You will be provided with detailed instructions on necessary stretching exercises prior to leaving from your appointment on the day of the procedure. It is critical to the success of the procedure that these stretches be done as directed and for the time period directed for. Please note that these exercises need to be done 5x/day for 5 weeks.
The Upper Lip is the easier of the 2 sites to stretch. If you must stretch both sites, I recommend that you start with the lip. Typically, babies don't like either of the stretches and may cry, so starting with the lip allows you to get under the tongue easier once the baby starts to cry. For the upper lip, simply place your finger under the lip and move it up as high as it will go (until it bumps into resistance). Then gently sweep from side to side for several seconds. Remember, the main goal of this procedure is to insert your finger between the raw, opposing surfaces of the lip and the gum so they can't stick together.
The Tongue should be your next area to stretch. Insert both index fingers into the mouth (insert one in the mouth and go towards the cheek to stretch out the mouth, making room for your other index finger). Then use both index fingers to dive under the tongue and pick it up, towards the roof of baby's mouth. The tongue needs three separate stretching motions:
Once you are under the tongue, try to pick the tongue up as high as it will go (towards the roof of the baby's mouth). Hold it there for 1-2 seconds, relax and do it once more. The goal is to completely unfold the diamond so that it's almost flat in orientation (remember, the fold of the diamond across the middle is the first place it will reattach). The key to the success of this stretch is that your fingers are placed deep enough prior to lifting the tongue up. I recommend placing your fingers on either side of the diamond and pushing past the diamond before lifting up on the tongue.
With one finger propping up the tongue, place your other finger in the middle of the diamond and turn your finger sideways and use a roller pin motion from front to back to try and keep the diamond as deep as possible. Use a lifting motion when you sweep through the diamond, trying to separate the horizontal fold across that diamond. Make sure your finger starts within the diamond when doing this stretch. Once it's done, repeat the motion on either side of the diamond (outside the diamond) to loosen up the musculature of the remainder of the floor of mouth.
These are additional exercises that are done “extraorally”, outside the mouth and will be demonstrated at your visit.
“Grandma Squeeze” : 5x/day
Lip pinch and press: 5x/day
Pacifier pulls: 5x/day
Touch lower gumline (before nursing), right side, left side, front. This encourages the tongue to move laterally and works the horizontal movement of the tongue.
"Absolutely MUST do stretches after a laser revision or it will reattach. Even with diligent stretching, my baby's started to grow back and he needed to have a good, slightly bloody stretch in the office about two weeks post-revision. If you can, please see Dr. Karen Wuertz. She is THE go-to provider for laser lip and tongue tie revisions in Hampton Roads and Elizabeth City!"
Active Wound Care Instructions must be followed.
STRETCHING IS VERY IMPORTANT AND CAN DETERMINE THE SUCCESS OF THE PROCEDURE.
As with any wound, an open oral wound will contract toward the center during the healing process.
This is why home care is critical to the success of this procedure, as wounds need to be kept open/stretched in order to