Frenuloplasty: Post-Operative Instructions
Post Op Instructions
***Patients should expect some mild swelling, pain, and/or discomfort as a normal process of wound healing. Pain can be controlled with over-the-counter pain medications, and other symptoms usually self-resolve over the course of 1-2 weeks with proper rest and myofunctional therapy. Possible (but very rare) complications of frenuloplasty may include bleeding, pain, numbness, failure of procedure, scarring, and injury to adjacent structures, which may result in salivary glanddysfunction***
​
-
1. Swelling and Inflammation: It is normal to experience some swelling and inflammation in the first 3-5 days after surgery. Your tongue may feel larger and more painful to move. It is recommended to use Tylenol and Ibuprofen as needed for pain, and to consider holistic options like arnica, turmeric, ginger, and CBD oil. For increased pain sensitivity, narcotic medications like Tramadol may be used.
-
3. Oral Hygiene: Continue regular tooth brushing. Rinse with your choice of salt water, xylitol, and/or diluted alcohol mouthwash multiple times a day to maintain wound cleanliness and reduce infection risk.
-
4. Food/Drink: During the first few days, you may find it helpful to have soft, cool foods. You may find it challenging to consume hot or spicy foods, or foods that require a lot of chewing.
-
6. Sutures: Absorbable sutures are typically used, which naturally fall out / dissolve between three - five days, but in some cases may come out sooner or extend longer. As these sutures fall out, granulation healing tissue fills the open wounds and provides a platform for wound healing.
-
7. PeriAcryl Glue: PeriAcryl glue may be applied to the wound site in place of or in addition to sutures. Over time, the glue can have a hard and rough texture, but try to refrain from picking at it. If the glue stays on past 1 week, we encourage gentle massage with Vitamin E oil, coconut oil, or mineral oil to dissolve and remove the material.
8. Ice Therapy Protocol: Apply a cold compress or ice pack to the neck and jaw area for 10-20 minutes every 2 hours (while awake) on the first day post-surgery, and continue as needed during recovery.
9. Myofunctional Therapy Exercises: Recommend gentle tongue movements for
-
the first three days after your procedure. Also recommend moving the tongue in fluid, natural motions - such as speaking, singing, reading out loud, etc. Refrain from strong suction, sticking your tongue out, and other strenuous stretches, and/or exercises to avoid losing the sutures within the first few days. Based on your healing process at your three day follow up, your therapist will determine next steps and guide you on recommended stretches and exercises.
-
10. Lip and Buccal Ties: Beginning on day 2-3, we suggest air puffs and thorough rinsing of the area. With clean hands place a finger and apply gentle pressure in the incision area, holding for 20-30 seconds 3-4x/day.
-
11. Bodywork/Physical Therapy: Many patients benefit from adjunctive therapies pre and post procedure including fascia physical therapy, chiropractic adjustments, craniosacral therapy, osteopathic manipulation, core strengthening through Pilates/Yoga, and 800nm-1064nm laser therapy to reduce inflammation and optimize mobility and function.
.12. Stretches - Generally, post-op stretches should begin three days (72 hours) after the procedure. The key stretches to focus on include the J Sweep, Forklift, and Tongue Pull Stretch. Manual stretches should be performed with the guidance of a qualified therapist to ensure they
are done correctly for proper healing and function. Improper technique or overstretching can lead to injury. Your therapist may recommend additional stretches tailored to your specific needs.
13. Wound Healing: Note tongue mobility may initially decrease between 1-3 weeks post-op but typically improves between 2-6 months. Wound contraction begins around days 5-10 and can last up to 2 months. If mobility remains tight, start using Serrapeptase around days 4-5 post-op, or when all sutures have fallen out and granulation tissue appears. Discontinue if bleeding occurs.
​​
Remember, individual recovery experiences may vary, and it's crucial to follow your healthcare provider's specific guidance.
​
At any time, call our practice if you experience any of the following:
-
Severe pain that does not improve with medication
-
Brisk bleeding
-
Severe swelling at the site of surgery
-
Difficulty breathing
-
Fever higher than 102 degrees F (~39 C).
