Frenuloplasty (plasty of the frenulum of the penis): Indications, General information, Contraindications, Recovery, Complications

What kind of frenulum occurs between the upper lip and gum of a child?

The frenulum, located between the gum (above the central front teeth) and the upper lip, is normal (0.5-0.8 cm from the edge of the jaw), low-mounted, short, and wide. These features are already noticeable at birth; in infants they make feeding difficult, and then interfere with speech and the formation of an even line of teeth.

Normal frenulum between front teeth

Normally, the frenulum between the upper front teeth begins at a distance of 5 to 8 mm from the necks of the central incisors. It should be visible when the lip is lifted, and its base is a thin fold no wider than 1 mm, elastic and stretchable.

Low

The low location of the beginning of the frenulum of the upper lip leads to the fact that when moving (eating, talking) it pulls on the interdental space. As a result:

a gap forms between the front teeth,
food accumulates under the lip,
the necks of the teeth are exposed.

This leads to an external defect and inflammatory processes in the oral cavity. In the absence of correction, clarity of speech and bite formation suffer.

Wide between upper teeth

If the bridle is attached between the front teeth with a wide base, then the front incisors will have a gap (diastema) or grow crookedly.

What does a short frenulum of the lips lead to?

A short frenulum of the lips creates problems with feeding in infants; for older children it is dangerous due to improper growth of the incisors and speech difficulties; in adults it leads to inflammation, destruction and loss of teeth.

In a baby

A short upper frenulum in an infant is accompanied by difficulty sucking the breast. After 2-3 sucking movements, the baby stops eating, cries, and cannot cope with nutrition even with severe hunger. Children gain weight poorly and develop slowly.

The child has

If the frenulum defect is not noticed by the parents, then in the future the teeth grow at intervals, the anterior central incisors move forward, and a pathological bite occurs.

When the speech function develops, the pronunciation of individual sounds is impaired, and speech is slurred. Exposing the necks of the teeth causes inflammation and increased sensitivity; the child reacts painfully to sour or sweet foods.

In an adult

Due to delayed correction of the frenulum, a chronic inflammatory process appears in the oral cavity - periodontitis, gingivitis. This causes loosening and loss of teeth, and in severe forms it can affect the bone tissue of the upper jaw - osteomyelitis.

Wide between upper teeth

With a wide frenulum between the lip and the upper central teeth, it is difficult to fully clean the oral cavity. Before surgery, cleaning is carried out using cotton swabs; regular rinsing after meals is recommended. If correction is not carried out when permanent teeth appear, they grow at intervals.

Watch this video about anomalies of the frenulum of the upper lip and their symptoms, diagnosis and treatment:

How is frenuloplasty performed?

The operation is performed under general or local anesthesia. The method of pain relief is selected depending on the complexity of the intervention, the wishes of the patient and his individual sensitivity to pain. The task of the doctors at the University Clinic is to make plastic surgery as painless as possible. Therefore, an anesthesiologist is located next to the man, who, if necessary, will intensify anesthesia, eliminating any pain that may arise.

Plastic surgery of the genital organ

The operation is performed using surgical instruments, laser and radio wave method. The use of radio waves and laser methods significantly reduces the risk of bleeding and shortens the recovery period after plastic surgery.

Immediately after processing the surgical field, the doctor cuts the frenulum of the penis using a surgical instrument, laser or radio knife. Scar tissue is excised.

There are several methods of plastic surgery:

Longitudinal-transverse
- the frenulum is cut transversely, the edges of the cut are moved up and down, and then stitched together, forming a longitudinal seam.
V-shaped
. An incision is made in the form of a Latin letter V, with the wide part facing towards the head. The edges of the incision are pulled up and down, and then stitched in the shape of the letter Y. In this case, the frenulum becomes longer.
Z-shaped
. A longitudinal incision is made in the shape of the letter Z, the edges of the teeth are spread apart so that the frenulum lengthens by about 1 -1.5 cm. Then a suture is applied in the form of a “snake”. The method is well suited for the surgical treatment of premature ejaculation. The presence of a Z-shaped seam protects the tissues from excessive tension and reduces their sensitivity, helping to prolong sexual intercourse.

