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.

It is not uncommon for people, especially men, to complain about having a weak jaw line. Sometimes they will try to enhance their jaw line by trimming their beard a certain way. There are several ways to augment the jaw and give you a stronger jaw line.

Fillers can be used to give you a stronger appearing jaw line, but they are temporary and do not actually give much structural support. They are a good option as either a tryout, or for someone who can not undergo surgery either for medical reasons or if they just cant have any downtime at all.

Fat injections work the same way as fillers, but are not the best option for a man who has always had a weak jaw. They are better for women or some men who have had a decent jaw line when they were young, but because of the loss of facial volume appear to have a smaller jaw.

Jaw augmentation surgery with the use of what are called jaw implants or angle of the mandible implants are a great option for men who have always had a weak jaw and jaw line. Jaw implants are placed through an incision inside the mouth so there are no external incisions at all. They do not move once healed and become a permanent structural support for your jaw. Think of Brad Pitt. Jaw implants can be used alone or in combination with a chin implant for those with a weak chin.

Jaw implant or angle of the mandible implants as well as remove and replacement of an existing chin implant before and after photos. Patient is less than 4 weeks after surgery. Notice how his jaw line is more defined, his mandible seems wider. He has a more masculine appearance.

The above patient also had a chin implant placed in the past. Notice how the implant is sitting to high on his chin. This is a subtle appearance that actually makes him look less masculine. We removed his old chin implant and exchanged it. Notice how much more natural his chin appears after the surgery in the pictures below.

Before and after jaw implants or angle of the mandible implants with exchanging of a chin implant. Notice how the chin seems more natural and masculine with the new chin implant. The previous implant was sitting too high and was not in the correct position.

Feel free to read more about facial implants by visiting the facial implants page

Under eye filler is a quick and easy in office procedure that can be done in less than 20 minutes. It is pain free and you will see results right away. It will not be the final results because you will have slight redness and puffiness, but with a bit of cover up you should be presentable right away. Below is an example of a man with under eye dark circles and under eye hollowness. The after pictures were taken IMMEDIATELY after the procedure. as you can see, there is slight redness, and a small area of blanching (whiteness of the skin). The white effect is from the numbing medicine and goes away after about an hour. Most of the redness is from ice application to the skin. He is not wearing any make up at all.

Before and After under eye dark circles treatment

Before and After under eye dark cirlces treatment

You can also read more about your options at our under eye dark circles page

It is possible to make your nose a bit bigger. It might even be possible to do without surgery, just with a bit of filler. This is called a non surgical rhinoplasty. If you prefer a more permanent solution, a revision rhinoplasty can be performed to make your nose bigger. Some of your own cartilage can be used, either from your septum, the inner bowl of your ear, or rib cartilage, or synthetic material such as gortex or an irradiated rib graft. Whatever the material to be used is, the concept is the same: give your nose a larger stronger structure.

There are pros and cons with either the non surgical rhinoplasty or the revision rhinoplasty. With the non surgical rhinoplasty the advantage is that it is quick and virtually pain free and you see the results right away with almost no downtime at all. You can actually go back to work or go out the same night as having the non surgical rhinoplasty procedure done. The downside is that it is not permanent and you will need touch up procedures to maintain the results anywhere between 6 months to one and a half years.

you can visit the non surgical rhinoplasty page

The advantage of having a rhinoplasty revision or redo nose job is that it is permanent and you will hopefully never have to deal with it again. The downside is that it is surgery, causes a fair amount of swelling and downtime of about 1-2 weeks.

You can visit the revision rhinoplasty page

Hairline lowering surgery or forehead reduction surgery can be done in several ways. Please read the Forehead reduction surgery and hairline lowering surgery page. for more detailed information.

The one stage hairline lowering procedure can usually reduce the hairline by about an inch to an inch and a half. Before the procedure I will instruct you to perform scalp loosening exercised to make your scalp more mobile and easier to lower.

If your hairline needs to be reduced significantly more than an inch and a half to two inches, a two stage forehead reduction procedure might be an option. For most people, though, a one stage hairline lowering procedure is more than enough.

As we age, we lose volume in our upper face and especially around our eyes. What do I mean by volume? Our facial fat goes away. If you looked at pictures of yourself from when you were younger, you had more volume--more facial fat. Bigger cheeks, more fullness in your temples, brows, and under eye area. As we lose this volume our skin droops and becomes looser. This is also because we lose some elasticity of the skin with age as well.

In the upper eyelid area, the main contributor to the appearance of loose skin is fat loss. We do lose some elasticity but not to a high degree. Most surgeons who perform upper eyelid surgery or a lid lift (blepharoplasty) not only cut away this loose skin but also cut away even more of this brow and eyelid fat! This gives your upper eyelids a hollowed out sunken appearance. No loose skin but the eyes become skelatonized. This does not make you look like you did when you were younger.

Is there a way to help you? There might be. Replacing some of the volume back into your eyes, either with fillers like restylane, or with your own fat, can decrease the hollowness and sunken look of your eyes. It can help bring the life back to them and make them look more like they did when you were young.

Check out the non surgical eyelid lift page for more information.

It seems that you had the filler injected too superficially. When filler is injected right under the skin and not deep enough, something called the Tindel effect happens which imparts a bluish hue to the skin. So even though your dark under eye circles are filled in, it imparts a bluish color which makes you look like you still have dark circles.

This effect does not happen when the filler is injected a bit deeper, which is the way I prefer to inject under the eyes.

It is possible to reverse the effect by dissolving the filler which can be done quickly and easily in the office. Once the filler is dissolved you can choose to have filler done again in the proper place.

Many doctors prefer to inject under eye dark circles superficially because they fear injecting deeper, and also because it takes less material to inject superficially and have the same surface effect. I inject a bit deeper because it consistently has superior results that are more natural.

feel free to visit the under eye dark circles page for more information.