Correct a Gummy Smile with Botox. Smile without worries again!

A Gummy Smile can be quite bothersome. However, Botox offers a solution that is both simple and effective. In this article, learn everything about the low-risk treatment of Gummy Smile with Botulinum toxin, which has already helped many people achieve a charming smile.

What Can Be Done About A Gummy Smile?

A Gummy Smile, also known as excessive gingival display, occurs when a large portion of the gums and teeth are visible when smiling. This can have various causes and often significantly affects the self-esteem of those affected. They may hesitate to show their spontaneous smile in social interactions, which can also negatively impact how they are perceived by others.

Causes Of A Gummy Smile

A Gummy Smile can occur due to genetic factors, misaligned teeth, an overactive upper lip, or a combination of these factors. For example, an elongated jawbone structure can cause the gums to be more prominent when smiling. In some cases, an unfavorable ratio between the size of the teeth and the length of the jawbone can cause a Gummy Smile. Muscular causes are not always the main reason, and Botox is not a helpful option in such cases.

Common Cause: Overactive Muscles of the Upper Lip

However, excessive gingival display is often simply due to an overactive upper lip. In such cases, Botox proves to be very effective. The muscles of the upper lip, the levator labii superioris and the levator labii superioris alaeque nasi, contract so strongly that the gums are fully visible. In some cases, the Gummy Smile is accompanied by a deepening of the nasolabial fold. In others, it is not. When correcting a Gummy Smile with Botox, this is an important factor to consider (more on this below).

Correcting Gummy Smile With Botox

In my practice in Munich, I have been able to help many patients correct their Gummy Smile with Botox. This has led to a charming, natural smile and a noticeable boost in self-esteem.

Botox Is Highly Effective…

In my opinion, correcting a Gummy Smile with Botox is both an effective and low-risk method. Therefore, it is well-suited for many people. By injecting a small amount of Botulinum toxin into the muscles of the upper lip, the Gummy Smile can be reduced without the need for surgical intervention (see “Alternative Methods” below). This is a significant advantage for many patients.

Typically, patients will notice a rapid improvement in their Gummy Smile after the Botox treatment. The results become visible within 3–14 days, and the effects last for about 3–6 months. After this period, the treatment can be easily repeated to maintain the desired result. Overall, my patients report high satisfaction with this type of Gummy Smile correction.

… If Administered By An Expert

However, caution is necessary: As with any Botox application, there are certain risks involved. These include weakening the wrong muscles and incorrect dosage. The consequences can include a “lopsided smile” or a “Joker smile” – neither of which are very appealing. Therefore, Gummy Smile correction should be performed by a skilled and experienced expert.

Max’s Story

One day, a young man visited my practice in Munich, let’s call him “Max”. He suffered from a very pronounced Gummy Smile. His gums were fully visible even when he smiled slightly. Max was initially skeptical about Botox for principled reasons. He was afraid of possible side effects and was concerned that his face might look unnatural after the treatment.

Max Had A Choice

After thoroughly researching his options, Max realized that Botox was not only the least risky method, but also promised the quickest results. He did not consider Gummy Smile surgery as an option. This led him to visit my practice and seek my advice. During the conversation, I was able to alleviate Max’s concerns.

And He Chose Botox

When Max learned that only two small injections and a minimal dose of toxin would be sufficient to correct his Gummy Smile, he was convinced. He opted for the treatment and was soon amazed at how quick and simple the procedure was. Within a few days, Max noticed a significant improvement in his Gummy Smile. He was overjoyed.

Since then, Max has been a regular patient at my practice and comes in for treatment every 3–6 months. He is very satisfied with the results and has overcome his initial skepticism about Botox.

How Does The Treatment Work?

The treatment for Gummy Smile follows my usual protocol for Botox treatment. First, there is a comprehensive consultation where the aesthetic issue is analyzed, and treatment options are discussed. Additionally, I thoroughly inform my patients about risks and side effects at this initial stage. Together, we also discuss the presence of any contraindications.

This is followed by the mandatory cleaning and disinfecting of the treatment area. We also take a few pictures of the untreated Gummy Smile to document the before and after of the treatment.

Only 2 Injections Needed

Then, the Botulinum toxin is injected directly into the muscle with a fine needle. The injections are low in pain and only take a few seconds. Typically, one injection point on each side of the nose is sufficient. Therefore, a total of 2 injections are planned.

Depending on whether the Gummy Smile is accompanied by a deepening of the nasolabial fold or not, the injection is placed slightly higher and closer to the nose. In this case, the primary goal is to weaken the levator labii superioris alaeque nasi muscle, which runs along the nose.

For a Gummy Smile without the formation of a nasolabial fold, the injection point is moved slightly further down and away from the nose to target the levator labii superioris muscle. The injection is made a bit deeper, as the needle must first penetrate the superficial orbicularis oculi muscle to reach the target muscle underneath.

And Only Small Amounts Of Toxin

Only minimal amounts of toxin are used, usually 2.5 to a maximum of 5 units per injection point. The exact dosage depends on the observed mimetic activity and age.

Gummy smile correction with Botox. The approximate injection point is shown in black. Injection is performed on both sides of the nostril.

Slight redness or swelling may occur after the treatment, but will quickly subside. Hematomas are also possible, but they pass after a few days. Due to the small amount of toxin and the fact that only two punctures are made, it can be assumed that the treatment is typically completely free of complications.

Alternative Methods

In addition to Botox, there are other, predominantly invasive options for Gummy Smile correction. These include dental procedures such as gum resection, crown lengthening, or orthodontic treatments. Another option is surgical lip correction, where the position of the upper lip is altered. The choice of the right method depends on individual needs and the cause of the Gummy Smile.