The operation lasts approximately 15-20 minutes. Then a bandage is applied to the wound. The man leaves the clinic immediately after the plastic surgery is completed or after some time.

Due to the effects of anesthesia, on the day of surgery it is undesirable to drive or do other work that requires concentration and quick reaction.

Types of frenuloplasty

Indications for surgery

Normally, this area of soft tissue, located under the upper lip, should be fixed at a distance of half a centimeter or 0.8 mm from the necks of the front teeth (“ones”). With a physiological location and the correct size, a child or adult does not have problems with articulation, speech, difficulties in eating, or aesthetic defects in this area of the face.

If they are noticed, it is easy to determine the “culpability” of the frenulum of the upper lip when examined by a doctor. Plastic surgery is performed when, due to its improper development, the following occurs:

Diastema is a pronounced, unattractive-looking gap between the teeth. The problem here is not just aesthetics. The frenulum, when secured in the interdental papilla, prevents the correct position of the teeth, injures them, resulting in periodontitis. The incisors gradually move apart, simultaneously leaning forward.

Periodontal diseases or identification of an increased likelihood of their occurrence. This is possible with a short frenulum, which lifts the gum upward, exposing the necks and roots of the teeth. The opened space is filled with food debris, which will later begin to rot.

Obstacles in installing a prosthesis. Upper lip frenuloplasty in adults is often done for this reason. If it is too short, the prosthesis cannot be secured. The impaired mobility of the lips that exists with a short frenulum will lead to constant slipping of the replacement structure.

Obstacles in correcting the bite. Incorrect positioning of the frenulum affects its formation, as it creates a load on the entire row of teeth. In order for the installation of braces or plates to give the desired result, it is necessary to tidy up this area of the soft tissues of the mouth.

Inability to pronounce certain sounds, usually vowels. This is the rarest reason requiring surgery.

Sucking dysfunction in infants. For the correctness of the process, the condition of all parts of the oral cavity is important. If, due to a problem, a child cannot get enough to eat, becomes noisy, and does not gain weight well. In this case, the intervention is carried out at an early age.

Laser correction of the frenulum of the penis

Any frenulum defects can provoke early ejaculation, not to mention pain and discomfort during sexual intercourse. All this disrupts the harmony of sexual life, leads to low self-esteem, and negatively affects the patient’s mood.

A short frenulum is a congenital pathology in which the frenulum is of insufficient length, which leads to its tension during erection and pain during sexual intercourse. Tears of the frenulum may occur, which lead to scarring and further shortening of the frenulum. In addition, with a short frenulum, the risk of infection of the frenulum and the development of inflammatory diseases increases. Experts recommend doing frenulotomy (correction) without waiting for the frenulum of the penis to break. So, if you have one or more of the symptoms listed below, it is recommended to consult a specialist:

severe pain during sexual intercourse in the frenulum area;
downward tilt of the penis during erection;
small tears on the frenulum after sexual intercourse;
frenulum injuries accompanied by heavy bleeding.

Plastic surgery of the foreskin frenulum: the possibilities of modern medicine

Frenuloplasty provides a 100% guarantee of the absence of tears during sexual intercourse and reduces the risk of inflammatory diseases to a minimum. The standard frenulotomy technique includes dissecting the frenulum transversely, a ligature is applied to the crossed artery, then the wound is sutured with thin threads in the longitudinal direction. It is also possible to remove scars from previous injuries to the frenulum, which leads to increased elasticity of the frenulum of the foreskin. After a week, the stitches can be removed. Wound healing lasts about two weeks - during this time it is necessary to abstain from sexual intercourse. Laser Frenuloplasty For all its advantages, operations to eliminate frenulum defects surgically are becoming less and less popular, giving way to laser technologies. Laser frenuloplasty is a bloodless and virtually painless operation. A laser device makes small, sometimes microscopic incisions on the frenulum, which do not require sutures (the edges are sealed on their own). The rehabilitation period is half as long as when using the standard technique, removal of postoperative sutures is not required, and the aesthetic effect of laser correction is better than with surgery.

