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Functional Frenuloplasty: How We Do It

Dear Patient and/or Provider, 


We are honored by the overwhelming interest in our functional approach to frenuloplasty. The success of our practice is based on our ability to provide a complete and effective release of tethered oral tissues by incorporating a multidisciplinary protocol that integrates myofunctional therapy (and sometimes physical therapy) both before, during, and after surgery. Our tongue-tie release procedure is based on precision: releasing the appropriate extent of tissues for maximal relief; not too much, and not too little.

The tongue is one of the most critical organs in our bodies with the ability to regulate and shape orofacial structure and musculature. Our functional frenuloplasty approach honors the changes that occur during a tongue-tie release and prepares the body for acceptance and optimal healing post-treatment.


Our group is highly active in clinical research and committed to anything that we can do to promote optimal outcomes after surgery. We hope that videos and resources below will help you learn more about our technique. In addition, we now offer monthly courses to share our knowledge and experience first-hand to help interdisciplinary teams strive for higher standards in the delivery of tongue-tie release surgery.

We are grateful and thank you for your interest in our work. 


Soroush Zaghi, MD (ENT- Sleep Surgeon)

The Breathe Institute

Case Study: Grade 3 tongue-tie released to Grade 1 (>80% mobility)

Updated Surgical Technique
June 2024

Research Publication

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Evaluation, Diagnosis, and Treatment of Frenum Restrictions: Tongue, Lip, & Buccal Tie
(40 minutes,  AAPMD Conference; November 2018).
Restrictive lingual frenulum, also known as ankylglossia or tongue-tie, can limit the mobility of the tongue. The tongue plays an important role in speech, swallow, sleep, and breathing and adequate tongue mobility is essential for optimal growth and development of the upper and lower jaws. Patients with very severe tongue-tie often present with swallow or speech issues that are hopefully identified and addressed early. On the other hand, patients with mild to moderate tongue-tie often present in a less obvious fashion and so may have the tongue-tie go unrecognized for a long time. Because the mobility of the tongue is restricted in the tongue-tie condition, the back of the tongue takes a posterior and inferior position which can block the airway and cause problems with sleep. These individuals often complain of difficulty sleeping on the back, snoring, or restless sleep and unrefreshing sleep. Compensation patterns during sleep may develop including open mouth breathing, teeth clenching, or predominant side-sleeping that can have secondary effects on maxillofacial development, temporomandibular health, and musculoskeletal posture issues. Similarly, compensation patterns such as forward head posture, anteriorly rolled shoulders, and other myofascial restrictions may also be adopted to offset the limitations of a restricted upper airway in affected patients even while they are standing upright and awake.  Effective release of a lingual with restoration of tongue mobility, tongue, and posture in these individuals can have a profound impact on many areas of the person’s life.
Introduction to a Functional Approach to Frenuloplasty. Learn about the surgical protocol with an emphasis on the clinical role of myofunctional therapy both before and after surgery. (44 minutes,  ASTLiT Conference; May 2018).
Ankyloglossia- A Verbal Dissection. Comprehensive background overview of tongue, lip, and buccal-tie surgery.  (1 hr: 50 minutes; IAOM Convention; October 2017).
Case Discussion with Dr. Victor Abdullah- Honorary Associate Professor of the the Department of ENT, Chinese University of Hong Kong and Consultant ENT surgeon of the United Christian Hospital of Hong Kong.  "Myofunctional therapy, lingual frenuloplasty, and the role of ENTs in the treatment of sleep and breathing disorders."  


Case Study: 
Katarina W-  Relief after many years.... Posture, sleep, and breathing.
Case Study: Nadia S. - Release of cervical neck tension with improved breathing and mobility. 
Case Study: Release of muscle tightness, easier to breathe. 
Case Study:
Maureen M. - Relief of cervical neck tension, TMJ pain, grinding; improved mood and sleep.
Case Study:  Bryce - Opera singer describes how release of posterior tongue-tie transformed the trajectory of his voice and singing career.
Case Study:  Rebecca - Professional dancer describes changes to her posture and flexibility immediately after her frenuloplasty.
Case Study:  Dylan - Professional violinist with a a very strongly positive, cathartic, and emotional response to the tongue-tie release which he shares in this video. 
Case Study:  Ann M describes her journey as a speech language pathologist watching patient testimonials to experiencing it all for herself. 

The Patient Experience

Case Series:  Compilation videos with highlights of case studies above showing the positive impact of functional frenuloplasty on sleep, breathing, and posture. 

Surgical Demonstration

Case Studies: Typical cases of lingual frenuloplasty with minimal partial genioglossectomy.   
Case Studies: Release of posterior tongue-tie with extensive partial genioglossectomy. (This technique should only be performed by adequately trained surgeons. Viewer discretion advised.)
Case Studies: Release of lip-tie and buccal ties with Q-tip blunt dissection. 

Lip-Tie Release: Scissors and Suture

Lip-Tie and Buccal Release: Advanced

Video: Post-Operative Myofunctional Therapy Exercises - Achieving optimal healing after surgery by dissociating the tongue from the floor of mouth when doing tongue rehabilitation stretches and exercises. 
Lingual Palatal Suction: Entire tongue should rest up against the palate. 
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