediately or seek emergency care
- Inability to keep down fluids, or signs of dehydration (dizziness, no urination, marked weakness)
- Fever greater than 101°F (38.3°C)
- Difficulty breathing
- Severe pain not controlled by prescribed medication
- Any other concerning symptoms
A thyroid lobectomy is a surgical procedure in which one half (one lobe) of the thyroid gland is removed. It is commonly performed to evaluate or treat a thyroid nodule, suspicious biopsy result, enlarging thyroid mass, or selected thyroid cancers. Removing one thyroid lobe often preserves enough thyroid function that lifelong thyroid hormone replacement may not be necessary, though monitoring is required.
This procedure is performed under general anesthesia, typically lasting 1–2 hours. A small incision is made in the lower front portion of the neck. The affected thyroid lobe is carefully separated from surrounding structures and removed. Special attention is given to protecting the recurrent laryngeal nerve, which controls vocal cord movement, and preserving the parathyroid glands, which help regulate calcium levels. The incision is then closed with sutures and/or surgical adhesive.
Common and usually minor:
- Temporary neck discomfort, soreness, or tightness
- Mild swelling or bruising around the incision
- Temporary swallowing discomfort
- Temporary voice fatigue or hoarseness
Less common but important:
- Infection
- Bleeding or hematoma formation
- Noticeable or keloid scar formation
- Need for thyroid hormone replacement: The remaining lobe may not produce enough thyroid hormone — approximately 20–30% of patients eventually need supplementation.
- Need for additional surgery depending on final pathology results
Rare but serious:
- Recurrent laryngeal nerve injury: Temporary hoarseness occurs in up to 5–10%; permanent vocal cord weakness or paralysis is rare (<1%) but can cause lasting voice changes.
- Significant bleeding causing airway compression
- Injury to nearby structures in the neck
- Persistent voice changes (including effects on pitch or projection from superior laryngeal nerve involvement)
- Low calcium levels — uncommon after lobectomy but possible if parathyroid function is affected
- Adverse reaction to anesthesia
- Mild neck discomfort, throat soreness, and swallowing discomfort are common during the first several days.
- Most patients are discharged the same day or after an overnight observation period.
- Keep the incision clean and dry and follow the wound-care instructions provided by your surgeon. You may shower as instructed.
- Walking is encouraged, but avoid strenuous activity, heavy lifting, and vigorous exercise for approximately 1–2 weeks.
- Mild voice fatigue or hoarseness may occur and usually improves with healing.
- Take prescribed medications as directed.
- Thyroid hormone levels (TSH, Free T4) are typically checked at approximately 6 weeks.
- Pathology results are usually available within about 1 week and reviewed at your follow-up visit. Follow-up visits and pathology review are important parts of your postoperative care.
- Rapid neck swelling — seek emergency care immediately (possible hematoma)
- Difficulty breathing or swallowing
- Bleeding from the incision
- Fever greater than 101°F (38.3°C)
- Increasing redness, swelling, or drainage from the incision
- Persistent or worsening hoarseness
- Numbness or tingling around the lips, fingers, or toes (possible low calcium)
- Any other concerning symptoms
A total thyroidectomy removes the entire thyroid gland through a horizontal neck incision. Performed for thyroid cancers requiring complete removal, large goiters with compressive symptoms, Graves' disease uncontrolled by medications, or bilateral thyroid nodules. Lifelong thyroid hormone replacement (levothyroxine) is required. Typically 1.5–3 hours with an overnight hospital stay to monitor calcium levels.
- Hypothyroidism (permanent): Inevitable and expected. Managed with daily levothyroxine for life.
- Hypoparathyroidism: Temporary low calcium occurs in 20–30%; permanent deficiency requiring lifelong calcium/vitamin D supplementation occurs in 1–3%.
- Recurrent laryngeal nerve injury: Bilateral RLN injury, though very rare (<0.5%), can cause significant breathing difficulty.
- Bleeding / hematoma: Rare (<1–2%) but potentially life-threatening emergency requiring immediate return to surgery.
- Superior laryngeal nerve injury: Affects vocal quality or projection.
- Scar: Heals well in most patients; keloid formation is possible.
- Most patients stay one night for calcium monitoring.
- Calcium and PTH levels are checked before discharge and may be rechecked at home.
- Begin levothyroxine as prescribed, usually the morning after surgery.
- Calcium supplements and Vitamin D may be prescribed as a precaution — take exactly as directed.
- Soft diet and limited activity for 3–5 days. No heavy lifting for 2 weeks.
- Avoid direct sun on the scar for 6–12 months (use sunscreen).
- Thyroid levels and calcium checked at 4–6 weeks to adjust levothyroxine dosing.
- Surgical follow-up at 1 week, then 6 weeks for labs.