By deciding to undergo laser Frenuloplasty, you get a guarantee that you will no longer experience problems with the frenulum of the penis.

Optimal time for plastic surgery

It is never too late to have surgery to normalize the frenulum of the upper lip. But it is better to carry it out without waiting for serious problems, including not only difficulties with teeth and gums, articulation, but also digestive pathologies.

Plastic surgery of the frenulum of the upper lip in children is done from 5.5 years old , if there are no difficulties with breastfeeding in infancy. During this period, milk teeth are replaced by permanent teeth. And until the latter have completely erupted, it is easy to use correction to prevent the incisors from moving apart, forming a diastema. The problem will be prevented, which will be helped by the appearing “twos”.

Some experts prefer to postpone intervention until the child is 7 or 8 years old. By this time, the front incisors have already erupted, and the bite can be traced more clearly. This means that plastic surgery will be more accurate.

Optimal age for plastic correction of the frenulum

If we consider the problem as a whole, the following should be noted: the urgency of surgical intervention depends on the complexity of the defect and the degree of its negative impact on the health and process of the general development of the child. There are two optimal ages for performing this operation on young patients.

Firstly, neonatologists recommend plastic surgery for children aged 2.5 to 6 months. This can solve problems with feeding infants. Previously, doctors tried not to resort to this measure. However, with the advent of modern techniques, the operation has become so safe that infants tolerate it well. Naturally, such operations are performed only by specialists in the field of pediatric dental surgery.

Diastema of the upper lip

Secondly, this type of treatment is indicated for children aged 6 to 9 years. By this time, children should have fully erupted their four front incisors on both the upper and lower gums. Moreover, due to some physiological characteristics, plastic surgery of the frenulum of the upper lip is recommended to be done at 6-8 years old, and for the lower lip - from 7 to 9 years old inclusive. As a rule, this operation is prescribed by speech therapists, orthodontists or periodontists.

Quite often, this correction is also necessary for adults. Basically, this is a consequence of the negligence of children's doctors. In such cases, there is no need to worry. Adults tolerate plastic surgery just as well as children.

Pathology of the frenulum

This is important to know! Plastic correction of the lower lip frenulum is carried out with special care. The fact is that a mistake or lack of qualifications of the surgeon can lead to an unwanted cosmetic defect, which is known as a “horse smile”. This occurs from excessive weakening of the connection between the lip and the gum. Therefore, there is no need to be tempted by “ultra-profitable” offers from dubious clinics. Such savings may result in additional costly treatment. Moreover, the current prices for this operation are quite affordable. On average, the price for frenuloplasty varies from 3,000 to 5,000 rubles. To make sure of this, look at the prices for plastic surgery of the frenulum of the upper and lower lips in the price lists of leading clinics.

Contraindications for surgery

Not everyone can intervene when there is a problem. There are also contraindications to plastic surgery:

pathologies of the oral cavity,
osteomyelitis (bone disease),
complicated caries,
previous radiation exposure to the head and neck area,
serious pathologies of the nervous system,
blood diseases,
worsened infections that do not affect only the oral cavity,
mental illness,
serious metabolic disorders with a tendency to collagenosis,
oncological pathologies.

Contraindications

Frenumplasty is not recommended if you have:

STI (STD);
AIDS or HIV;
bleeding disorders;
severe concomitant diseases;
inflammation of the genitourinary system.

After frenulotomy, the risk of frenulum rupture and the development of an inflammatory process is significantly reduced.

You can contact the URO-PRO clinic with this problem, our specialists will conduct a detailed consultation and find the most effective way to solve your problem.

Make an appointment now by filling out the online form on our website.

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Stages of preparation for plastic surgery

Frenumplasty is a simple intervention. But given the list of contraindications, the patient must be examined:

take general blood and urine tests, and also do a coagulogram,
perform fluorography.

The oral cavity must be sanitized, that is, caries and other dental problems must be cured. Immediately before the intervention, the patient needs to eat well, since food intake is prohibited for some time after it. Then you need to brush your teeth and rinse your mouth.

