Getting Ready for a Vocal Fold Injection

How is the procedure done?

• Most vocal fold injections are done in the operating room under general anesthesia (completely asleep).
• A scope is passed through your mouth to look closely at your throat and voice box.
• A small needle on a long syringe is passed through the mouth to the side of the vocal cord, and a filler is injected to plump up the weak or thin vocal cord.
• Usually one vocal cord is injected. Sometimes both are, for example when both vocal cords have thinned (vocal fold atrophy).

What are the risks?

Every procedure has risks. Your surgeon will go over them with you, and you can ask about any of them.

• Anesthesia is safe, but it has some risks. The anesthesia team can go over them with you. Tell us if anyone in your family has had a problem with anesthesia.
• Pain, bleeding and infection are risks of any procedure.
• Injury to the lips, teeth, tongue or gums can happen. Your tongue may be temporarily numb afterward.
• Trouble swallowing, almost always temporary.
• Airway swelling causing trouble breathing. This is rare, but it can be serious and need more treatment.
• The voice may get worse or not improve, and the vocal cord can become inflamed or scarred.
• The filler dissolves over time, so the effect is temporary and more injections may be needed. How long it lasts depends on the filler used.

How do I get ready?

• As soon as surgery is scheduled

  • Give us a list of every medicine, vitamin and supplement you take. We will tell you which to stop and when.
  • If you smoke or vape, stop now. Stopping helps your body heal and makes anesthesia safer, and the earlier you stop, the better: aim for at least 4 weeks before surgery, though even 2 weeks helps. Stay off until your surgeon says you have healed.
  • Plan time off. Most people take 24 to 48 hours off work or school.
  • Arrange for an adult to drive you home. After general anesthesia, we recommend having an adult stay with you the first night.

• 1 to 2 weeks before

  • Aspirin is usually stopped 1 to 2 weeks before surgery. If you take aspirin or a blood thinner for your heart, a stent or stroke prevention, do not stop it on your own: your surgeon will check with whoever prescribes it.
  • Ask us whether to pause ibuprofen (Advil, Motrin) or naproxen (Aleve).
  • Ask about herbal remedies and supplements, such as fish oil, vitamin E, ginkgo or garlic pills, which can raise the chance of bleeding.
  • If you take insulin or other diabetes medicines, ask how to take them before surgery.
  • Plan for 48 hours of complete voice rest afterward: no speaking or whispering. Tell the people you live and work with.
  • Get the supplies in the next section.

• The night before

  • Follow the eating and drinking instructions from our office or the surgery center exactly. If you eat or drink when you should not, surgery may need to be postponed for safety.
  • Many places ask for nothing to eat after midnight, and some allow clear liquids until a few hours before.
  • Take only the medicines we said to take that morning, with a small sip of water.
  • Get a good night’s sleep.

• The day of surgery

  • Wear comfortable clothes.
  • Wear glasses instead of contact lenses, and leave jewelry and valuables at home.
  • Bring your photo ID, insurance card and list of medicines.

What happens after the procedure?

• Most people go home the same day and take 24 to 48 hours off work or school.
• Complete voice rest for 48 hours: no speaking or whispering.
• There is no special diet: eat as usual when you feel ready.
• If the injection helps, your voice often improves soon after the rest period ends. It may sound rough or uneven at first and keeps improving over the next several weeks.
• Your follow-up visit is about 1 week after the procedure.

The Vocal Fold Injection Recovery Guide has everything you need after the procedure, including when to call us.

When should I call before surgery?