What is labial frenuloplasty?
The labial frenulum is a fold of mucous membrane that connects the lip and gum. Plastic surgery of the frenulum of the upper and lower lips is done to eliminate pathologies that can have unpleasant consequences in the form of impaired diction and the formation of malocclusion. This operation itself is very simple and has minimal contraindications. It is done if the frenulum is too short or too wide, which affects the position of the teeth and the condition of the gums. For example, due to a wide frenulum, a diastema may appear - a gap between the central incisors. In this case, either surgery using the classical method or laser plastic surgery of the upper lip frenulum will help.
Sometimes plastic surgery is performed on the frenulum of the tongue - the membrane connecting the lower part of the tongue and the mucous membrane of the lower jaw. In children, surgery promotes the correct formation of the bite and prevents speech defects; in adults, it is a necessary measure for effective prosthetics with a removable structure or implantation. Read more about tongue frenuloplasty here.
Why perform a frenulum trim?
Some violations in the structure of the frenulum lead to quite serious consequences. If there is a short mucous membrane under the tongue, its movement is difficult, which means the patient cannot eat properly, and speech therapy problems appear. In infancy, the baby will not be able to fully suck mother's milk, and therefore the frenulum is cut in the first weeks or months of life.
If trimming the frenulum of the tongue is most often carried out in infancy, then the problems of the short mucous membrane of the lips (usually the upper) may not be so obvious. Shortened and non-elastic films can lead to tension in the gums, a reduction in its volume and exposure of the roots of the front teeth. The consequence of exposure is increased sensitivity of the enamel, pain and active development of caries.
A frenulum that is too voluminous, on the contrary, leads to overhang of the mucous membrane over the surface of the teeth, which primarily affects the aesthetics of the smile.
Thus, the indications for the operation are as follows:
- short bridle,
- disturbances in speech and pronunciation of certain sounds,
- excessive exposure of teeth due to reduction in gum volume,
- problems with nipple latching in babies,
- malocclusion caused by the position of the labial frenulum.
The dentist is able to determine that the frenulum is of incorrect size even when only the first signs appear. In such a situation, an operation to trim the frenulum can help - in infants it takes only a few seconds, does not cause any pain and does not require long-term rehabilitation. This is explained by the fact that the film is still very thin. Adult patients can also undergo a smile correction procedure, but it may involve a longer recovery period and pain, since the mucous membrane is denser and more sensitive to injury. In addition, adult patients experience additional problems in the form of exposed teeth and a reduction in the volume of mucous membranes, which also requires solutions.
What are the differences between upper and lower lip frenuloplasty?
Although the operations themselves to correct pathology on the upper and lower lips are similar, they require a different approach to rehabilitation. After plastic surgery of the lower lip frenulum, the wound takes longer to heal, about two weeks, while plastic surgery of the upper lip frenulum requires only a few days to recover. In the first case, anti-inflammatory therapy is often prescribed to prevent complications.
Contraindications for dental surgery
The main contraindications to the procedure are:
intolerance to individual components required during treatment;
- allergic reactions to drugs;
- infectious diseases;
- blood diseases;
- oncology;
- HIV;
- exacerbation of chronic diseases;
- inflammation of the oral mucosa;
- diseases of teeth and gums: pulpitis, caries, periodontitis and paradontosis.
After consultation and examination, the specialist makes a decision on the impossibility of performing the operation or postpones it until the reasons preventing the surgical intervention are eliminated.
When is lip frenuloplasty required?
The pathology of the labial frenulum does not always indicate that the patient requires surgery. Sometimes it is minor and does not cause any particular inconvenience. As a rule, surgery is necessary in the following cases.
- Diastema.
The excess gap between the central incisors tends to widen, causing the teeth to move forward and move apart in different directions. Also, constant stress on the gums leads to periodontitis. - Orthodontic treatment.
Correcting the bite with braces requires that the frenulum be of the correct shape and have an anatomical location. Therefore, before starting treatment, the orthodontist often sends the patient for plastic surgery. - Periodontal diseases.
A short frenulum can expose the roots of the teeth. - Complete prosthetics.
A short frenulum does not allow a removable denture to be firmly and securely fastened. This is one of the most common cases when plastic surgery of the lower lip frenulum is performed in adults.
Photo of a short frenulum of the upper lip in a child.
Rehabilitation process after plastic surgery of the frenulum and tongue
The process of rehabilitation and full recovery after frenulum grafting takes only a few days. Only the first few hours may become uncomfortable due to disorientation due to the anesthesia used.
