Plastic surgery of the upper lip frenulum: all about the operation, consequences and reviews

May 31, 2020

Under the upper lip, right in the center of each person, there is a ligament that connects the lip to the alveolar part of the jaw and is called the frenulum. For some, this ligament is short and attached too low, which creates certain difficulties and health problems, which we will definitely talk about below. In this regard, doctors suggest that such patients undergo plastic surgery of the upper frenulum. And UltraSmile.ru journalists will tell you about the operation and its indications in detail.

There are many indications for frenuloplasty

Few people know that the upper frenulum is very important for the correct and full functionality of the dental system. Thanks also to her, we can move our lips, pronounce different sounds, and open our mouths. It also plays an important role in the formation of a beautiful smile aesthetics. If it is shortened or positioned incorrectly, then in some cases this creates conditions for the development of various anomalies and leads to serious problems and consequences, which, in fact, are indications for trimming the frenulum of the upper lip in adults and children.

At what age is it best to have surgery?

Trimming the frenulum of the upper lip is a relatively easy operation, but the optimal age for it, according to most doctors, is 5–7 years, when the permanent incisors begin to emerge. If you carry out the procedure during this period, you can avoid the formation of a diastema and further manipulations to correct the bite by the orthodontist. But according to indications, it is not too late to perform plastic surgery in adolescence, and even in adults.

“I took my child to this operation. My son was 8 years old at the time. He already understood everything that was said to him, and at the same time he was very afraid. Before the operation, we sat and calmed down in the doctor’s office for about 15 minutes. I want to say that the child’s psychological attitude is very important here. About the operation itself: it didn’t hurt, my son didn’t cry. But after the anesthesia began to wear off, he complained that his gums hurt, but this problem was solved with Nurofen syrup. Already on days 4–5, the trace of the wound was almost invisible, although it was done with a scalpel. But in children everything heals quickly.”

Lada, review from the dental portal gidpozubam.ru

The operation is best performed at the age of 5-7 years

Indications for surgery

Indications for correction are:

The presence of a diastema between the frontal incisors . In this case, a wide frenulum prevents the incisors from converging towards the center, and due to the influence of regular light load, the gap increases over time and the teeth move to the sides from the center. In addition, due to constant damage to the interdental papilla, periodontitis develops.
When prescribing orthodontic treatment . All soft tissue cords of the oral cavity, including the frenulum of the upper lip, place stress on the dentition and affect bite formations. Therefore, if orthodontic therapy is indicated, the frenulum must be corrected first.
At risk of periodontal disease.
Due to the shortened frenulum, the removable denture will constantly be reset , so it is advisable to correct it before installing it.
For problems with diction.

Types and technologies of upper frenuloplasty

Before the procedure, it is important to carry out a complete sanitation of the oral cavity, treat diseased teeth and stop acute inflammatory processes, remove bacterial plaque - all these are sources of infection, which can subsequently provoke postoperative complications. You should also eat before surgery, as hunger can impair blood clotting.

There are several techniques for performing the procedure. The doctor decides which one to use depending on the patient’s age, the location and attachment of the frenulum. Let's list all the technologies that exist today:

frenotomy, or frenulotomy: involves transverse dissection of the frenulum if it is very narrow and thin. This is the so-called minor operation, which is considered the least traumatic. The purpose of the manipulation is to relieve the tension of the ligament. The procedure can be performed on newborns, as well as older children,
frenectotomy: this is a more complex operation, during which the frenulum of the upper lip is trimmed and part of the tissue located in the space between the central incisors is removed. The procedure is performed if the frenulum is thick, as is often the case in adolescent and adult patients,
frenuloplasty: the doctor releases the ligament and moves it to the area where it should be.

The operation is performed under local anesthesia.
Each of the listed operations is performed on an outpatient basis, under local anesthesia. Traditionally - using a scalpel. Afterwards, the doctor applies self-absorbing sutures and sends the patient home. Everything lasts about 10–15 minutes. Next, the patient receives clear recommendations on how to behave during the rehabilitation period. 1 and 3 days after the operation, you need to visit the doctor again for follow-up examinations.

Today, plastic surgery of the upper frenulum can be performed using a laser, which allows the procedure to be carried out quickly, without pain and blood, and to disinfect the operated tissues. This also reduces the likelihood of developing postoperative complications (swelling, pain, inflammation, scars). A big advantage is that when using laser equipment there is no need to apply stitches.

Laser frenulum trimming is the least traumatic

The rehabilitation period takes about 10–14 days. During this time, the patient is not recommended to eat food that can irritate the operated tissues (cold, spicy, hot, hard). It is also necessary to rinse your mouth with an antiseptic and apply wound-healing ointments (for example, Solcoseryl).

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prevention

Alimirzoev F.A. Dental anomalies in childhood and their diagnosis // Achievements of university science. – 2014.

