Frenuloplasty – removal of a short frenulum of the penis

Features of frenuloplasty

Plastic surgery of the frenulum of the penis is aimed at restoring the normal functioning of the organ. Performed for medical or reconstructive plastic purposes. During the surgical procedure, the doctor makes a transverse incision and then sutures the edges of the wound. The procedure lasts approximately 30 minutes and is often performed under local anesthesia. If the pathology is accompanied by phimosis, flesh circumcision is performed in parallel with frenuloplasty.

If sexual intercourse is accompanied by discomfort or unpleasant sensations in the frenulum area, a consultation with a urologist is recommended. Don't wait for the rupture to happen - it's painful and dangerous!

Vestibuloplasty and Frenuloplasty

Vestibuloplasty is the correction of the small vestibule of the oral cavity through surgery.

Frenuloplasty is plastic surgery of the frenulum of the tongue and lips.

A small vestibule of the oral cavity is a pathological condition that can be congenital or acquired due to tissue scarring. A decrease in the depth of the vestibule of the oral cavity causes noticeable tension in the gums in the area of the teeth, limited lip mobility, and increased tone of the chin muscles during swallowing. While chewing food, gum tissue is constantly damaged and their blood circulation is disrupted.

Excessive tension of tissues in the vestibule of the oral cavity leads to significant problems: dentofacial deformations - the formation of malocclusion, exposure of the roots and necks of teeth in the areas of attachment of ligaments and bands - gum recession, inflammatory processes of the mucous membrane in areas of pronounced gum tension, the formation of pathological periodontal pockets.

Vestibuloplasty surgery can stop or at least significantly slow down the exposure of the roots and necks of teeth. We are talking about surgically detaching a section of the oral mucosa and fixing it in a new position.

Vestibuloplasty is indicated in preparation for dental prosthetics to improve the fixation of removable dentures. Vestibuloplasty is also widely used in periodontology, as one of the methods for the prevention and treatment of periodontal diseases. Vestibuloplasty and Frenuloplasty are performed in both adults and children and are preparation for orthodontic treatment.

Frenuloplasty is considered a simple operation and is performed as follows:

· Y-shaped plastic – a diamond-shaped suture is formed after excision of the frenulum using a scalpel, as well as special scissors for working with gums;

Z-shaped plastic - three incisions are made, one vertically and two obliquely. It is necessary to fix the mucosal flap especially carefully so that it is not stretched.

Types of vestibuloplasty.

There are several correction methods using vestibuloplasty. Each of them has its own advantages, disadvantages and features.

According to Clark . This method is used primarily for correction of the upper jaw, is carried out over a large area and is relatively simple. Without affecting the periosteum, the area between the mobile mucosal area and the gums is dissected. After detachment of the lip mucosa by 1 cm, the muscles and tendons move along the periosteum deeper in the lateral and frontal sections. Single muscle fibers may be removed. At the end of the operation, the mucosal flap is sutured to the periosteum with catgut, and the alveolar process is covered with a special film while the wounds heal.

According to Adlan-Meicher. This technique gives the most lasting results, therefore it is practiced most often. Meicher oral surgery is usually used to correct the lower jaw. The dissection is carried out as in the first case, but a deeper displacement of the submucosal tissues - muscles and tendons - is used. The fibers remaining on the wound tissue are removed, the mucous membrane is fixed in the new vestibule of the mouth and a protective bandage is applied for two weeks, for example, Diplene Denta films. The films are impregnated with lidocaine, which allows the patient to easily endure the rehabilitation period and not experience pain. And also chlorhexidine, which eliminates the risk of infection entering the wound.

According to Schmidt. It is performed on the upper or lower jaw without detachment of the periosteum tissue. The operation is characterized by cutting off the cords with muscles in a direction parallel to the periosteum. As a result, a flap is formed, the free edges of which are immersed into the depth of the new vestibule and fixed with sutures.

According to Glickman. This method can be used both over large areas and locally for the upper/lower jaw. At the site of attachment of the lip, a dissection is performed, soft tissue is detached to a depth of about 1.5 centimeters, and the free edge is sutured to the resulting depression.

Tunnel. This technique is considered low-traumatic and is applicable to both jaws. The technique is universal, but vestibuloplasty of the lower jaw is more often done. It differs from the previous two options in that it is minimally traumatic. During its implementation, only three small incisions are made - two horizontally to the premolars, the third along the frenulum. After the tunnel is formed under the mucosa, the muscles and tendons move along the periosteum. Thanks to the gentle technique, the wounds heal completely within no later than 2 weeks.

Laser vestibuloplasty is possible using any of the methods described above. Its only difference is the use of a laser instead of a scalpel. This method has many advantages. Complications are virtually eliminated, high precision incisions are achieved and scars are invisible, there is no bleeding, and healing proceeds very quickly. Naturally, the price of the procedure will be higher, but the pain and rehabilitation period will be reduced.

Recovery after surgery.

This is a simple operation that is performed quite often, but, as with any other surgical intervention, after it is performed, you must adhere to certain rules.

Follow a gentle regimen.
Avoid increased physical activity for two weeks.
For the same period, stop eating any irritating food.
Regularly carry out thorough antiseptic treatment of the operated area.
Perform applications with wound healing agents.

A speedy recovery and the absence of complications depend on carefully following the doctor’s instructions.

