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Tongue Tie Surgery: Procedure, Risks & Surgical Methods

Tongue tie surgery is performed by Plastic Surgeon to relieve a patient born with the condition of tongue tie or ankyloglossia using surgical techniques such as Frenotomy and Frenuloplasty.


The tongue is one of the most crucial organs of the body. Various essential and daily activities like talking and eating are highly dependent upon the tongue. Having a freely moving tongue aids in all these activities. However, a tongue-tie is an issue many individuals are born with. It is necessary to correct this issue in order to have a freely moving tongue.


There are multiple questions which might arrive in one’s mind like what is a tongue tie, what causes it, what can be done to correct it, so on and so forth.


Dr Shrirang Pandit [MBBS, MS, Mch (Plastic & Reconstructive Surgeon) MS Gen Surgery, M Ch Plastic Surgery] of Pandit Clinic, Pune explains what is a tongue tie and answers various frequently asked questions that might sprout up in one’s mind regarding the same in this blog.

What Is Tongue Tie?

Tongue tie, also referred to as ankyloglossia, is a defect that hinders the free movement of the tongue. This happens due to a thick band at the base of the tongue which is attached to the floor of the mouth. 

This particular band disallows the complete movement of the tongue and thus causing an impediment in various daily activities like eating, swallowing, and even speaking.

Generally, the band, often also called lingual frenulum, generally separates before the birth itself enabling the free movement of the tongue. However, in these cases, the frenulum fails to separate thus literally tying the tongue to the floor of the mouth.

Some of the common symptoms of a tongue tie involve:

  • Difficulty in the movement of the tongue when moved from side to side.
  • Difficulty in extending the tongue beyond the front teeth.
  • When the tongue is stuck out, it appears heart-shaped instead of the regular one

The causes of this issue are largely unknown. However, most of the time it is related to genetics. Dr Shrirang Pandit notes that tongue-tie is not an uncommon issue and often can be corrected with the help of a small corrective surgery.

Tongue-tie surgery at Pandit Clinic, Pune is a very safe and effective way to get rid of the issue once and for all.

Does Tongue Tie Surgery Improve Speech?

Ankyloglossia affects the speech and articulation of the child. It restricts the movement and development of the tongue leading to obstruction in feeding as well as speech. 

Tongue Tie Surgery can remove the obstruction effectively and help in improving the speech of the child. It also boosts his/her self confidence when articulating thoughts loudly becomes easier. 

Is Tongue Tie A Birth Defect?

Yes, ankyloglossia is a birth defect found amongst newborn infants. 

At What Age Can Tongue Tie Be Treated?

According to Dr Shrirang Pandit, Pandit Clinic’s expert Plastic and Reconstructive Surgeon, generally when an infant is born with a tongue-tie, immediate surgery can be performed in order to avoid any issues further. However, sometimes parents tend to adopt a wait and watch technique in order to analyze and then come to a conclusion. 

In case the surgery is not performed immediately, Dr Shrirang Pandit suggests visiting a doctor immediately if and when the following issues are observed:

  • The baby finds it difficult to breastfeed.

Generally for a suckling action, the free movement of the tongue is necessary. When a baby is sucking at the nipples, the tongue lies on the lower gum. However, if the baby has a tongue tie, the hindered movement makes the baby chew on the nipple which can be very uncomfortable for the mother. Also, this means that the amount of milk consumed is less and this may pave the way for the baby getting less nutrition than required.

  • A speech problem develops during the growing years of the baby.

As and when a baby starts speaking, the difficulty can be observed as the tongue is a very important part when it comes to clear speech. This issue may become more severe with age. The child might find it difficult to pronounce specific sounds like ‘s’, ‘z’, ‘t’, ‘d’, ‘r’, etc

  • When the child complains of difficulty in doing daily activities that involve the tongue. 

An older child or adult can have oral hygiene issues because of a tongue tie. It becomes difficult to remove the debris from teeth easily which might contribute further in tooth decay or gum inflammation. A gap can also be created in the lower front teeth.  

It also becomes difficult for children to lick ice-cream or even play any wind instrument.

What Questions To Ask During A Consultation?

