The size of the tonsil is not significant if there are no symptoms. Only if the size of one tonsil is significantly more than the other one, surgery for histopathological examination is advised. Cigarette smoking for long increases the risk of cancer. Every one has tonsils but only if they start causing problem they need treatment. Small swelling in the neck less than 1 cm is common but the size may increase and they may become painful if there is any infection anywhere in the head and neck.