We have gone in-depth several times regarding frenulectomies in our blog posts, so you may be feeling like somewhat of an armchair expert on the subject! At least, that’s our goal when it comes to educating our patient’s families! However, did you know that there are different protocols when it comes to this procedure? It can be performed using two separate modalities: steel (scissors/scalpel) or laser. Which method is best? This question is actually up for some debate.

When using scissors, the area below the tongue is numbed and the frenulum is released back to the base of the normal tongue leaving a diamond shaped wound. This wound can be left open or sutured closed. Lasers, on the other hand, cauterize (burn) as it cuts, also leaving a diamond shaped wound below the tongue and is not typically done with anesthesia. While there are no good double blind, randomized controlled studies that directly compare traditional scissors to laser techniques, some retrospective systematic reviews have been done, though have significant limitations.

One advantage of the laser is that there is less bleeding since the laser cauterizes as it denatures tissues. A disadvantage is that parents cannot stay in the room due to laser safety guidelines and may not be covered by insurance since lasers are commonly used by dentists, and newborns may not have dental insurance. Scissors or scalpels are typically used by physicians such as ENTs or craniofacial/maxillofacial surgeons. For this reason, it’s more likely to be covered by medical insurance and can easily be done in office.

When it comes to physicians who have performed frenulectomies using both methods, they typically state that a successful frenulectomy is more provider-dependent than method-dependent. We agree and feel both methods can provide adequate release of the tongue. At Wellspring Pediatric Plastics, our providers are specialty-trained and perform a significant amount of frenulectomies both in the hospital and clinic setting. We love supporting breastfeeding mothers and are privileged to take care of your child, regardless of modality.

Our goal is to ensure that both mom and baby have the tools for a successful breastfeeding journey, so please contact our office at 512-600-2888 or pediatrics@thewsps.com if you feel that a frenulectomy consultation may benefit your family!