A tongue tie (ankyloglossia) is a congenital condition where the lingual frenulum, the band of tissue connecting the underside of the tongue to the floor of the mouth, is unusually short or tight. This restriction limits the tongue’s movement, potentially causing difficulties with feeding, speech, and other oral functions. The common procedure to correct this is a frenotomy or frenuloplasty, which releases the restrictive tissue. A frequent concern following this procedure is the possibility of the tissue fusing back together, often termed reattachment. This article explains the biological process of healing and the crucial role of post-procedure care in ensuring a lasting result.
Understanding Reattachment After Release
The question of whether a tongue tie can “grow back” is common; the site can reattach, though the tissue itself does not regrow to its previous state. This phenomenon, often termed “reattachment” or “relapse,” results from the body’s natural healing process. Following a frenotomy or frenuloplasty, the procedure leaves a diamond or linear-shaped open wound on the floor of the mouth.
The body attempts to close this wound quickly, primarily by forming scar tissue. Reattachment occurs when the two sides of the surgical wound heal together across the gap, rather than healing separately and open. If the wound edges stick together, the resulting scar tissue can be short and tight, limiting the tongue’s mobility once more.
Reattachment is most likely to happen in the first few weeks following the procedure, which is the period of most active wound contraction and healing. The goal of the release is to allow the wound to heal “long and lean,” preserving the newly created space and flexibility. While the incidence rate varies, reattachment occurs in a small percentage of cases, underscoring the need for careful post-operative management.
Crucial Role of Post-Procedure Stretching
Active wound management, commonly referred to as stretching exercises or “sweeps,” is the primary defense against reattachment. These exercises are designed to physically keep the surgical site open and encourage the edges to heal apart. The goal is to prevent the formation of a restrictive scar that would limit the tongue’s movement.
The exercises involve using a clean finger to gently lift the tongue toward the roof of the mouth and massage the diamond-shaped wound site. This action stretches the tissue and briefly separates the healing wound edges, helping the area heal with a functional, non-restrictive scar. For infants, the exercises are typically performed several times a day, often three to five times, for a period of three to four weeks.
The frequency and duration are determined by the practitioner, but consistency is important for the procedure’s success. Caregivers are instructed to apply firm but gentle pressure, ensuring the entire diamond-shaped area is stretched. This active management helps ensure the patient retains the full functional benefit of the initial release.
Identifying Symptoms of Recurrence
If reattachment occurs, the symptoms often mirror the original issues the procedure was intended to resolve. In infants, this may manifest as a return of feeding difficulties, such as an inability to maintain a proper latch or a renewed clicking sound during nursing. Other signs include the baby becoming fussy during feeds, struggling with poor weight gain, or exhibiting increased gassiness and reflux.
For older children and adults, signs of recurrence include a noticeable reduction in tongue mobility, making tasks like licking an ice cream cone or articulating certain sounds difficult. Visually, the tissue under the tongue may appear thick and tight, or the patient may have trouble elevating the tongue fully toward the palate. A visible sign of reattachment is sometimes a horizontal line or “T” shape forming across the wound site where the tissue has prematurely fused.
If any of these symptoms return, the next step is to contact the original provider or a specialist for a thorough assessment. While reattachment may require a second, minor intervention, sometimes a “deeper stretch” performed by the practitioner can reopen the healing area if caught early. A professional evaluation is necessary to accurately diagnose whether the symptoms are due to a true reattachment or other issues.