- Rapid neck swelling or breathing difficulty — go to the ER immediately
- Tingling or numbness of the lips, fingertips, or toes (low calcium)
- Muscle cramping, twitching, or spasms — especially hands or face
- Hoarseness worsening after the first week
- Fever above 101°F, wound redness, or discharge
- Palpitations or feeling overheated (too much thyroid hormone)
- Extreme fatigue, cold intolerance (too little thyroid hormone)
Most parathyroidectomies are performed for primary hyperparathyroidism, most commonly caused by a single benign overactive gland (adenoma). A focused or minimally invasive parathyroidectomy removes only the abnormal gland through a small incision. Intraoperative PTH monitoring confirms successful removal before the incision is closed. Most patients go home the same day. Cure rates exceed 95%.
- Persistent or recurrent hyperparathyroidism: Occurs if an additional abnormal gland is missed. Intraoperative PTH monitoring significantly reduces this risk.
- Temporary hypocalcemia: After removal, the remaining suppressed glands may need time to recover. Transient low calcium (tingling, cramping) is managed with supplements.
- Permanent hypoparathyroidism: Rare (<1%) in focused parathyroidectomy.
- Recurrent laryngeal nerve injury: Same risk as thyroid surgery — rare but possible.
- Bleeding / hematoma: Rare but potentially serious.
- Ectopic gland: Occasionally a gland is in an unusual location and may require a more extensive exploration.
- Most patients go home the same day within a few hours of surgery.
- Calcium supplements are often prescribed for 1–4 weeks to prevent low calcium symptoms.
- Soft diet for 1–2 days; normal diet resumes quickly.
- No heavy lifting or strenuous activity for 1–2 weeks.
- Calcium and PTH levels rechecked at follow-up at 1–2 weeks.
- Long-term follow-up with a calcium level at 6 months and annually.
- Numbness or tingling of the lips, hands, or feet
- Muscle cramping or twitching, particularly in the face or hands
- Rapid neck swelling or difficulty breathing — go to the ER immediately
- Hoarseness developing or worsening after surgery
- Fever, wound redness, or drainage
A subtotal parathyroidectomy is performed for secondary or tertiary hyperparathyroidism (most commonly in chronic kidney disease or after kidney transplant) or multigland parathyroid disease. All four parathyroid glands are identified, and 3.5 of the 4 are removed — leaving a carefully measured remnant of the most normal-appearing gland to maintain some parathyroid function. The procedure takes 2–3 hours and may require an overnight stay.
- Permanent hypoparathyroidism: Higher risk than focused parathyroidectomy. Lifelong calcium and vitamin D supplementation may be required.
- Hungry bone syndrome: Previously calcium-depleted bones rapidly absorb calcium after surgery, causing a sharp drop in blood calcium. Close monitoring and aggressive supplementation are required.
- Recurrent hyperparathyroidism: The retained remnant may regrow or become overactive again over time.
- Recurrent laryngeal nerve injury: Bilateral exploration increases relative risk compared to focused surgery.
- Bleeding / hematoma: Rare but serious.
- Wound complications: Particularly in patients on dialysis or immunosuppressed after transplant.
- Overnight or multi-day hospital stay is typical for calcium monitoring.
- Aggressive calcium supplementation (IV and oral) started immediately after surgery.
- Calcium, phosphorus, and PTH levels checked frequently in the first days and weeks.
- Take calcium supplements exactly as prescribed — dose adjustments are made frequently.
- No heavy lifting or strenuous activity for 2–3 weeks.
- Close coordination with your nephrologist is important, especially for dialysis patients.
- Follow-up labs and visits at 1 week, 1 month, 3 months, and regularly thereafter.
- Tingling of the lips, face, hands, or feet — especially if spreading or worsening
- Muscle spasms, cramps, or rigidity — particularly carpopedal spasm of the hands
- Rapid swelling of the neck or breathing difficulty — go to the ER immediately
- Hoarseness or voice change after surgery
- Fever above 101°F, wound redness, or discharge
- Extreme fatigue, confusion, or irregular heartbeat
The parotid gland is the largest salivary gland, located in front of and below each ear. A partial (superficial) parotidectomy removes the outer portion of the gland, which lies directly on top of the facial nerve and all its branches. Meticulous identification and dissection of the facial nerve is the central technical challenge of this surgery. Common indications include benign tumors (pleomorphic adenoma, Warthin's tumor), suspicious masses, or chronic parotid conditions. The incision begins in front of the ear, curves naturally around the earlobe, and extends into the upper neck crease — designed to heal with minimal visible scarring. Typically 2–3 hours.
- Facial nerve weakness (temporary): Stretching or manipulation of the facial nerve during dissection commonly causes temporary weakness of facial muscles (forehead, eye closure, smile, lower lip) in up to 20–40% of patients. The vast majority recover fully within weeks to months.
- Facial nerve injury (permanent): Permanent facial weakness occurs in fewer than 1–2% of carefully performed superficial parotidectomies for benign disease. Risk is higher for deep lobe tumors, malignancy, or revision surgery.
- Frey's syndrome (gustatory sweating): A common delayed complication occurring in up to 30–50% of patients — flushing and sweating of the cheek during eating due to aberrant nerve regeneration. Mild cases are often well tolerated; treatment options include antiperspirant cream or Botox injections.