In order for the wound on the frenulum to heal and heal as soon as possible, you will need to follow the instructions that the doctor will leave:
- Maintain good oral hygiene by brushing your teeth twice a day and rinsing your mouth after every meal;
- For 3-4 days after surgery, eat mostly liquid food at room temperature;
- Visit a dental consultant within the first week after trimming;
- Conduct independent studies in your spare time to develop “new” functions of facial expressions and chewing.
Don’t worry that you will still have difficulties with pronunciation for some time. In this case, only hard work on yourself and your pronunciation will bring the desired result. Within 5 days, the wounds will heal and the discomfort will disappear.
Is it necessary to perform labial frenuloplasty in children?
Pathology of the labial frenulum in a child can lead to many unpleasant consequences, both medical and aesthetic. Therefore, if a specialist recommends plastic surgery, you should definitely take his advice. In children, this anomaly can cause the following problems:
- The upper lip in newborns is actively involved in the sucking process along with the tongue, therefore, if the frenulum is shortened, the child will not be able to feed normally;
- A frenulum of the upper lip that is too short does not allow the correct pronunciation of labial sounds and some vowels, as a result of which the child will experience difficulties with diction;
- Frenum defects are directly related to malocclusion and chewing functions. Thus, there is a risk of digestive problems.
According to doctors, it is best to perform plastic surgery of the upper lip frenulum in children aged 5 to 8 years (the indications for surgery on the lower lip are identical). At this time, the child’s baby teeth are replaced by permanent teeth, and it is important that this process proceeds correctly. However, if necessary, plastic surgery of the upper lip frenulum can be performed in adults or adolescents. As for newborns, it is recommended that they undergo surgery only in case of serious nutritional disturbances.
Indications for surgery, ways to solve the problem
Frenuloplasty is an operation that eliminates defects in the oral cavity.
The procedure is performed for a number of indications.
- Aesthetic.
A shortened frenulum leads to a thickening of the tongue; as the child grows, it can take on a forked or square shape, becoming too enlarged.
- Medical.
A shortened frenulum is the cause of difficulty breathing, impaired swallowing function and chewing of food, and increased salivation. A baby with such an anomaly is not able to fully suck on the mother’s breast and receive nutrition in the required amount, which negatively affects its growth and development.
- Speech therapy.
A shortened frenulum of the tongue and lips is the main cause of diction defects.
- Emotional.
Any defect negatively affects self-esteem.
For medical reasons, a dentist, therapist, ENT specialist and speech therapist can recommend frenuloplasty for both children and adults.
Plastic frenulum of the tongue
The arch-shaped frenulum of the tongue stretches from the tongue to the base of the gum. The normal length of the cord is 2.7 - 3 cm, located in the center of the lower palate. In front, the frenulum resembles a thin film at the time of the baby’s birth, but during the process of growth it becomes denser, and vessels appear in it. If it is displaced to the side or towards the tip of the tongue, its normal functioning is impossible; this is an anomaly that requires correction.
Consultation with a specialist is necessary if:
- Limited tongue mobility.
- The tongue takes on the shape of a groove, and its tip loses its roundness.
- The baby is unable to breastfeed.
What dangers does pathology pose in infancy? For the mother, the feeding process causes pain, and the child does not receive adequate nutrition.
The defect is diagnosed in the early stages during the initial examination of the newborn. In a growing child, such a defect leads to speech disorders.
Upper lip frenuloplasty
The standard length of the upper cord is 0.5 - 0.8 mm; a sign of pathology is a low attachment or extending beyond the front teeth. Frenuloplasty is prescribed when a gap appears between the incisors, before starting prosthetics and treatment by an orthodontist. Surgery is required if, due to pathologies of the frenulum, the bite is disturbed, chewing is difficult, and problems with the stomach and intestines arise.
Correction is carried out in two ways:
- Y – after removal of the frenulum, a diamond-shaped suture is formed;
- Z – during removal, 3 cuts are made – 1 vertical and 2 oblique.
The operation on a baby can be performed by a neonatologist right in the maternity hospital.
An anomaly is indicated by:
- difficulty swallowing;
- problems with pronunciation;
- diastema (interdental gap);
- malocclusion.
A thick, shortened frenulum in children 2-3 years old may be normal, and as the body grows, the defect disappears. If this does not happen, the clinic performs excision of the cord.
Frenuloplasty in aesthetic medicine is indicated in cases where a person’s gums are very exposed when they smile.
Plastic surgery of the frenulum of the lower lip
In the process of chewing food, at the moment of pronouncing sounds, the frenulum of the lower lip is also involved. In this case, the following anomalies are possible:
- the cord is completely absent or noticeably shortened;
- off-center or attached high;
- a pair of frenulums developed at the same time.
Strong tension on the frenulum can cause exposure of the roots of the teeth and increase their sensitivity. If the defect is not corrected in a timely manner, the lower incisors may fall out.