Here is a list of pertinent questions that Dr Shrirang Pandit has formulated for you to ask at a consultation:

  1. How severe is the tongue tie?
  2. Is surgery the only option?
  3. What are the other options available apart from surgery?
  4. Is consulting a speech pathologist helpful in case of trouble speaking?
  5. What is the duration of the surgery?
  6. What is the procedure involved in the surgery?
  7. Will the surgery bring positive changes for the infant to breastfeed well?
  8. What are the risks and complications associated with the surgery?

What To Expect Before The Tongue Tie Procedure?

The primary step involves the analysis of the frenulum. As the thickness of the frenulum varies, the procedure varies as well. Here the doctor does a complete examination and tries to understand all the issues that the patient is suffering because of the tongue tie. The main aim is to perform the procedure in a way that allows the tongue to move freely.

The procedure is then decided after a complete analysis.

What Is The Procedure For Tongue Tie Surgery?

In certain situations, a tongue tie may resolve on its own. But in case it does not, procedures are carried out in order to correct the issue according to Dr Shrirang Pandit the expert Plastic Surgeon of Pandit Clinic.

A tongue tie surgery has two procedures:

  • Frenotomy

Frenotomy is a very easy procedure done either with the help of anesthesia or without. Administration of anesthesia is not mandatory when performing a frenotomy. 

In this particular case, the doctor uses a sterile scissor to cut the lingual frenulum thus removing the connection between the tongue and the roof of the mouth. In this case, the frenulum is very thin thus making it very easy to perform this procedure without the help of anesthesia.

Hardly a drop or two of blood can be observed and the procedure is quite painless; this is because there are very few nerve endings in the frenulum. In the case of infants, the baby can start breastfeeding immediately.

  • Frenuloplasty

Frenuloplasty is a comparatively complicated procedure than a frenotomy. In case the frenulum is thick, a frenotomy is not possible. Frenuloplasty is done under local anesthesia. Surgical tools are required in order to cut the connection of the frenulum from the floor of the mouth. 

After the procedure, the wound is sealed with absorbable sutures. 

After the procedure, tongue exercises might be suggested in order to regulate the movement of the now free tongue.

Is Tongue Tie Surgery Painful?

Tongue tie surgery is a minor surgical procedure. It is quite painful. The child may feel slight discomfort and a snip. Apart from that no major pain will be experienced by the patient due to the procedure. 

What Is The Recovery And Aftercare After A Tongue Tie Procedure?

The recovery after a frenotomy is very simple. As the skin of the frenulum is very thin, it does not require any sutures or stitches. This is generally done in the case of babies.

In the case of frenuloplasty, stitches are used. However, these are absorbable. The necessary care will be instructed by the doctor. 

Certain exercises might be prescribed by the doctor in order to regulate the movement of the tongue and make the patient habitual to this new movement.

Can Tongue Tie Grow Back After Tongue Tie Surgery?

Tongue tie cannot magically grow back after a tongue tie surgery. But it is important that the exercises prescribed by the Plastic Surgeon are done everyday without fail so as to ensure that the tongue tie doesn’t reattach itself. 

What Are The Risks Associated With Tongue Tie Procedure?

The risks associated with a tongue tie procedure involve:

  1. Poor wound healing
  2. Scarring
  3. Bleeding 
  4. Chances of infection
  5. Damage to the salivary glands or the tongue

The risks associated with the procedure are very rare and utmost care must be taken at all times in order to have a smooth and risk-free procedure.

Dr. Shrirang Pandit

Dr. Shrirang Pandit is the founder of Pandit Clinic. He has an experience of 30+ years in plastic surgery. He is a renowned name in the industry and pioneer of aesthetic lasers in India. Dr. Shrirang Pandit has performed numerous surgeries on children with facial clefts, managed patients with burn injuries and also has a large experience with lasers on Asian and Indian skin. He has attended various laser workshops and courses as faculty and is keen on educating the next generations. He is a life member of all the top plastic surgery associations like Association of Plastic Surgeons in India, Association of Surgeons of India, Indian Association of Cosmetic Laser Surgeons, to name a few. He also acts as a key opinion leader for Ultrashape Inc., Lumenis Inc, VASER Sound Surgical Technologies, USA.