- Great auricular nerve numbness: This nerve is often divided during the approach, causing permanent numbness of the lower earlobe and adjacent cheek. This is expected and permanent, though most patients adapt well.
- Salivary fistula or sialocele: Saliva may collect under the skin flap or leak through the wound. Managed with pressure dressings, aspiration, or medications to reduce saliva production.
- Hematoma: Blood accumulation under the skin flap occurs in 1–3% of patients and may require drainage.
- Infection: Wound or salivary gland infection is uncommon and treated with antibiotics.
- Tumor recurrence: Benign pleomorphic adenomas have a small risk of recurrence if margins are inadequate. Malignancies may require additional treatment based on final pathology.
- Scar: The incision generally heals well along natural skin lines; hypertrophic or keloid scarring is possible.
- Most patients are discharged the same day or after one night in the hospital.
- A small surgical drain is placed and typically removed at your first follow-up within 1–2 days when output decreases. Drain care instructions will be provided.
- A pressure dressing is applied to the cheek and neck immediately after surgery and worn for several days to minimize fluid accumulation.
- Keep the incision clean and dry per wound care instructions. Sutures or Steri-strips removed at 7–10 days.
- Soft diet for the first 1–2 weeks — avoid chewing hard or chewy foods to reduce salivary stimulation and stress on the incision.
- Avoid gum, sour candies, or anything that strongly stimulates saliva in the early healing period.
- No heavy lifting (>10 lbs) or strenuous activity for 2–3 weeks.
- If eye closure is affected by temporary facial weakness, lubricating eye drops and a moisture chamber patch may be recommended to protect the cornea.
- Pathology results available in approximately 1–2 weeks and reviewed at your follow-up appointment.
- Surgical follow-up at 1 week (drain removal, wound check), then 3–4 weeks for pathology review and nerve assessment.
- Long-term tumor surveillance is important — typically annually for several years.
- Rapidly increasing cheek or neck swelling — go to the ER immediately if associated with breathing difficulty
- Significant drainage from the wound or fluid collection at the surgical site
- Inability to fully close the eye on the side of surgery — call promptly so we can protect your cornea
- Facial weakness that appears to be worsening after an initial period of improvement
- Fever above 101°F (38.3°C) or wound redness, warmth, or discharge
- Heavy or bright red drainage from the drain or wound
- Questions about your pathology results or recommendations for further treatment
A neck dissection removes lymph nodes and surrounding fatty tissue from the neck as part of the surgical treatment for head and neck cancers (thyroid, oral, throat, skin, or salivary gland cancers). Lymph node removal provides accurate staging of cancer spread and can provide definitive regional disease control. A selective neck dissection removes specific lymph node regions relevant to the primary tumor; a comprehensive dissection may also include the sternocleidomastoid muscle, jugular vein, or spinal accessory nerve depending on tumor involvement. Typically 2–4 hours, often combined with removal of the primary tumor.
- Shoulder weakness / drop: The spinal accessory nerve (CN XI) controls the trapezius muscle. Stretching or removal causes shoulder weakness, drooping, and pain — physical therapy is important.
- Numbness of the ear and neck: The great auricular nerve is often divided, causing permanent numbness of the lower earlobe and surrounding skin. Expected and generally well tolerated.
- Lymphedema: Disruption of lymphatic channels can cause chronic swelling of the face, jaw, or neck.
- Chyle leak: Injury to the thoracic duct (left side) causes milky lymphatic fluid to accumulate in the wound. Managed with low-fat diet or, rarely, surgical repair.
- Nerve injuries: Marginal mandibular nerve injury causes lower lip asymmetry; hypoglossal nerve injury affects tongue movement; vagus nerve injury affects voice or swallowing.
- Vascular injury: Injury to the jugular vein or carotid artery is rare but serious.
- Wound complications: Infection, delayed healing, or fistula — particularly if prior radiation has been given to the neck.
- Hematoma / seroma: Fluid or blood accumulation under the skin is fairly common and may require aspiration.
- Hospital stay typically 1–3 days depending on the extent of surgery.
- A surgical drain is placed and usually removed within 2–5 days when output is low. Drain care instructions will be provided.
- No heavy lifting (>10 lbs) for 3–4 weeks.
- Physical therapy for shoulder strength and range of motion is strongly recommended if the spinal accessory nerve was affected.
- Keep incision clean and dry; follow specific dressing instructions provided at discharge.
- A soft or modified-texture diet may be required if concurrent oral or pharyngeal surgery was performed.
- Final pathology results in approximately 1–2 weeks will guide further treatment decisions.
- Surgical follow-up at 1–2 weeks, then every 1–3 months during the first year of cancer surveillance.
- Rapidly increasing neck swelling, tightness, or breathing difficulty — go to the ER immediately
- Drain output that suddenly increases, becomes bright red, or turns milky/white (possible chyle leak)
- Fever above 101.5°F or wound redness, warmth, or discharge
- Significant asymmetry of the lower lip, tongue deviation, or sudden voice change
- Shoulder pain or weakness limiting function
- New facial or neck swelling developing after the first 2 weeks
- Questions about pathology results or next steps in your cancer care