My husband was born with a tight frenulum. For some reason, his parents opted not to have the surgery done to correct it. We would like to have it corrected for improvement of our love life, but is there any medical reason to have it corrected?

U.H.

The frenulum, for those readers who don't have the slightest clue what you and I are talking about, is a band of tissue underneath the tongue. If you plaster your tongue to the roof of your mouth, then open your mouth, you can feel (and see) the frenulum as it stretches from the undersurface of the tongue to the floor of the mouth.

The common name for a short frenulum is "tongue-tie," and the medical term is "ankyloglossia." In infants, tongue-tie can be a problem if tongue mobility is so hampered as to interfere with feeding. In toddlers, speech development is a concern. As a very crude rule of thumb, if the child with tongue-tie is unable to touch the tongue tip to the roof of the mouth, or to the incisors, then tongue-tie may very well lead to impaired speech development.

If there are no problems with feeding or with speech development, many doctors advise against "clipping" the frenulum. Even though the operation is not very risky, the sentiment is, "It's not causing problems, so why incur any risk at all?" Many such patients visit an ear, nose and throat specialist (ENT) in their teenage years or early 20s, for the same reason as your husband: tongue-tie can put a serious cramp in one's love life.

I think this is a perfectly good reason to have the operation. I'm afraid I cannot think of a "medical" reason to have the operation. As far as I'm concerned, sex is pretty damn important. Isn't that reason enough?

On an adult, the operation can be performed in the office under local anesthesia. The risks are: pain, bleeding, infection (all of which are risks whenever a surgeon cuts into ANYTHING), allergic reaction to the local anesthetic and reformation of the tight frenulum via contraction (shortening) of the wound during scar formation. This last risk can be minimized by the technique used in clipping the frenulum. The technique I prefer has the ungainly name "horizontal-to-vertical plasty," a very simple method that nonetheless provides excellent results.