Types of operations on the frenulum of the upper lip

How the problem area will be corrected depends on its structure and the type of developmental disorder. There are several possibilities:

Laser plastic surgery

The most modern method, which reduces the time of surgery and subsequent rehabilitation. There is no need for stitches or worry about a lot of blood. The likelihood of getting an infection, experiencing severe pain and getting a postoperative scar with laser plastic surgery is also reduced to zero. This is especially important if the correction is performed on a child.

Laser plastic surgery is performed with local anesthesia with gel. The beam is directed to the problem area. Under its influence, excess tissue evaporates, sterilizes it and seals damaged blood vessels.

Frenuloplasty

An old and proven method of correcting its position, carried out using surgical instruments. The intervention is performed under local anesthesia, but infiltration. There are 2 methods of performing the operation. Y-shaped frenuloplasty involves creating an incision on the frenulum of the appropriate shape.

During the Limberg operation, defects on the mucosa have the outline of the letter Z. But both interventions are done in order to move the frenulum to the desired location. They are carried out after an injection of an anesthetic, and self-absorbable material - catgut - is used to apply sutures. Frenotomy is performed with a narrowed frenulum. The mucosal area is cut transversely, as a result of which it acquires a greater length. The suture is placed along the cut edge.

Frenum removal or frenectomy

The operation is performed if the frenulum is too wide. Then a lot of plaque accumulates on the teeth, and problems with them become more threatening. During the operation, an incision is made along the edge of the mucosal area, the interdental papilla and a certain portion of the tissues located near the roots of the central incisors are removed.

Methods of frenulum surgery in men

Frenulotomy is a quick and uncomplicated operation, which is characterized by an excellent result, guaranteeing a 100% solution to the problem of frenulum pathology.

The procedure is performed on an outpatient basis using local anesthesia. The injection is given directly into the genital organ.

For patients under 18 years of age, anesthesia is administered intravenously.

The duration of the procedure is 15-20 minutes.

Operation methods:

Classic surgery on the frenulum in men using a scalpel. This traditional method of cutting tissue is still used most often. Its disadvantage is significant blood loss and the possibility of tissue infection during surgery.
Laser frenuloplasty is a modern way of performing operations. Laser equipment is successfully used in medicine for a variety of manipulations with body tissues.

Many patients prefer the virtually painless and bloodless method of laser surgery. Indeed, the laser beam acts on tissue more gently than a scalpel. When organs are cut with a laser, the process of coagulation of blood vessels and cells occurs, and the liquid instantly evaporates. Thus, blood loss becomes minimal. Thanks to this, the recovery period is easier to bear, and the incision sites sealed with a beam are practically invisible after the tissue has healed.

However, the practice of laser frenuloplasty has revealed serious disadvantages of this method. The most attractive advantage of laser surgery is the absence of stitches. But unlike other organs, which can be in a calm state during the rehabilitation period, the penis is mobile.

Even a slight erection can lead to divergence of laser-fused tissues.

Thus, until the wound edges heal, repeated fixation of their position is required. Otherwise, the constant divergence of tissue forms a rough scar.

Another significant advantage of a laser over a scalpel is the impossibility of causing infection during surgery.

The laser beam cuts tissue by heating it to 400 degrees Celsius, which eliminates wound infection. Therefore, when deciding on the method of surgery, it is necessary to take this factor into account, since more than 10% of all postoperative complications are due to inflammatory processes and infections.

Regardless of the chosen method of surgical intervention, surgery on the frenulum in men can cause a number of complications encountered during the operation or during the rehabilitation period:

severe pain;
pronounced swelling of the body of the genital organ;
bleeding from wounds;
poor aesthetic results;
scarring of sutures;
infection of the genital organ.

All complications are treated on an outpatient basis and do not require hospitalization. Pain is usually relieved by analgesics, and swelling is reduced by using decongestant ointments. The issue of dissatisfaction with the appearance of the penis after surgery is resolved directly with the surgeon.

