The labial frenulum is a fold of mucous membrane (between the central incisors of the upper and lower teeth) that connects the lip and gum. It is involved in lip movement and articulation in speech. The health of the teeth, the correctness of the bite, the pronunciation of sounds, and the beauty of the smile depend on the quality and elasticity of the place where it is fixed to the gum.
The frenulum of the lip meets the gingival tissue at a distance of 5-8 mm from the necks of the anterior teeth. If it starts very close to the teeth, then it is considered to be shortened. It may also be that the frenulum is too wide. To avoid unpleasant consequences in the future or eliminate existing problems, doctors often recommend plastic surgery of the labial frenulum.
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.
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.
- Frenectomy, which completely excises the cord. It is recommended for large widths.
- Frenotomy, which involves partial dissection of the connective tissue cord. The operation is performed with fewer injuries than with a frenectomy.
- Frenuloplasty, which helps to change the attachment sites of the mucous fold.
- 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.
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.
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.
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.
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.
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.
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Oral and maxillofacial surgeon, orthopedic dentist
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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.
How does the procedure work?
The form and duration of the operation to correct the lip frenulum directly depends on its type. Surgery using a scalpel or laser lasts about 10 minutes. The child must sit still in a chair until the operation is completed. During the procedure, the dental surgeon makes the necessary incision or resection. Then he puts stitches.
Plastic surgery using a laser does not require additional antibacterial treatment - the frenulum is sealed, which eliminates the further development of infection. This procedure lasts less than 10 minutes and is completely bloodless.
Before plastic surgery, the mucosal area is numbed with a special anesthetic gel.
Minor discomfort may occur for several hours after surgery. In the next few days, it is necessary to maintain careful hygiene and avoid eating hard and hot foods so as not to irritate the frenulum. The rehabilitation period is aimed at ensuring that the frenulum heals faster.
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.
Contraindications for surgery
Like any surgical intervention, frenuloplasty has contraindications:
- Bleeding disorder
- Congenital pathologies of the oral mucosa
- Multiple caries (operation is carried out after treatment)
- Osteomyelitis
- Malignant neoplasms
- Mental disorders
- Autoimmune diseases
- Immunodeficiency
- Tendency to form keloid scars
- Severe diabetes mellitus
- Any infectious and somatic diseases during exacerbation
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.
Content:
Lip frenuloplasty is a corrective operation to trim the fold that attaches the lip to the jaw. Lip frenuloplasty was first performed in the middle of the last century. But now this procedure can be performed using a laser. It is laser lip frenuloplasty that will be discussed later in this article.
If there is an incorrect structure of the frenulum, a person begins to experience problems from this even in childhood, and over time they gradually intensify. The development of malocclusion, predisposition to periodontal disease, problems with articulation - this is not all that a person with an irregular lip frenulum may encounter.
Laser lip frenuloplasty can not only make your smile more beautiful, but also correct various problems with speech or with the installation of orthopedic structures, which are often observed in patients with improperly developed labial frenulum.
Laser excision of the labial frenulum is performed without complex special preparation, and the entire operation takes place quite quickly, and the patient does not experience any significant inconvenience. Laser surgery for lip frenuloplasty is a modern and excellent method of correcting it.
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.
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:
- 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.
- 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.
Basic treatment methods
The choice of correction method is influenced by the degree of development of the pathology. To date, several types of measures have been developed to correct the labial frenulum:
- Frenotomy. Transverse dissection is used when there is an abnormally narrow process that is not attached to the gum.
- Frenectomy. The excision method allows you to effectively remove an excessively wide frenulum.
- Frenuloplasty. During the operation, the frenulum is moved and secured to the anatomically correct area of the gum.
Surgery can be performed classically or using laser equipment, which ensures minimal trauma and rapid rehabilitation of the patient.