Methods of lip frenuloplasty
There are three main methods of lip frenuloplasty: frenotomy, frenectomy and frenuloplasty. The choice of technique depends on the characteristics of the pathology.
- Frenotomy is a dissection of the frenulum. It is performed when the process is too narrow and is not attached to the edge of the alveolar ridge. The frenulum is cut transversely.
- Frenectomy - excision of the frenulum. This method is used for excess soft tissue width, with the incision along the ridge.
- Frenuloplasty - relocation of the frenulum attachment site.
In all three cases, self-absorbable threads are used to suture wounds. The operation usually lasts about 15 minutes and is painless using local anesthesia.
Recently, laser lip frenuloplasty has become widespread. This operation is more expensive, but easier to tolerate. A focused laser beam removes excess tissue while sealing the edges of the wound. This means that there is no need for stitches, the operation is completely bloodless, and recovery takes less time. Laser plastic surgery of the upper lip frenulum in children is preferable to the classical technique, since it is performed with less trauma. Of course, we also recommend giving preference to laser frenuloplasty of the upper lip in adults.
Frenuloplasty: ways to eliminate defects
There are several methods for treating dental pathologies, and in recent years the most effective way is to eliminate defects with a medical laser. Surgical plastic surgery is often performed on newborns. Laser correction is suitable for older children and adults.
Surgical method
The surgical excision of the frenulum takes up to 20 minutes.
Conventionally, there are 3 types of frenuloplasty:
- dissection (on thin bridles);
- excision (wide);
- moving the frenulum (on the upper lip).
In infants, plastic surgery is performed under local anesthesia, and for adults, general anesthesia can be used due to age-related thickening of the cords.
Laser plastic surgery
Laser frenuloplasty lasts several minutes. Before starting the procedure, the doctor treats the oral cavity with an anesthetic gel. After the operation, the edges of the wound are sealed, sutures are not required in this case, and complete healing of the scar takes only a few days.
Advantages of the laser method:
- painlessness;
- lack of blood;
- the child’s stress is reduced to zero;
- no postoperative complications.
Post-operative care
The rehabilitation period takes one to two weeks. To avoid complications, you must follow your doctor's recommendations:
- monitor the hygiene of the oral mucosa and perform procedures prescribed by a specialist;
- exclude hot, sour and solid foods;
- undergo a follow-up examination with the surgeon who performed the operation;
- do gymnastics to strengthen the chewing muscles.
The above rules will help you return to your normal lifestyle in a short time and prevent deterioration in your health after lip frenuloplasty.
Types of pathologies
Frenules of the mucous membrane in the oral cavity are thin folds formed for additional fixation of the lip or tongue to the jaw. When formed correctly, they do not cause problems, but sometimes abnormal changes occur that require surgical intervention.
Main deviations from the norm:
- short bridle:
- offset from the center of the tongue and gums;
- forked;
- close attached to the jaw.
During the growth of a child, pathologies can negatively affect the structure of the dentition, the formation of the bite, and provoke a violation of natural facial expressions.
Consequences of frenulum anomalies:
- gap between incisors;
- the appearance of pronounced speech defects;
- diseases of the gums, periodontal disease, manifestations of hypersensitivity of the oral mucosa and teeth;
- a change in the bite, which will be more difficult to correct in the future.
An abnormality in the structure of the oral cavity can be easily corrected with timely treatment.
How much does lip frenuloplasty cost?
The price for lip frenuloplasty usually starts at 3,000 rubles and reaches 5,000 - 6,000 rubles. In this case, there is usually no difference whether we are talking about the price of plastic surgery of the frenulum of the upper lip or the lower lip. Plastic surgery of the frenulum of the upper lip with a laser is more expensive and can cost from 3,500 to 8,000 rubles. Traditionally, the cost of the operation already includes anesthesia, but this must be clarified in advance. Parents often ask how much it costs to have upper lip frenuloplasty in children. Typically, the costs for this procedure are no different from those for surgery in adults.
Preparing for surgery
During the consultation, each client has a question: how much does frenuloplasty cost? The price will depend on the location (upper or lower lip), and on the instrumentation that will be used. Also, the cost may differ depending on the city in which the intervention is planned; the price of surgical services in Moscow, for example, will be slightly higher than in other regions, but this again depends on the choice of clinic.
Before the client decides to undergo frenuloplasty surgery, it will be necessary to sanitize the oral cavity, because infectious problems and caries can cause complications in the future. The clinic specialist will also write out a referral for tests and x-rays to avoid injury. A small condition when preparing for the frenuloplasty procedure will be a full stomach, because during surgery a hungry person may have difficulty clotting blood.