Postoperative care

After the intervention, slight pain may be felt in the area affected by the instruments or laser. In the latter case they are less pronounced. In order not to intensify them, to allow injured tissues to heal, and to prevent infection, it is necessary:

Don't eat for 2, 3 hours. And in the next couple of days, food should not be rough or hot. Otherwise, there is a risk of injuring healing tissues.
Maintain oral hygiene. Use a soft brush to brush your teeth. Rinse the mouth thoroughly. It is better to have an adult brush your child's teeth.
On one of the first postoperative days, go to the doctor for examination.
After a week, start doing gymnastics to strengthen the chewing and facial muscles.

For some time after the intervention, some discomfort may be felt due to the changed characteristics of the movement of the lips and tongue. But this is a stage of adaptation to a new situation, lasting no longer than 4, 5 days. During this period, all damage to the mucous membrane has time to heal, and previous problems with diction disappear. It will take more time to eliminate the diastema.

What is recommended after excision of the frenulum of the lower and upper lips

After surgery to excise the upper or lower frenulum, the following is prescribed:

eating liquid or semi-liquid foods - ice cream, vegetable, fruit, meat, fish purees, pureed soups and cereals,
restriction of speech - until healing you need to try to remain silent more,
rinse your mouth with a solution of hydrogen peroxide, Chlorhexidine, Miramistin after each meal,
from the 5th day, gymnastics of the facial muscles is shown - stretching the lips into a tube, stretching in a smile, prolonged pronunciation of vowel sounds.

Cost of upper lip frenuloplasty

The price for an operation in Russia can reach 1400, 6000 rubles. In Ukraine, a similar intervention will be carried out for 300, 1500 hryvnia. The cost also includes consultation and anesthesia; it also depends on the method in which the operation is performed. Laser plastic surgery will cost more. The price is higher in a prestigious clinic, but you don’t always need to go there.

Damage to the frenulum on the gum of a child

An incorrect anatomical shape of the frenulum in a child can cause inflammation and pain, injury - rupture and tearing.

Mouth hurts after eating hot food

A painful reaction in the mouth to eating hot food is possible due to inflammation of the mucous membrane. This is a consequence of a short upper frenulum. It is often injured when chewing or talking, and due to the tight fit of the lip to the teeth, the cleansing of this space is disrupted.

If surgery is not yet indicated due to age, then rinsing with a decoction of sage, chamomile or calendula is prescribed. It is prepared at the rate of a tablespoon per glass of boiling water. Leave for 30 minutes, then strain and use warm.

Inflammation under the upper lip

Inflammation of the frenulum under the upper lip occurs when irritated by hard food, tartar, part of the filling, or hot food. The provoking factor is often malocclusion and anatomical changes in the growth of the frenulum. For treatment, rinsing with a solution of hydrogen peroxide or tincture of calendula and eucalyptus (a teaspoon per glass) is recommended.

Applications of anti-inflammatory drugs are also prescribed. To do this, apply cotton strips moistened with solutions of Chlorophyllipt, Chlorhexidine, Miramistin. To speed up healing, use sea buckthorn or rosehip oil.

Tore off or was torn due to injury

If the frenulum of the upper lip has come off, or the child has ruptured it due to injury, then you should immediately apply a cotton pad moistened with hydrogen peroxide. It can also be treated with Miramistin spray.

On this day, food should be cool in temperature and have the consistency of puree. If there are no contraindications, then ice cream is recommended. Usually such injuries heal quickly. If the bleeding does not stop for a long time, a dental examination is necessary.

To speed up the restoration of the integrity of the mucous membrane, use Solcoseryl dental paste after treating the wound with Chlorhexidine and spray Tantum Verde aerosol.

Process on the frenulum

The appearance of a process on the frenulum of the upper lip can be due to a viral infection - papillomatosis, trauma, accelerated cell division (tumor nature). The size of the neoplasm is from 0.2 to 2 cm. The color matches the color of the mucous membranes or is lighter. A dental examination is required to make a diagnosis.

Treatment is surgical - the papilloma is cut off and sent for examination. If a viral origin is confirmed, the immunomodulator Groprinosin is prescribed.

Other types of treatment for foreskin frenulum

It is important for men to know that frenuloplasty today is the only correct and reliable way to treat a short frenulum. It is not possible to correct the defect yourself at home.

