A frenulectomy is a minor surgical procedure that removes or releases a frenulum, which is a small fold of tissue that connects two structures in the body and limits their movement. The most common locations are under the tongue, inside the upper lip, and on the underside of the penis. The procedure is quick, often performed in a doctor’s or dentist’s office, and typically takes only a few minutes.
Where Frenulectomies Are Performed
Your body has several frenula, but three locations account for nearly all frenulectomy procedures:
- Lingual frenulum (under the tongue): This connects the underside of your tongue to the floor of your mouth. When it’s too short or tight, a condition called ankyloglossia or “tongue-tie,” it restricts tongue movement and can interfere with breastfeeding in infants or speech in older children.
- Labial frenulum (inside the upper lip): This connects your upper lip to the gum tissue above your front teeth. An abnormally thick or low-attaching labial frenulum can create a gap between the two front teeth and contribute to gum recession.
- Penile frenulum (underside of the penis): This thin band connects the head of the penis to the foreskin. When it’s too short, a condition called frenulum breve, it can cause pain during erections and sexual activity.
Why Infants Get the Procedure
The most common reason for frenulectomy in newborns is difficulty breastfeeding caused by tongue-tie. A tight lingual frenulum prevents the baby from latching properly, which leads to poor milk transfer and significant nipple pain for the mother. Providers assess the severity using standardized tools that score the baby’s latch quality, audible swallowing, and the mother’s comfort level during feeding.
One study of 422 frenotomies in tongue-tied neonates found that 93.1% were breastfeeding at hospital discharge. At three and a half months, 81.7% of those infants were still breastfeeding, compared to 70.4% in a comparison group. By six months, though, the difference narrowed, likely because other factors beyond tongue-tie influence whether mothers continue breastfeeding.
Some infants also have a lip-tie, where the frenulum inside the upper lip is too tight. This can be addressed at the same time as a lingual procedure when both are contributing to feeding problems.
Dental and Orthodontic Reasons
In older children and adults, a thick or fibrous labial frenulum can cause a persistent gap between the upper front teeth, called a median diastema. Orthodontic treatment can close the gap, but research shows it’s twice as likely to reopen if the abnormal frenulum isn’t addressed. A frenulectomy reduces that relapse risk by removing the tissue pulling the teeth apart.
The timing matters. Dental professionals generally recommend completing orthodontic treatment to close the gap first, then performing the frenulectomy to help maintain the result. A frenulectomy alone, without orthodontic work, isn’t considered an effective treatment for the gap.
Penile Frenulectomy for Frenulum Breve
Frenulum breve is when the band of skin connecting the head of the penis to the foreskin is too short and tight. The most noticeable symptoms are pain during erections, discomfort or pain during sex, and tearing or bleeding of the frenulum during activity. Some people with this condition also experience premature ejaculation, possibly because the tight tissue creates heightened sensitivity.
Mild cases can sometimes improve with steroid creams and gentle stretching over time. More severe cases, especially those involving repeated tearing and scar tissue buildup, typically require a frenulectomy to either lengthen or remove the frenulum. The procedure is done under local anesthesia and resolves the pain and tearing in most cases.
What the Procedure Involves
For very young infants with tongue-tie, the procedure is remarkably simple. A provider uses sterile scissors to snip the frenulum, and it’s over in seconds. Infants generally don’t need any anesthesia for this. Some providers offer a sugar solution beforehand to help calm the baby, and most infants can breastfeed immediately afterward.
For older children and adults, the procedure is slightly more involved. It’s still typically done in-office, but local anesthesia is used to numb the area. Some providers use a scalpel or scissors, while others use a laser, which can reduce bleeding. The whole process usually takes 15 to 30 minutes depending on the location and technique.
What Recovery Looks Like
After an oral frenulectomy, a white or yellowish patch forms at the wound site in the shape of a diamond. This is normal healing tissue, not an infection. In infants, the patch begins forming within the first three days, reaches its largest size around one week, then gradually shrinks over the next few weeks. By four to six weeks, the patch is gone and a new, more flexible frenulum has formed in its place.
Pain is generally mild. Infants may be fussy for a day or two but often feed better almost immediately. Older children and adults can expect some soreness and swelling for several days, manageable with over-the-counter pain relievers and soft foods.
Post-Procedure Stretching Exercises
For infant tongue-tie and lip-tie releases, most providers prescribe stretching exercises to prevent the wound edges from healing back together. These typically start the day after the procedure. With clean hands or gloves, you gently lift the tongue or lip to open the diamond-shaped wound, hold for a few seconds, and repeat three times per session. Sessions happen every four to six hours and continue for about six weeks.
The stretches can be uncomfortable for the baby, but they’re considered important. If the tissue reattaches prematurely, a repeat procedure may be needed. In one survey of healthcare professionals, about 32% reported cases where a repeat procedure was considered, requested, or performed, making reattachment the most commonly noted issue after the initial release.
Possible Complications
Frenulectomy is a low-risk procedure overall. Bleeding is the most immediate concern, but it’s usually minimal and stops quickly, especially in infants whose lingual frenulum has very little blood supply. Scarring or tissue retraction at the procedure site occurs in roughly 12% of cases based on provider-reported surveys. Infection is uncommon when basic wound care is followed.
The most practical complication to watch for is reattachment, where the released tissue heals back together before full mobility is achieved. Consistent stretching exercises are the main prevention strategy. If the original symptoms return, such as difficulty feeding in infants or restricted tongue movement in older patients, a second procedure can be performed.