Gummy smile surgery is an option, especially for those looking for a more permanent solution. The procedure aims to balance the ratio of gums to teeth to achieve a more aesthetically pleasing smile. There are various surgical techniques that can be applied, depending on the cause and severity of the Gummy Smile.

A common method is gum contouring or gingivectomy. In this procedure, excess gum tissue is carefully removed, and the gum line is reshaped to achieve a more balanced smile. This procedure is usually performed under local anesthesia.

Another surgical approach is lip repositioning or lip lengthening, where the position of the upper lip is altered to reduce the visibility of the gums when smiling. By raising the upper lip, lip coverage increases, and the gums become less visible.

In some cases, orthodontic surgery may be necessary to address the underlying issue of the Gummy Smile. In this form of Gummy Smile surgery, the bone structure is corrected to improve the ratio of teeth and gums.

Advantages Of Botox Treatment

Botox treatment offers several advantages over the invasive methods of gummy smile correction:

Fast results: The relaxing effect of Botox usually occurs within a few days. Thus, the treatment shows results much faster than other treatment methods. And this already after a single session.

Minimal downtime: Botox treatment requires no recovery time and allows patients to quickly return to their daily lives.

Low pain: the injections are painless and do not require anesthesia. Typically, only 2 punctures are needed to relax the chin muscle evenly.

Temporary effect: Botox offers a temporary solution, so patients have the option to repeat the treatment if needed or decide not to continue if they are not satisfied with the results.

Low cost: Since only minimal amounts of Botox are needed, the cost is relatively low. As a rule, much lower than the above-mentioned alternative methods.

Risks Of Botox Treatment

As with any cosmetic intervention, risks and side effects can occur with Gummy Smile correction with Botox. These include redness, swelling, bruising or infection at the injection sites.

From an esthetic perspective, the appearance of asymmetries is one of the most common complications. Typically invisible at rest, they only reveal themselves in facial expressions, for example as “crooked” laughter. If the muscles on the left and right sides of the nose have not been weakened equally, then one part of the upper lip will hang lower than the other.

Similarly, excessive weakening of the muscles of the upper lip can cause muscles that exert a lateral pull on the lip and corners of the mouth (especially the zygomaticus major muscle) now become excessively prominent. The result is a widening of the oral fissure, which produces a less-than-attractive “joker smile” when laughing.

To minimize potential complications, it is critical to consult an experienced and qualified professional. I have been treating my patients in Munich with Botox for Gummy Smile for years, and I have not encountered any serious complications.

For Whom is Botox Not Suitable?

Although a gummy smile can be reliably corrected with Botox often, the treatment is not suitable for all patients. This is because the known contraindications of botulinum toxin must of course also be observed in this application. These include:

Pregnant or breastfeeding women should avoid Botox in any form, as the effect on the unborn child or infant has not been adequately researched.

Individuals with neurological conditions such as myasthenia gravis or Lambert-Eaton syndrome should also refrain from gummy smile correction with Botox, as it can lead to worsening of symptoms.

Treatment is not possible in the case of a known allergy to botulinum toxin or any of the other components of the injected preparation.

Individuals with acute infection or inflammation of the face must allow it to subside before treatment can be given.

Treatment costs

Botox Gummy Smile correction does not cost much because only 2 punctures are made and small amounts of toxin are needed. As a rule, it is almost not worth it to open a separate vial of toxin for this purpose. It is more cost-effective to include the Gummy Smile as part of the treatment of a larger area, so that the 50 units of a standard pharmacy vial of botulinum toxin are optimally utilized.

But even if a separate vial were to be used exclusively for Gummy Smile correction, the costs in my practice in Munich would be around 290 euros (guideline price, individual billing according to the German Medical Fee Schedule, GOÄ). And that is still quite favorable in relation to the cost of the alternative processes.

Conclusion: An effective solution for the Gummy Smile

Botox treatment provides an effective, low-risk, and low-cost solution for gummy smile correction. By relaxing the muscles of the upper lip, Botox can improve if not eliminate the appearance of a gummy smile. The treatment is fast, the results are visible within a short time, and the cost is low compared to other procedures.

Possible complications, apart from short-term redness, swelling and hematomas, are mainly of an aesthetic nature. They consist of asymmetries, such as a “crooked” laugh. They should not happen if an experienced expert performs the treatment. But even if they are, corrective Botox injections can neutralize them in numerous instances.

Since Botox is contraindicated in several cases, the treatment is not suitable for everyone. It is always important to consult a qualified expert for possible treatment to achieve optimal results with the lowest possible risks.

If you require supplemental information about this treatment, feel free to email me or book a personal consultation appointment.

I look Forward To Your Visit!

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About the author:

Dr. med. univ. Eva Maria Strobl is the owner of LIPS and SKIN Aesthetic Medicine practice in Munich. She is a trained specialist in general medicine (MedUni Vienna) and has over 10 years of specialization in non-surgical aesthetic procedures. She is a member of the German Society for Aesthetic Botulinum Therapy e.V. (DGBT), the German Society of Anti-Aging Medicine e.V. (GSAAM) and of Network Global Health. She publishes regularly on her blog and on DocCheck.

Sources of this article:

Pedron/Mangano, Gummy Smile Correction Using Botulinum Toxin With Respective Gingival Surgery, Link.
Sattler, Pictorial Atlas of Aesthetic Botulinum Toxin Therapy, KVM.

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