Any manipulations to independently stretch the frenulum can lead to damage, bleeding, scarring, and inflammatory processes.

Therefore, experts recommend not to self-medicate, “not to turn a blind eye to the problem,” and if you suspect a pathology, come in time for a consultation with an experienced doctor. Only a doctor can give the correct recommendations and decide on the need for surgical resolution.

When is conservative treatment used?

Raising the issue of conservative treatment, we will consider methods that can be used at home if tissue damage occurs.

The frenulum is a rather vulnerable place and can easily be injured by strong tension. This can happen during active masturbation, anal sex, passionate sexual intercourse, as well as due to insufficient use of special lubricant.

With pathologies of the frenulum, the risk of developing such injuries increases several times, so a man must be able to act correctly in these situations and provide himself with first aid.

Video: “Plasty of the frenulum using a radio knife (18+)”

What to do in case of tissue tears

It is important to know that the tissues of the genital organs are equipped with good hematopoiesis, so even the slightest injury can lead to bleeding. There is no need to be afraid of this. To eliminate bleeding, a man must press the area of the rupture to the head of the penis and hold the organs in this position for about fifteen minutes. After stopping the bruising, it is necessary to carry out disinfection using a cotton swab soaked in hydrogen peroxide. If these actions do not bring results and the bleeding continues, the man should immediately consult a doctor.

Precautionary measures:

Note!
A swab with an antiseptic should be applied to the wound carefully, gently wetting the sore spot. There should be no rubbing movements. This will provoke a new tissue rupture and bleeding will occur again.
Handling must be done with clean hands. If injuries occur during sexual intercourse, you must first wash the genitals under warm running water with baby soap. The use of aromatic products (foams, scented soaps, shower gels) is not recommended.
The use of alcohol antiseptics is strictly prohibited . Even simple brilliant green or iodine can cause severe damage to the tissues of the penis and cause a burn.
If the tissue is severely torn after treatment, it is recommended to apply a gauze bandage. This will reduce the risk of rebleeding.

How to proceed

After an injury, a man is recommended to consult a specialist (urologist or andrologist) within 5-10 days. Before visiting a doctor, you can treat the frenulum at home using some herbal or pharmaceutical remedies.

Warm baths using a weak solution of potassium permanganate or chamomile have a good effect. It is recommended to carry out the procedures twice a day in the morning and in the evening before bedtime. They have a bactericidal effect, and also soothe damaged tissues and reduce the risk of developing an inflammatory process.

Note! After injury, sexual rest is necessary for the first 6-9 days. Physical activity, heavy lifting, and wearing tight-fitting synthetic underwear are also prohibited.

Remarkable! As the results of multiple frenuloplasty operations show, frenulotomy provides a 100% guarantee of no further ruptures, and greatly reduces the risk of infection and the development of inflammatory diseases.

Do I need to take medications?

Before consulting a doctor, self-prescribing and taking medications is not allowed. In addition, for injuries there is no need to take oral medications.

If frenulum pathologies are accompanied by other diseases (phimosis, balanoposthitis, STDs), the doctor prescribes medications based on the type and severity of the pathological process.

If a bacterial infection occurs, antibiotics may be required. In case of inflammatory processes, local treatment of the penis and prepuce with ointments with corticosteroids ( Prednisolone , Hydrocortisone ) is prescribed.

They not only have a healing effect on the body, but also help restore elasticity to tissues and promote good stretching of the frenulum.

Treatment of pathologies of the frenulum on the gums of a child

If the frenulum is short, wide or low, surgical correction is performed - excision, trimming, plastic surgery. All interventions are performed under anesthesia; in normal cases, local anesthesia is sufficient.

We recommend reading about cleft lip surgery. From the article you will learn about the causes of the development of pathology, symptoms and types of pathology, options for surgical correction of the defect.

And here is more information about the correction of rhinolalia from a speech therapist and surgeon.

Parents should know that not all cases require surgery. But if the doctor talks about obvious indications for her, you should not refuse plastic surgery or put it on the back burner out of pity for the baby. The consequences of this may be worse than short-term, minor pain and fear during the intervention.