Upper Lip Tie Aftermath

Hi ho, hi ho it’s off to the Surgery Center we go.

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Makenzie’s lip tie surgery came and went and I am happy to report that all is healed and she is carrying on like a normal 17 month old.

The night before the surgery I was super nervous for the next morning. Was she going to be in a lot of pain afterwards? How would she react to the anesthesia? What the heck were we going to feed her for the next 7 days? Will she mess with the stitches? All of those normal questions that would run through the mind of a parent.

Brian and I woke up at 5:15, got ready and decided that we would wake her as soon as we were ready to go. We kept her in her pi’s, brought her favorite baby, and a sippy cup of milk for afterwards. We got to the Surgery Center around 5:55 and got her all checked in. She was pretty happy considering she hadn’t had anything to eat or drink since 5:45p the night before. She walked around the waiting room in her jammies, flirted with the ladies behind the reception desk, and had some quality FaceTime with Elmo before we were called back at 6:15. The nurses were great and made Makenzie feel very comfortable along with Brian and myself. The surgery itself was only supposed to last 5-10 minutes and was to start at 7:00a. At 6:30 the anesthesiologist came back and introduced herself, told us a little bit about what to expect after surgery and warned us, “She is going to be incredibly upset and almost inconsolable. Babies usually become very agitated and crabby when they wake up from being put under.” So we both mentally prepared ourself for that.

The doc was running a little late but they started the surgery around 7:30a. Makenzie went right to the anesthesiologist and she took her back while Brian and I went to the waiting room. I think we were only waiting for 5 minutes when the nurse came back out to get us. “She’s all done and doing great,” she said.

Brian and I got up and were preparing to hear a screaming baby when we walked back there but instead we peaked our head into her little room and saw her sitting on the anesthesiologists lap, she took one look at us both and said, “HI! Hi! Hi!” Not the screaming that we had expected. Her upper lip was puffy and swollen but not terribly. She drank quite a bit of milk and sat on my lap for the next 20 minutes. The anesthesiologist and nurses all kept commenting at how great she did. Two things irritated they said, the first being that she did not want to lay down on the table for the mask so the anesthesiologist held her instead and the second was the pulse oximeter that was hooked onto her big toe. She kept trying to take her slipper sock off and repeated, “all done, all done.” They measured her O2 for about 20 minutes, the specialist came to give us an update and said they were able to get 7 small dissolvable stitches in her mouth and to limit her to a soft diet for a few days. Give Tylenol for pain and see him again in 2 weeks for a post op check. At that point we were free to go home.

We got home and she had scrambled eggs with cheese and applesauce for breakfast. She gobbled those right up and afterwards she asked to watch Buzz. Brian and I try to limit how much tv she watches, and when I say TV I’m speaking mostly about Toy Story II/III or football, but that day we decided she could watch as much as she wanted. She seemed it pretty good spirits until about 9:45a when she got a little fussy. I think a combination of anesthesia starting to wear off and being just tired from waking up so early. We gave her some Tylenol for pain and I rocked her for a little bit and she fell asleep. She took a little nap then, maybe 30 minutes, and stayed awake until lunch time. The rest of the day was pretty normal. Nap from 12-3 and then she wanted to play with her kitchen when she woke up. We played until dinner time at 5:30 and went through the normal nightly routine. Buzz (the exception), bath, jammies, books, and bedtime at 7.

Depending on how she slept was going to be the deciding factor as to whether or not we would take her to daycare. The specialist had specifically said she could go back the next day but we would have to watch the food. Well, she slept great all night long and woke up in good spirits. I had checked out the food menu earlier in the week and made a few snack substitutions but otherwise she was good to go. She did great! We did soft foods until Saturday and then tried our luck with lasagna. I wasn’t sure about the acidity but it didn’t seem to bother her at all. By day 7 she was eating hard cereal and animal crackers again. The mouth seems to heal very quickly.

2 weeks had passed and I took her to her post appointment. Dr. Paul took a quick look in her mouth, she was not a fan of that, and said that all had healed well.

So all in all, the surgery went well, Makenzie was a huge trooper and it was not nearly as bad as I thought it was going to be.

Keeping occupied in the waiting room

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Hanging with Da Da

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My blanky, my bed, and some FaceTime with Elmo

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Hanging with mommy after the procedure

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At home, recovering. Mommy calls these my Angelina Jolie lips.

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Buzz always makes me feel better!

Before procedure

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Today

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The Discovery of the Upper Lip Tie

At Makenzie’s 12 month appointment 5 months ago her pediatrician was looking inside of her mouth and noticed that she had what she thought was an upper lip tie or upper lip frenulum. She recommended we set up an appointment with Dr. Paul, a pediatric plastic surgeon in the Quad Cities. On the day of her appointment with Dr. Paul, he took a look at her upper lip and said on a 1-10 scale, with 10 being the worse; hers fell at a 7 and recommended that we clip it.

What is a Lip Tie?
A lip tie is when the lip is attached to the gums. This can really range in severity and there are degree’s that define how severe of a lip tie it is. It is really common for people to have some kind of lip tie but only when it is severe or causing medical issues does it need to be corrected. What problems can it cause? 
Problems are mostly seen by the breastfeeding mom. A severe upper lip tie can cause a shallow latch, the inability to flail lip out adequately (incorrect latch), slow growth (due to poor nursing), and pain for the mom while nursing. In addition to this, it can cause a severe gap between the front teeth when the tie comes down between them, tooth decay in the front teeth, speech difficulties from the limited mobility of the upper lip, and problems with it tearing and causing pain in rough play or accidents.

What is a labial frenectomy?
The labial frenulum often attaches to the center of the upper lip and between the upper two front teeth. This can cause a large gap and gum recession by pulling the gums off the bone. A labial frenectomy removes the labial frenulum. Orthodontic patients often have this procedure done to assist with closing a front tooth gap. The removal of the frenulum does not cause any adverse effects to the lip and mouth.

Makenzie’s upper lip tie

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The interesting thing about her upper lip tie is that at the age of 12 months old, she was gaining weight perfectly on a breastfed and solids diet. Prior to starting solids, the only issue we had nursing was when I would eat dairy thus the reason I cut it out completely at around 10 weeks old. Nursing was never excruciating for me and if her latch did seem shallow it was not shallow enough to cause me any pain or preventing her from receiving a sufficient supply of milk. She was great at nursing but we were worried about the speech difficulties that may go along with it so we scheduled her surgery.

This Wednesday the 8th, we have to be to the Surgery Center by 5:55a to start the surgery by 7a. The surgery itself is pretty quick and generally done within 10-15 minutes. They are putting Makenzie under general anesthesia and will be cutting the frenulum by scalpel. Many of you may already be familiar with a frenectomy from tongue ties but for an upper lip clip tie it can be a bit more than the “snip” we think of for the tongue tie. This is especially true for the most severe degree where it goes into the palate of the gums. There are two different methods for cutting the lip tie and most pediatric dentists are more comfortable with the scalpel method, which is the method Dr. Paul will be using for Makenzie. The tie is cut out and stitches are used to mend the area back together. We’ve also been instructed to give only soft foods for the 7-10 days following surgery. Sorry baby girl, no animal crackers are in your future for a few weeks.

Please say a lot of prayers for Makenzie; between the surgery and her next wonder week to hit in 7 days, she may have a rough start to the 2014 year.