Lip frenuloplasty: indications, technique, rehabilitation



Frenuloplasty of the frenulum of the tongue and lips

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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.

There are other possible reasons for the development of shortening.

Classification

There are two types of violation. They are divided according to the thickness of the formation.

The following varieties are distinguished:

1. The first one is characterized by a short, triangular-shaped, powerful frenulum (width more than 3 mm). Its lower edge ends at the interincisal papilla. In the thickness of the formation, a pronounced cord of connective tissue is determined, which is fixed to the jaw bone. Often this anomaly is facilitated by the development of a wide diastema.
2. The second type is represented by a shortened, thin bridle. It is transparent and looks like a duplicate of the mucous membrane. The formation is located between the front incisors, attached to the crest of the alveolar process. This option is characterized by low attachment. With it, a narrow diastema is formed.

The tactics of surgical intervention depend on the type of shortening.

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.

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.

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:

1. 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;
2. 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;
3. 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.

How is bridle trimming done?

Trimming the frenulum in babies is quick and completely painless, taking only a couple of minutes. In adolescent and adult patients, the operation may take 20-30 minutes. Carrying out laser surgery in a dental clinic by the hands of professionals guarantees the absence of complications and painlessness.

Expert opinion
Dzhutova Aida Vladimirovna Implant surgeon Work experience 10+

“The ability to use painkillers during frenulum trimming depends on the condition of the frenulum, the patient’s age and sensitivity. In children, the film is very thin, so the procedure takes only a few seconds, but in adult patients, anesthesia may be required, since the frenulum becomes denser, and the operation can cause unpleasant and even painful sensations.”

Stages of the operation:

1. injection of anesthetic,
2. dissection of the frenulum using a laser device, surgical instruments,
3. sutures, which usually dissolve on their own 4-5 days after surgery.

At Smile-at-Once, a laser may be used to trim the frenulum. In this case, no anesthesia is required; the laser beam simultaneously carries out antiseptic treatment and stops blood vessels, which prevents bleeding and injury to the mucous membrane.

Additional treatments

After the operation, speech therapy treatment is required to help the child speak and move his tongue again - this will solve all pre-existing speech problems.

If shortened labial mucosa has caused aesthetic problems with the shape of the gums, flap plastic surgery may additionally be performed. Its goal is to form a new gingival contour by cutting and displacing the mucosa.

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.

Types of plastic surgery

The operation to trim the frenulum lasts no more than 20 minutes and is performed under local anesthesia, which is often called freezing. At the moment, there are several types of oral plastic surgery.

1. Frenectomy, which completely excises the cord. It is recommended for large widths.
2. Frenotomy, which involves partial dissection of the connective tissue cord. The operation is performed with fewer injuries than with a frenectomy.
3. Frenuloplasty, which helps to change the attachment sites of the mucous fold.
4. Limberg frenuloplasty, which involves two incisions at an angle of 60-90 degrees. No mistake should be made here, otherwise the problem will not be fixed. This method is the most unpopular, due to the fact that it is almost ineffective.

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.

Comments

Which doctor can give a referral for this operation?

Marina (06/14/2020 at 07:28 pm) Reply to comment

You can get a referral after an examination by a dentist or periodontist, orthodontist, speech therapist, or neonatologist (for newborns). The operation itself is performed by a dental surgeon.

Editorial staff of the portal UltraSmile.ru (06/17/2020 at 09:07) Reply to comment

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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.

Laser plastic surgery

Laser has become an innovative method in modern medicine. With his participation, the procedure will not last even 5 minutes. Laser plastic surgery, like conventional plastic surgery, also involves primary sanitation and, if necessary, treatment.

Laser frenuloplasty is performed under local anesthesia. In this case, nothing is required for preparation except a special gel. The attending physician directs a laser beam at the source, under the influence of which the cord is cut. The advantage of this method is that the same beam carries out parallel work on disinfecting and sealing the edges of the wound.

Why are clients increasingly choosing laser surgery? This is easily explained by the fact that there is no blood loss, no stitches are required, no pain or scarring. This type of operation will allow you not to change your usual lifestyle.