Why is Plastic Surgery of Frenulums and Mucosal Strands Necessary?
The tongue, lips, and cheeks are attached to the jawbones by special mucosal strands (frenulums). In a normal state, these are imperceptible. However, developmental anomalies can make these strands too short or cause them to attach in atypical locations, hindering the movement of the lips and tongue and making it difficult to open the mouth.
Serious consequences of frenulum anomalies:
- formation of a diastema (a gap between the central incisors);
- malocclusion development;
- impaired chewing and swallowing functions;
- periodontal diseases (gum recession, root exposure);
- speech impediments.
When is Correction Necessary?
Most anomalies are detected in childhood. It is recommended to perform surgical correction before the full transition to permanent teeth to prevent complications. If the surgery was not performed in childhood, it is done later as a vital stage of orthodontic, orthopedic, or periodontal treatment.
1. Lingual Frenoplasty (Tongue-Tie Release)
If detected early, it is recommended to perform lingual frenoplasty immediately after birth—at this age, the procedure is virtually painless. Otherwise, the optimal age is 3–6 years, combined with myofunctional exercises.
Signs of a short lingual frenulum in a child:
- Newborns: difficulty nursing, quick fatigue during feeding.
- 6–9 months: a visible “dimple” in the chin; restricted tongue mobility.
- 5–9 years: difficulty pronouncing “L” and “R” sounds, malocclusion, gum inflammation.
2. Labial Frenoplasty (Upper and Lower Lip)
The optimal time is 7–8 years (after the eruption of permanent incisors) or 12–13 years. Common symptoms include diastema, gum bleeding, and impaired pronunciation of certain sounds.
3. Vestibuloplasty
A surgery to deepen the oral vestibule (the space between teeth and lips). A shallow vestibule restricts jaw mobility and leads to periodontal diseases. The optimal age is 8–9 years.
How the Operations are Performed
I. Preparatory Stage
A comprehensive diagnosis is performed (surgeon, orthodontist, periodontist). Professional oral hygiene and sanitation are mandatory to ensure faster healing.
II. The Procedure
The procedure is minimally invasive and virtually bloodless. It is performed under local anesthesia or sedation. The surgeon incises the strand, repositions it, and secures it with sutures.
III. Postoperative Period
Full rehabilitation takes about 2 weeks; sutures are removed after 7–10 days. During the first few days, spicy, hot, and acidic foods should be excluded. It is crucial to maintain strict hygiene and follow the doctor’s recommendations.
Myths About Frenoplasty
Myth 1: Correcting a frenulum in infants is dangerous.
On the contrary, in infants, the surgery is easiest because the frenulum contains almost no muscle fibers or nerve endings.
Myth 2: It is a traumatic surgery with a long recovery.
Labial frenoplasty is a minor intervention. Initial healing occurs within just 2–3 days.
Myth 3: The surgery changes the shape of the lips.
This is false. The procedure relieves muscle strain on the gums but has absolutely no effect on the external shape or volume of the lips.
