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.

There are several reasons for people to have a gummy smile. One is gingival hyperplasia, which needs to be treated by a periodontist to resect away some of the extra gum. Most people who have a gummy smile, however, have a condition of increased tone and contraction of their upper lip retractor muscles which causes the upper lip to raise a bit too much.

There is a surgery to help weaken these muscles, but it is not without its potential downsides and complications.

Botox is a good option for many patients who have a gummy smile because it can be used to weaken those upper lip retractor muscles. Over time, your upper lip gets retrained to not elevate so much, and after a couple of treatments with botox you might not need it again.

This technique is not for the novice botox injector. Too much, and your lip wont raise enough, too little and you will need more, or if injected asymmetrically, you might have a funny asymetrical smile.

Speaking of an asymentrical smile, botox can sometimes be used to make your smile more symmetrical.

I have many patients who are extremely happy with their botox treatment for their gummy smile. Most of them come in every 4-6 months for their injection, and a good number of them never need it again after about 3-4 treatments.

You should see your gummy smile improve after about 4-5 days, and your gummy smile should keep improving for about 10-14 days. After that point, you might need to come back in to get a small touch up (which I do not charge for). This is especially true if it is your first injection, since I am very conservative and would rather aim on the side of caution. I would rather need to give you a small touch up than over do it and give you a paralyzed lip for 1-2 months.

Botox for a gummy smile is relatively painless and quick. It can be done in under 5 minutes in the office.

you can read a bit more about botox for a gummy smile by visiting our gummy smile page.