Consulting specialist

Geraskina Inna Igorevna

Doctor rating: 9 out of 10 (2) Specialization: Dentist-therapist, orthodontist Experience: 10 years

Types of operation

There are several methods of performing plastic surgery; the choice of a particular method depends on the anatomy and fixation of the frenulum of the upper lip:

If it is very narrow in the form of a transparent film and is not attached to the edge of the alveolar process, frenotomy , or dissection of the frenulum, is performed. They cut it across and apply a suture along it.
With a wide frenulum, they resort to frenectomy , or its excision. It is cut along the tense ridge, and at the same time the interdental papillae and tissues localized in the bone space between the roots of the spread frontal incisors are excised.

During frenuloplasty, the attachment point of the frenulum is moved.

The procedure is carried out in two ways:

With Y-shaped frenuloplasty, the fixed frenulum is excised with a scalpel or gum scissors. After which a diamond-shaped defect remains on the mucosa. Then the cut edge of the mucosa is moved with a rasp inside the vestibule that has formed and there it is fixed to the periosteum using an interrupted suture and the wound is sutured.
With Z-shaped frenuloplasty (according to Limberg), after freezing, a vertical incision is made, which runs through the middle of the frenulum. On both sides of it, two oblique cuts are made at an angle of 60-85 degrees so that two triangular flaps are formed, which are then fixed, while the central cut should move to the horizontal plane. Next, the submucosal tissue along the periosteum is peeled off with a rasp, then the horizontal incision is sutured. The flaps are fixed to the periosteum using catgut. These surgeries are performed on an outpatient basis.

For anesthesia, Ultracain D-S forte is used, the wounds are sutured with absorbable suture materials. The entire procedure lasts a maximum of 15 minutes.

Comments

Which doctor can give a referral for this operation?

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

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

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Laser plastic surgery

Laser removal of the upper lip frenulum is becoming increasingly popular. The operation site is treated with an anesthetic gel, then a laser light guide is directed to the frenulum, forming a beam of light that “dissolves” the frenulum. At the same time, the laser disinfects and seals the edges of the wound.

Advantages of laser plastic surgery:

absence of vibrations and various sounds that can frighten a child;
bloodlessness;
no need for stitches;
there is no risk of infection;
absence of pain and postoperative scars;
reducing the duration of plastic surgery;
fast rehabilitation.

The cost of the procedure varies from 3 to 5 thousand rubles.

Familiar firsthand

My son had problems with diction. The speech therapist said that this was due to a short frenulum of the upper lip and advised it to be corrected.

After the operation, the child began to pronounce sounds more clearly. During the procedure itself I did not feel any pain, and after the operation there was no stitch left.

Valentina Semyonovna, 36

Is it necessary to trim the short frenulum of the upper lip of a child?

A bridle is considered defective if it is too short, wide, tight, incorrectly positioned, or consists of two folds instead of one. Low attachment of the frenulum to the lower or upper lip provokes the following complications:

Photo: short frenulum of the upper lip in a child
disturbance of the sucking reflex in infants;
caries of baby teeth;
speech defects and pathologies of speech organ development;
discomfort while chewing food;
the formation of gum pockets in which plaque accumulates;
exposure of tooth roots;
increased sensitivity of enamel;
increased risk of developing periodontal diseases: periodontal disease, periodontitis, gingivitis;
tooth mobility;
change in the position of the dentition.

A frenulum that is too short and tight is fraught with the following problems:

formation of interdental diastema (gap);
inability to part your lips wide and smile fully;
speech impairment, distortion of sound pronunciation;
malocclusion: due to the constant tension of the interdental papilla, the front teeth protrude strongly forward.

Optimal age for intervention

Different sources specify different periods for frenulum correction - 5-6 and 6-8 years . In essence, the guideline for when to perform the operation should not be the child’s age, but the condition of his upper central incisors. They must be completely erupted. The lateral incisors at this time can only be half-erupted.

Early correction is undesirable for the reason that the eruption of incisors after frenuloplasty can introduce undesirable changes in the structure of the anterior region of the alveolar process.

But it happens that a short frenulum prevents the baby from sucking mother's milk. In this case, they take a certain risk by carrying out the correction in the first 2-6 months of the baby’s life.

The logic of this choice is clear - the potential risk (which may not materialize) is neglected in favor of solving a real existing problem. Impaired milk sucking slows down the baby's development and can make the feeding process painful for the mother.

As for later frenulum correction, it can be performed at any age, even in adults who may not like a short frenulum due to a violation of the aesthetics of the smile.

Need for surgery

The need for frenulum surgery
Most parents have a rather vague idea of the functions of the frenulum of the upper lip and its role in the normal functioning of the dental system. Therefore, when a specialist talks about the need for plastic surgery, many do not understand the importance of it. In reality, the problem must be resolved in a timely manner to avoid unpleasant medical and aesthetic consequences. It is the presence of the frenulum that allows you to correctly articulate, move your lips, open and close your mouth. With its defects (too short frenulum, its improper fastening), the mobility of the lips is significantly reduced, their functioning is disrupted, and various aesthetic defects develop.

