I regularly see consults for treatment of a gummy smile. Recently I have seen several patients who have had gummy smile surgery to weaken the lip elevator muscles by other surgeons. I would strongly urge people against this procedure. Even in the best of hands, surgery for a gummy smile to weaken the lip muscles is fairly risky. It is highly probable to have an asymmetric smile after this surgery, numbness, or difficulty speaking or eating. I have seen several patients who have had such surgeries by other doctors, and I have had to try to fix these issues. It is possible usually to treat lip asymmetries after a gummy smile lip lowering surgery. Most of the time Dysport or Botox can be used to make the lip more symmetrical. Lip numbness is potentially permanent.
The safest and most predictable treatment for a gummy smile due to excessive lip elevation is Botox or Dysport. It is true that it is not a permanent solution and you will need regular treatments. However, this is unlikely to cause irreversible permanent damage to your lips.
Treating a gummy smile with Botox or Dysport is safe, efficacious, and simple, in the right hands. It is still possible to have asymmetries and other problems with this treatment, if the doctor does not have sufficient experience with this procedure. Fortunately, these problems would be temporary. In my hands it is exceptionally rare to have any issues with gummy smile treatment, the only major issue is the possibility of needing a little more Botox or Dysport about a week or two later. If that is the case, I do not charge for touch ups for this treatment.
I am usually on the conservative side of treatment the first time we will treat your gummy smile with either Botox or Dysport. That is because we can always inject a little more after about a week. After we figure out how much Botox or Dysport is right for your smile, subsequent treatments are simple and more predictable.