-
5. Bleeding: Some bloody oozing in the first 1-2 days may occur. If steady bleeding occurs, place gauze under the tongue to hold pressure and call Dr. Zaghi, or go to your local emergency department.
​
Serrapeptase Application Instructions:
-
Apply 1/4 of a Serrapeptase capsule's powder under the tongue (use only Serretia brand).
-
Place a piece of gauze on wound site and wait 3 minutes before wound care exercises.
-
Repeat 2-5 times daily.
-
Avoid eye contact and wipe away drool.
​
Office Hours: Monday – Friday | 9:00 AM – 5:00 PM Call: (310)579-9710 ext 0
After Hours: Call Dr. Zaghi: (818) 489-2444 or (818) 48-ZAGHI
10921 Wilshire Blvd. Suite 912, Los Angeles, CA 90024
Post-Op Instructions
PRE-OP FREQUENTLY ASKED QUESTIONS
Your active participation is important to the post-operative success of your treatment. The following FAQ's will help you know what to expect in the days following surgery, and will help to optimize a successful surgical outcome.
Q: CAN YOU DESCRIBE THE TREATMENT FOR A PATIENT THAT IS TONGUE TIED? DOES IT HURT?:
A frenuloplasty is a straightforward outpatient procedure that can be completed in office without the need for general anesthesia. If a release is recommended, the treatment takes less than an hour. Dr. Zaghi will apply an effective topical anesthetic gel on the frenular tissue underneath the tongue prior to treatment, followed by an injection of lidocaine, allowing for zero to minimal discomfort during the procedure. The anesthetic wears off approximately 30-45 minutes after the procedure is completed. For the first several days (occasionally up to 5 days) following surgery, pain is to be expected. This can usually be controlled with over-the-counter medication such as Tylenol or Ibuprofen.
​
Q: ARE THERE ANY PRE-OPERATIVE INSTRUCTIONS?:
We encourage you to eat a full meal prior to your procedure. We also encourage getting a good night's sleep the night before. Please refrain from consuming caffeine prior to the procedure.
​
​
Q: WHAT HAPPENS AFTER THE PROCEDURE?:
It is normal to experience some swelling and inflammation in the first 3-5 days after surgery. We recommend using Tylenol and Ibuprofen as needed for pain. During the first few days, you may find it helpful to have soft, cool foods. You may find it challenging to consume hot or spicy foods, or foods that require a lot of chewing. We will provide you with detailed post-operative instructions at the time of your procedure.
​
Q: ARE ANTIBIOTICS ADMINISTERED?:
No, antibiotics are not administered. We recommend rinsing with salt water and/or alcohol-free mouthwash several times a day to keep the wound clean and reduce the risk of infection.
​
Q: WHAT ARE THE POSSIBLE RISKS?:
Complications of surgery are rare, but may include numbness, bleeding, pain, failure of procedure, infection, injury to adjacent structures, and scarring. It is crucial to follow the post-operative instructions to prevent scarring or re-attachment of the frenum. Pre- and post-operative myofunctional therapy is essential for optimal recovery after frenuloplasty.
​
Q: WHAT IS THE PROPER WAY TO ACTIVELY MANAGE THE WOUND POST-PROCEDURE? WHAT CAN I EXPECT TO SEE AFTER THE PROCEDURE?:
​
We use absorbable sutures that will usually fall off or dissolve on their own within 3-5 days and sometimes anywhere from 1-10 days after surgery. As the sutures fall out, white tissue will fill the open wounds. This is normal and not an infection, rather, it is granulation healing tissue that will heal and disappear in approximately two weeks. You can use a soft toothbrush to remove any oral debris if necessary. Please refer to the post-operative instructions for more details regarding wound management.
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.
Video: Infant Lingual and Labial Frenectomy Post- Op Wound Stretches. Learn to set yourself up for success with this video by Dr. Chelsea Pinto.
