Girlie had tieback surgery at 13yrs 3 months - one-sided tieback. Apparently, the risk of aspiration is greatly reduced compared to a tie-back on both sides. A specialist soft tissue surgeon did her surgery - through the side of her throat (from the outside), which doesn't carry the risk of internal bleeding and scar tissue build up that making an incision inside the throat may. Girlie did wonderfully well. I was extremely careful with her food for about 3 weeks post surgery - handfeeding her for a week, so that she didn't try to gulp her food down too quickly. She was on a strict diet of cubes of raw meat, which was fine, because she was on a full raw diet already. A week before surgery, Girlie had had a life threatening respiratory attack, where she came close to asphyxiating. Post surgery, she breathed beautifully, normally, the regular bouts of panting stopped, she could cope with the heat (it was during our summer) and "stress", she stacked much-needed weight on her previously very skinny frame and was comfortable and happy. Surgery gained her another 8 comfortable and contented months, before cancer snatched her away. Worth every dollar! Oh, and no aspiration problems. I watched her drinking for the first few days, heart in mouth, but no aspiration.