The presence of such an anomaly leads to a number of consequences:

Limited sucking function in newborns. Since in infants the upper lip, together with the tongue, takes an active part in sucking, impaired mobility becomes an obstacle to the process of breastfeeding. In some cases, a neonatologist can independently trim the frenulum of the upper lip.
Impaired speech formation and correct sound pronunciation. With a shortened frenulum of the upper lip, as a rule, difficulties arise when pronouncing labial sounds, vowels (“o”, “u”, etc.). In this case, the speech therapist recommends plastic surgery, after which the diction is automatically corrected.
At an older age, due to frenulum defects, bite and chewing functions may be impaired, resulting in digestive problems.
The shortened frenulum of the lip, as well as its close attachment to the edge of the alveolar process, causes retraction of the interdental papillae of the gums in the space between the incisors. As a result, a gap is formed in the bone tissue between the sockets of the teeth - a diastema. In addition, the distance between the crowns increases.
A short frenulum pulls back the gums and leads to the formation of a gum pocket, the deposition of tartar and the development of an inflammatory process in the gums.
The consequences of defects in the frenulum of the upper lip can be instability of the teeth, exposure of their roots, and increased sensitivity. Plastic surgery allows you to avoid the development of a number of dental diseases.
A frenulum that is too wide leads to regular accumulation of food debris and the formation of plaque.
Surgery to correct the frenulum of the upper lip is necessary for the prevention of periodontal diseases and inflammatory processes in the oral cavity.

When should the procedure be performed?

The optimal age for surgery is 5-6 years. Children under 4 years of age are not subject to correction. The beginning of cutting off the mucous membrane should be done when the temporary front teeth have already completely fallen out, and the permanent incisors are at the stage of eruption.

What complications can be visualized during the procedure before the age of five: the formation of the jaw after the procedure, as a result of which repeated intervention may be necessary in the future; the child's upper lip performs only a third of the prescribed functions (the child does not speak, does not bite solid food, etc.).

Postoperative care

As a rule, the period after plastic surgery of the upper lip frenulum is quite calm. Minor pain may occur after the anesthetic wears off. Rules to follow at this time:

Result of frenuloplasty

Perform thorough oral hygiene daily.
Avoid hot and solid foods for 2 days.
Go through a post-operative examination (on the second or third day).

For older patients, special myogymnastics is recommended - exercises to strengthen facial and chewing muscles.

Over a certain period of time after frenuloplasty, one becomes accustomed to the freer movements of the tongue. Diction changes almost immediately after the correction. To eliminate the gap between the teeth (if it has already formed) it takes a little longer, and in some cases additional dental treatment is necessary.

The rehabilitation period lasts no more than 4-5 days. During this time, all unpleasant sensations disappear, and the wounds are completely healed.

Benefits of using a laser

Laser frenuloplasty is the most modern technology today, which has many advantages compared to scalpel surgery.

The essence of using a laser is to evaporate the tissue being prepared under the influence of a laser beam. In this case, the wound is sterilized and the vessels are sealed.

During laser surgery, there is no need for traumatic manipulations performed with a scalpel and other traditional surgical instruments - flap detachment, sutures, etc.

Before the operation, local anesthesia with dental gel is performed.

The advantages of laser frenulum correction include the following:

short duration of the operation – about 5 minutes;

no bleeding;
preventing wound infection (the laser beam has a disinfecting effect);
no need for stitches;
Comfort for the patient, no noise or vibration;

It is also noted to be atraumatic, painless, rapid wound healing, a reduction in rehabilitation time to 1-2 days and the absence of postoperative scars.

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Anatomical educational program

Lip frenulums are special elastic folds of the oral mucosa that support the lips in the correct position. In addition, the frenulum serves as additional attachments of the lips to the gums. The length, location and degree of elasticity of the frenulum are purely individual for each person.

Every parent dreams of their child growing up healthy and happy.

But there are still certain physiological norms. When positioned correctly, the frenulum of the upper lip (lat. frenulum labii inferioris) is woven into the gum in the middle, 5-8 mm from the neck of the teeth. The frenulum of the lower lip (lat. frenulum labii superioris) should be thin and located on the center line, below the neck of the lower incisors. If the frenulum of the lip is too short (intertwined with the interdental papilla), wide or not elastic enough, only plastic surgery of the frenulum of the upper lip can correct this defect.

This is important to know! In some people, the lower frenulum may be absent or there may be several frenulums. This is quite rare and is considered a pathology. This anomaly can cause the development of malocclusion and a number of periodontal diseases. Timely plastic surgery will prevent these troubles.