At Melbourne ENT in St Kilda East, Victoria, patients benefit from the expertise of two highly experienced FRACS surgeons: Dr Stephen Kleid (ENT and Head & Neck Surgeon) and Dr Simon Braham (ENT Surgeon). With decades of combined practice across major Victorian hospitals – including the Royal Melbourne Hospital and the Royal Victorian Eye & Ear Hospital – they provide safe, evidence-based ENT surgery for both children and adults.
This article explores modern surgical options, including Coblation tonsillectomy and approaches to nasal surgery, highlighting how Melbourne ENT supports patients through consultation, surgery, and recovery.
Tonsil and nasal conditions are some of the most frequent reasons patients are referred to an ENT surgeon. For children, problems such as recurrent tonsillitis, enlarged tonsils causing sleep apnoea, or persistent snoring are common. For adults, issues include chronic throat infections, obstructive sleep apnoea, and nasal obstruction. Cosmetic nasal reshaping is also a major area of ENT surgery.
Daily life can be significantly affected by these conditions. Children with large tonsils often experience restless sleep, behavioural changes, or delayed learning due to sleep fragmentation. This can place stress not only on the child but on the entire family, as disturbed sleep patterns affect household routines. Adults may find their professional and social lives disrupted by fatigue, chronic halitosis, or repeated time away from work due to infections. In many cases, these conditions reduce overall quality of life and can lead to secondary health issues if untreated. For many families, consulting Dr Kleid or Dr Braham at Melbourne ENT is the first step toward long-term relief, improved function, and better wellbeing.
ENT surgery has evolved significantly over recent decades. Improved surgical techniques, safer anaesthesia, and refined post-operative care have made procedures safer and more comfortable for patients. Patients today benefit from a combination of long-standing surgical expertise and modern innovation.
Modern practice includes minimally invasive options such as Coblation, which reduces tissue trauma compared with older methods. Surgeons also use microdebriders and endoscopic approaches to limit collateral damage. Recovery protocols have been enhanced, with pain management strategies carefully adapted to the different needs of children and adults. Surgery is rarely an isolated effort, with ENT surgeons working closely alongside anaesthetists, oncologists, and sleep physicians to provide holistic care. The result is a treatment plan that addresses not only the immediate surgical need but the overall health and wellbeing of the patient.
At Melbourne ENT, patient care is guided by three principles: evidence-based practice, personalised care, and transparency. Evidence-based practice ensures that every recommendation aligns with current medical research and international guidelines. Personalised care reflects the belief that every patient is different, requiring a tailored approach based on age, anatomy, lifestyle, and expectations. Transparency means patients receive honest communication about risks, likely recovery pathways, and all available treatment options. Both Dr Kleid and Dr Braham embody these values, meaning each patient understands their options before committing to surgery and feels supported throughout their journey.
Coblation, also known as cold ablation tonsillectomy, uses low-temperature plasma to dissolve and remove tonsil tissue. Unlike traditional “hot” techniques such as diathermy or electrocautery, Coblation minimises heat spread to surrounding tissues, which reduces collateral damage and may make the recovery less eventful for many patients.
One of the main advantages of Coblation is reduced post-operative pain. Children in particular often find that swallowing is easier and less uncomfortable after Coblation compared with older methods. This can lead to earlier return to normal eating and drinking, which is vital in reducing dehydration risk after tonsil surgery. Coblation also offers a lower risk of secondary bleeding in children and may shorten overall recovery time. The technology is versatile, allowing surgeons to perform both intracapsular (partial) tonsillectomy, where part of the capsule is preserved, and extracapsular (total) tonsillectomy, where the entire tonsil and capsule are removed.
Coblation is particularly valuable for children who suffer from sleep-disordered breathing and sleep apnoea. Enlarged tonsils can block the airway during sleep, leading to poor rest, behavioural changes, and learning difficulties. By using Coblation, Melbourne ENT offers a gentler approach to resolving these issues. For adults with recurrent tonsillitis, Coblation can also be applied in extracapsular surgery, helping to reduce the frequency of infections while still offering a less traumatic surgical experience.