Indications and contraindications for frenuloplasty

Indications for frenulotomy may include:

Curvature of the erect organ. During an erection, the head bends downwards.
Difficulty retracting the skin fold, an unpleasant feeling of tightness.
Painful frictions.
Microtears of the frenulum, which are accompanied by bleeding.
Phimosis, paraphimosis.
Early ejaculation in men can also be associated with a short frenulum.

60% of men with the problem of early ejaculation note excessive tension on the frenulum during sex. Frenuloplasty solves this problem.

The manipulation is not classified as complex, but requires sophistication and skill from the surgeon - many receptors are concentrated in this area.

Indications for frenuloplasty of the lingual frenulum

Ankyloglossia is various pathologies in the development and structure of the frenulum.
When properly developed, the frenulum starts from the root of the tongue and runs exactly along its center, ending at the base of the lower incisors. The following types of ankyloglossia occur:

The frenulum is too short with little mobility, which provokes a violation of diction, the development of malocclusion and limits the movements of the tongue.
Abnormal placement of the film, which also limits the movement of the tongue.
Excessive length of membrane, which can reach almost to the tip of the tongue. As a result, the mobility of the tongue is greatly limited, making it more difficult to swallow and speak. This pathology is especially dangerous for infants, since it is sometimes almost impossible to eat normally.

Ankyloglossia can lead to more serious problems:

slow weight gain and slow growth;
indigestion;
retarded growth and development of the lower jaw;
high sensitivity of teeth and the formation of stones under the gums, which provoke diseases.

Therefore, if there are orthodontic, speech therapy, periodontological or gastroenterological indications, the doctor decides to perform frenuloplasty of the lingual frenulum.

Progress of the operation

Plastic surgery for truncation of the frenulum of the penis takes place without hospitalization. The procedure takes half an hour, and after 1-2 hours the man can return home.

If the operation is performed under local anesthesia, the doctor will give a pain-relieving injection under the frenulum and wait until the target area is completely numb. In a classic frenulotomy, the doctor performs a transverse dissection with a scalpel and stretches the edges into a diamond shape. After adjusting the tension, the specialist applies sutures. If there are scars or tissue growths, they are also removed.

Laser plastic surgery is characterized by the absence of blood and an almost zero chance of infection. The tissues are burned out with a laser, and the vessels are sealed. There are no scars left.

Rehabilitation after surgery

Patients with a short frenulum do not need to adhere to any diet, even in case of surgery, since the latter is performed under local anesthesia. As for lifestyle, until the postoperative wound is completely healed, a man must refrain from sexual intercourse, since this can lead to separation of the surgical sutures and in such a situation a repeat operation will be simply inevitable.

Hygiene of the external genitalia in the postoperative period is also very important. It should be done after every visit to the toilet. The postoperative wound is treated not only with water, but also with a solution of non-concentrated antiseptic, followed by application of an aseptic dressing.

The main goal of rehabilitation in the postoperative period is to prevent the development of purulent infection, as well as to ensure that the surgical wound heals as quickly as possible with the formation of the smallest scar. As for the prevention of purulent infection, modern antibacterial agents are prescribed for this purpose. Since in most cases, the operation is performed in adolescence, the use of fluoroquinolone drugs is contraindicated for patients. In this case, drugs from the group of macrolides, which include clarithromycin and azithromycin, are better suited.

For rapid healing of a surgical wound and a small scar, it is recommended to treat the surgical site daily with alcohol or iodine with the obligatory application of an aseptic dressing. If the wound is clean, then under no circumstances should you use any fat-based ointments, since they are intended to treat purulent wounds, and for clean wounds they can only prolong the healing process.

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Possible consequences

Abnormalities of the hyoid and labial frenulum can lead to various problems. Among them:

loss of soft tissue
development of gingivitis and periodontitis,
gastrointestinal diseases due to insufficient chewing of food,
formation of malocclusion and displacement of teeth,
serious speech defects.

With a short or thick frenulum of the upper lip, a gap inevitably forms between the incisors. Because of it, many people develop complexes, which interferes with communication and leads to a decrease in self-esteem.

Penis frenuloplasty - what is it?

This term refers to the correction of the frenulum of the foreskin if it is naturally short or torn during intercourse. It is easy to find out that the frenulum is short. When the penis is erect, the short frenulum will pull the head back. Over time, this can lead to ptosis and problems with insertion of the penis into the vagina.

A short frenulum can also cause pain during active sexual intercourse. Tension can cause it to tear, causing bleeding. As a rule, a scar forms at the site of the tear, which further shortens the frenulum and provokes new ruptures and bleeding.

A simple and quick solution to the problem will be surgery in our clinic. It is performed by experienced specialists, it is painless and requires virtually no preparation.

Frenuloplasty of the penis is carried out under local anesthesia, the operation does not last long, and after it a barely noticeable whitish stripe-suture remains, coinciding with the anatomical suture on the penis.

Methods of frenuloplasty

Glikman - the frenulum is fixed deep into the mouth and dissected using a special clamp, after which it is sutured.
Vinogradova - excision is carried out by making two incisions towards each other. The separated flap is sutured along the edges of the wound.
Z-shaped incision - made vertically followed by diagonal excision of the frenulum. The flap is fixed to the periosteum, the wound is sutured.
Y-shaped incision - after the incision, the flaps are placed upward and sutures are applied.