This is one of the most distressing situations families come to us with. They took the step, they went through it, and it did not give them what they hoped for. We approach this with honesty and without criticism of whoever performed the initial procedure.
Why can a tongue tie release fail to improve feeding?
A release may be incomplete if the posterior component of the restriction was not addressed, if the procedure was performed without adequate visualisation of the full extent of the tether, or if it was completed without a preceding functional assessment to confirm the diagnosis and clinical significance. Reattachment occurs when the wound heals with new fibrosis, which is why post-operative wound care through correct feeding technique, resting tongue posture, and sometimes manual stretching and bodywork are critical, not optional.
What if the release was adequate but feeding did not improve?
In some cases, the release was technically adequate but the baby had developed compensatory feeding patterns so entrenched that they continue even with the restriction gone. These babies need structured feeding rehabilitation, a change in how the tongue moves, rather than a second procedure. Identifying which situation applies to your baby requires careful assessment.
Our assessment after a previous release
We will consider what procedure was performed; assess current tongue and lip function; examine the scar tissue and determine whether there is residual restriction or reattachment; evaluate feeding in detail; and advise clearly on whether revision is indicated and what preparation and rehabilitation should accompany it.
Older infants after a failed release
If your baby has had a division and is now older than 12 weeks, a revision procedure requires additional consideration. We offer the only functional frenuloplasty under conscious sedation service in Ireland for infants aged 12 weeks to 6 months, which allows a thorough revision to be performed safely in an older infant when this is clinically indicated.
Our approach: Release Restrictions, Retrain Function, Relieve Tension, is designed to address not just the structural restriction but the full functional and tensional picture that surrounds it.
The National Tongue Tie Centre was established in 2007 as Ireland's first clinic dedicated entirely to the assessment and treatment of tongue tie. The centre treats over 1,000 patients per year and receives patients from across Ireland and internationally.
Led by Dr. Justin Roche (Consultant Paediatrician, FRCPCH, FRCPI, IBCLC), Kate Roche (Chartered Physiotherapist, IBCLC, Feeding Therapist). Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frequently asked questions
Some improvement in latch and maternal pain can occur within days. For others, particularly where posterior restriction was involved or where compensatory patterns are entrenched, improvement may be gradual over several weeks with active rehabilitation. The absence of immediate improvement does not mean the procedure failed; it may mean more rehabilitation is needed. However, some change should be seen within 48 hours of release.
Reattachment is a recognised complication and occurs when the wound edges heal back together or the diamond-shaped area tightens during the healing process. Revision is sometimes indicated, and the approach to the revision matters as much as the decision to revise.
This depends on the current clinical picture. Laser frenuloplasty allows greater precision, better haemostasis, and in experienced hands a more complete release of posterior restriction with sutures placed to bring the skin edges together in a vertical orientation. Whether revision is indicated, and by what method, depends on the functional assessment findings, not the original technique alone.
Functional assessment is more informative than a visual assessment of the scar. If feeding mechanics are still not working correctly, the issue may be residual restriction, a compensatory pattern that needs rehabilitation, or a concurrent factor such as jaw tension or a lip tie that was not addressed. Please come for a comprehensive assessment and we will give you an independent clinical opinion.
Yes, it is possible. Not all feeding difficulties are caused by tongue tie. If a division did not improve feeding and the assessment is now showing adequate tongue mobility, other causes, positional, anatomical, neurological, or relating to maternal anatomy, need to be considered. We will assess the full feeding picture.
Book a comprehensive assessment at the National Tongue Tie Centre. Our clinical team will assess current tongue and lip function, examine the scar tissue, and give you an independent opinion on whether revision is indicated and what it involves. Call us, complete our online enquiry form, or visit www.tonguet.ie. Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frenuloplasty is a surgical procedure. Risks, benefits, and individual expectations will be discussed in full at your assessment appointment before any decision to proceed is made.