Dr Stephen Kleid and Dr Simon Braham are highly trained in Coblation techniques. They perform these procedures in trusted Melbourne facilities, including Masada Private Hospital in St Kilda East, as well as public hospitals across Victoria. Their experience ensures that Coblation is used appropriately, always balancing the potential benefits with the known risks, and ensuring that patients are fully informed before proceeding.
At Melbourne ENT, no single technique is considered universally superior. Surgery is individualised, taking into account the patient’s anatomy, medical history, and long-term goals.
Intracapsular tonsillectomy removes most of the tonsil but preserves the protective capsule over the throat muscles. This results in less pain and a lower risk of bleeding, but there is a small chance that the tonsil tissue can regrow, requiring further treatment in rare cases. Extracapsular tonsillectomy removes the entire tonsil and capsule, eliminating the risk of regrowth but creating a recovery that is often more painful, with a slightly higher risk of bleeding.
Coblation is carried out at lower temperatures, which reduces tissue damage, swelling, and pain. Diathermy, while widely used and effective, applies greater heat and can result in a more uncomfortable recovery. Patients considering tonsillectomy at Melbourne ENT are guided carefully through these options, ensuring their choice is informed and appropriate.
ENT surgery extends beyond the throat, with nasal procedures often raising important debates. Open rhinoplasty provides maximum visibility of the nasal structures and is particularly valuable for revision or complex cases. Closed rhinoplasty hides the incisions within the nostrils and may be suitable for more subtle refinements, though it is technically demanding. Structural rhinoplasty rebuilds nasal support, offering long-term stability and predictability, while preservation rhinoplasty aims to conserve as much of the natural cartilage as possible, potentially offering smoother recovery but with limitations in some complex cases. Surgeons also debate the use of grafts versus sutures for nasal tip support. Cartilage grafts can provide strong, lasting support, while sutures allow subtler reshaping but may not always last as long. At Melbourne ENT, these decisions are made carefully in consultation with patients, always with the goal of achieving natural-looking, functional results.
Choosing surgery is an important step, and Melbourne ENT places great emphasis on preparation. Patients are assessed not only for their suitability for surgery but also for their readiness to undergo recovery.
Patients with pre-existing medical conditions, such as bleeding disorders or reflux, require extra planning to reduce risks. Sleep studies may be arranged if sleep apnoea is suspected, to confirm whether tonsil surgery is the best solution. Allergy and infection history is carefully considered, particularly for children who have frequent illnesses.
Recovery requires planning. Children may need up to two weeks away from school to recover fully, while adults often require 10 to 14 days off work. Families are advised to prepare soft, cool foods at home, ensure hydration, and arrange for extra support during recovery. Adults should anticipate that the first week may be challenging, with pain that requires regular medication.
Setting realistic expectations is crucial. Melbourne ENT places great importance on reminding patients that all surgery carries risks. Recovery experiences vary, particularly between children and adults. Revision procedures, while uncommon, may sometimes be necessary. Patients are encouraged to focus on long-term outcomes, such as improved breathing, reduced infections, and better sleep, rather than expecting an entirely risk-free process.
Every patient at Melbourne ENT receives detailed written and verbal guidance before and after surgery. In addition, surgeons provide patients with 24-hour emergency contact details to address any urgent concerns promptly.
Children generally recover within one to two weeks, with parents often noticing an immediate improvement in sleep quality. Adults, however, may find recovery slower and more uncomfortable, often requiring up to two full weeks off work.
It is normal to experience a sore throat, earache, and temporary bad breath following surgery. A white coating on the throat is a sign of normal healing and should not cause alarm. Some children may temporarily lose weight due to reduced eating, but this typically resolves quickly as appetite returns.
