Ask an expert: How is tongue tie surgery performed?

Written in association with: Mr Brian MacCormack
Published:
Edited by: Sophie Kennedy

Although it does not always cause issues, tongue tie, which relates to how the tongue is fixed to the floor of the mouth, can in some cases cause a child difficulty in producing some sounds. In this expert guide to the condition, highly respected consultant paediatric surgeon Mr Brian MacCormack explains how corrective surgery for tongue tie is performed and the benefits it brings.

 

What is tongue tie?

 

A tongue tie is where the tongue is more tethered or fixed than usual to the floor of the mouth. This happens because the separation of the two structures during normal development hasn't quite completed properly.

 

 

What are the symptoms of tongue tie?

 

Tongue ties are quite variable and many have no symptoms. A typical anterior tongue tie may give the tongue a heart-shaped appearance. Reduced tongue mobility and difficulty with front of the mouth sounds such as 'l', 's', 't' and 'th' may be present.

 

 

What’s involved in tongue tie surgery?

 

In babies under 3 months of age, a tongue tie can usually be safely released in the clinic without the need for a general anaesthetic. The procedure involves wrapping the infant up in a blanket, elevating their tongue and carefully releasing the tethering using a small pair of scissors. Older children have head control that is far too good and therefore require a short general anaesthetic.

 

 

What are the benefits of having tongue tie surgery?

 

Releasing a tongue tie in a breastfeeding infant may improve latch, increase weight gain and reduce nipple pain. However, the evidence in bottle-fed babies or with regards to speech problems is not clear.

 

 

What causes tongue tie to occur? Does it run in families?

 

Usually the tongue separates from the floor of the mouth before a baby is born. This is part of normal development. In a case of tongue tie, this natural process of separation doesn’t quite complete properly and so the movement of the tongue is reduced. We don’t really know what causes a tongue tie but there may be some genetic factors that contribute and it can run in families.

 

 

How common is tongue tie in babies?

 

Tongue tie is very common and can occur in up to 1 in every 10 babies. It is a little more common in boys.

 

 

Can tongue tie resolve itself as the child grows up?

 

Some tongue-ties may resolve as the child gets bigger, places more things into their mouth, and as their teeth develop.

 

 

 

Mr Brian MacCormack is a highly respected consultant paediatric surgeon who specialises in tongue tie. If you are concerned about tongue tie and wish to book a consultation with Mr MacCormack for your child, you can do so by visiting his Top Doctors profile.

Mr Brian MacCormack

By Mr Brian MacCormack
Paediatric surgery

Mr Brian MacCormack is a consultant paediatric surgeon based in Northern Ireland, who specialises in tight foreskin (phimosis), undescended testicles and hernia, as well as tongue tie, endoscopy (camera tests) in children and cholecystectomy in children up to 16 years old. He privately practices at the Kingsbridge Private Hospital, Kingsbridge Maypole Clinic and Kingsbridge Private Hospital North West, while he also practices at various Western Health and Social Care Trust hospitals.     

Mr MacCormack works to improve the minimally-invasive treatment of children and neonates. He has consolidated his training in Edinburgh, Glasgow, and Belfast along with a fellowship in Auckland. Thanks to this, he has developed advanced techniques in minimally-invasive pyloromyotomy, duodenal atresia repair, and oesophageal atresia repair. In the next three years, he will have developed proficiency in laparoscopic colectomy for inflammatory bowel disease. 

Additionally, Mr MacCormack aims to innovate and improve the processes within the department where he works. His quality improvement projects such as the creation of an electronic operative note platform have been extremely rewarding. Collaborative safety and quality improvement projects will form a core component of his consultant practice and he will complete one such project per year. 

Mr MacCormack wishes to enhance the outcomes for children and neonates in the future by delivering exceptional teaching and training throughout his consultant practice. Designing and delivering a broad and robust teaching portfolio to trainees was one of the most rewarding components of his fellowship year in Auckland. Currently, he is a clinical supervisor. 

Mr MacCormack is highly respected by his peers, who nominated him and he was subsequently awarded for his contribution to excellence in postgraduate clinical education in the Belfast Health & Social Care Trust (2021–22).  Mr MacCormack's clinical research has been published in various peer-reviewed journals, and he is a member of the British Association of Paediatric Surgeons (BAPS). 


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