As with all surgical procedures, there are risks. Bleeding is the most significant, particularly in the first 24 hours or again around day 7 to 10 as healing tissue separates. Mild infections are not uncommon but usually settle with rest and fluids. Regrowth of tonsil tissue is rare, though it can occur in intracapsular cases. Melbourne ENT emphasises early recognition of complications and ensures patients are supported at every stage of recovery.
What distinguishes Melbourne ENT is the unwavering commitment to personalised and transparent care. The focus is always on long-term function and patient satisfaction. In tonsillectomy, this means ensuring the throat heals well, swallowing returns to normal, and airway obstruction is removed. In rhinoplasty, the emphasis is on creating results that look natural and blend with the patient’s features, rather than appearing artificial.
The surgeons prioritise realistic communication, providing patients with clear explanations of risks and outcomes. Continuity of care is another defining feature of Melbourne ENT. Both Dr Kleid and Dr Braham are directly involved from the initial consultation through surgery and recovery, ensuring consistency and trust throughout the process. Their backgrounds reinforce this philosophy: Dr Kleid, with decades of experience in oncological and reconstructive surgery, and Dr Braham, with advanced training in ENT surgery, bring a unique combination of skills that benefit every patient.
With a GP referral, Medicare rebates apply to most tonsil and nasal surgeries. Rebates are available for tonsillectomy, adenoidectomy, and septoplasty procedures. Out-of-pocket expenses vary depending on the surgeon’s fee, anaesthetist’s fee, hospital charges, and the level of insurance coverage. Melbourne ENT is committed to financial transparency, providing patients with written estimates prior to booking surgery. Families are reassured that the choice of Coblation versus traditional methods does not affect Medicare rebates, and every effort is made to minimise unexpected costs.
Coblation uses low-temperature plasma energy to dissolve tonsil tissue, which causes less heat damage than traditional methods. This often means less pain, faster return to eating, and smoother recovery for many patients.
Yes, Coblation is suitable for both children and adults. Children often benefit from reduced pain and quicker return to normal routines, while adults find that recovery can be more manageable compared with older surgical techniques.
Most patients are able to drink fluids and eat soft foods sooner with Coblation compared to traditional hot techniques. Swallowing is still uncomfortable in the first week, but Coblation generally makes it less difficult.
If the surgery is performed intracapsularly, meaning some tissue is left behind, there is a small risk of regrowth. In most cases the regrowth is minimal and does not cause significant symptoms. Total Coblation tonsillectomy removes all tissue, which prevents regrowth.
Research shows that Coblation is associated with lower rates of secondary bleeding in children, while still being effective for adults. However, any tonsil surgery carries some bleeding risk and patients are carefully monitored.
Sleep studies help confirm whether enlarged tonsils are causing obstructive sleep apnoea. This ensures that Coblation or other tonsil surgery is the right treatment, especially when symptoms include restless sleep, snoring, or pauses in breathing.
Dr Stephen Kleid and Dr Simon Braham consider the patient’s age, medical history, and the severity of symptoms. They also take into account the likelihood of infection, airway obstruction, and the need for long-term results. Their goal is always to recommend the safest and most effective approach for each individual.
If you or your child are struggling with recurrent throat infections, sleep apnoea, or nasal breathing problems, Melbourne ENT can provide the expert care you need. Our team is dedicated to helping children and adults across Melbourne achieve better health, improved breathing, and more restful sleep.
Book a consultation today with:
Dr Stephen Kleid – ENT and Head & Neck Surgeon
Phone: (03) 9038 1630 · visit the website
Dr Simon Braham – ENT Surgeon
Phone: (03) 9038 1311 · visit the website
At Melbourne ENT in St Kilda East, patients receive clear advice, evidence-based treatments, and supportive care from consultation through to recovery. With decades of combined experience across Melbourne’s leading hospitals, Dr Kleid and Dr Braham provide trusted care for children and adults – helping families breathe easier, sleep better, and enjoy optimal outcomes.