A gummy smile looks different for each person. Some show a hint of extra gum tissue at full grin, others reveal several millimeters along the upper teeth, which can make the smile feel unbalanced or overly perky. If you love the way you smile but wish the gums played a smaller role, small, strategic doses of botulinum toxin can recalibrate the upper lip’s lift. The effect is gentle, quick to achieve, and reversible. When properly done, you simply look like you, only more relaxed around the middle third of the face.
I have treated hundreds of gummy smiles, and while the injection plan varies from one face to another, the fundamentals remain consistent: target the muscles that pull the upper lip too far north, do so conservatively, and watch how the lip settles over two weeks. With thoughtful technique and clear goals, Botox treatment for gummy smile can be an elegant fix.
What a “gummy smile” really means
Most clinicians define a gummy smile as more than 3 millimeters of visible gum tissue above the upper teeth when smiling. That number is a guideline, not a rule. Some patients show 2 millimeters and dislike it, others show 4 and feel perfectly at ease. The “problem” is less a measurement and more a harmony issue between lip position, tooth display, and gumline.
Causes often overlap. The upper lip may be short at rest, or hyperactive when smiling, meaning it lifts higher than average. Underlying skeletal patterns, such as vertical maxillary excess, can lengthen the midface and expose more gum. Dental factors matter as well. Short clinical crowns, delayed passive eruption, or altered tooth proportions can increase gum show. The reason this matters: Botox works beautifully for hyperactive lip elevator muscles, but it does not change bone, tooth length, or gum anatomy. Proper diagnosis is the compass for setting expectations and choosing the right treatment.
How Botox softens a gummy smile
Botox injections interrupt nerve signaling to muscle. In the upper lip, the main targets for gummy smile are the levator labii superioris alaeque nasi and the levator labii superioris, sometimes with minor contributions from the zygomaticus minor and the depressor septi nasi. By gently weakening these elevator muscles, the upper lip doesn’t shoot upward as forcefully. The smile still reaches the eyes, the teeth still show, but the lip rests lower and covers more gum.
Dosing is delicate. For most women, total units per side fall in the 1 to 3 unit range at each point, often touching two to four points in total. Men typically require slightly more, though individual muscle bulk and animation habits are the real drivers. More is not better. Too much botulinum toxin can drop the lip into a flat line, make diction feel awkward, and in a few cases cause asymmetric smiles that take weeks to resolve. The hallmark of a skilled injector is restraint and the willingness to stage results across two visits.
What treatment feels like
A well executed botox procedure for gummy smile is a five to ten minute appointment. The skin is cleaned, the injector marks tiny spots beside the nose, sometimes slightly lateral along the nasolabial zone, and occasionally along the base of the columella if the depressor septi nasi is overactive. Needles are very fine. Most patients describe the sensation as a quick sting. Ice or vibration can distract the nerves and reduce the pinch.
You leave with small, temporary blebs that flatten within minutes. Makeup can be applied gently after several hours. There is no significant downtime. As with other botox cosmetic procedures, you should avoid strenuous exercise and heavy rubbing of the area the day of treatment.
Timeline: when you see change, how long it lasts
The early phase arrives by day three. The full effect declares itself by day 10 to 14. At that mark, the lip should sit a few millimeters lower on smiling. If your injector planned a two-step approach, a conservative touch up may be offered in week two to fine tune symmetry or add a fraction more lift control. Most patients enjoy the results for 8 to 12 weeks in this area, slightly shorter than botox for forehead lines or botox for crow’s feet, where three to four months is more typical. Lip elevators are small and dynamic, which tends to shorten duration. With consistent botox maintenance across several botox sessions, some people notice the effects last a bit longer as the habit of over-elevating softens.
Who is a good candidate
The best candidate has a gummy smile driven primarily by hyperactive lip elevators. In the chair, I ask patients to smile in stages: a polite smile, then a big laugh. If the lip rockets upward from stage to stage, and if the central gumline above the two front teeth dominates the exposure, botox for gummy smile is likely to help. When the gumline exposure is broad and driven by dental proportions or skeletal height, I discuss combined plans that may include gingival contouring by a periodontist, orthodontic tooth movement, or in complex cases, orthognathic consultation.
The other ideal candidate is someone seeking subtle change. If you desire a two or three millimeter reduction in gum show without altering tooth shape or undergoing surgery, botox treatment is a smart, low-commitment option. It is also useful as a “preview” before permanent dental changes. Some of my dentistry colleagues request a trial of botulinum toxin to estimate where the lip will sit after more definitive work.
Mapping injections: technique that respects anatomy
There is more than one map, and rigid formulas miss the individual nuances of muscle pull. The classic approach focuses on two small injections per side near the alar base and along the levator labii superioris line, using micro-doses. If the smile is asymmetric, the heavier side receives a touch more. If the central lift is dominant, a tiny dose at the depressor septi nasi insertion can reduce the nasal tip tug that contributes to central gum show. Massachusetts botox options If the lateral pull is excessive, small points closer to the zygomaticus minor can help.
Experience matters. Overlying veins are common in the perinasal region, and shallow, slow injections reduce bruising risk. Angling superficially avoids diffusion into deeper muscles that influence speech. If you have a history of significant bruising, schedule the appointment at least two weeks before events.
What results look like: real-world expectations
Expect a smile that looks like your smile, just with more tooth and less gum. The best botox results here do not read as “done.” Friends often comment that your smile looks relaxed or that your photos seem more balanced. You should still be able to pronounce F, V, and P sounds without effort. Whistling should feel normal. And you should be able to sip through a straw cleanly. If any of those feel off in the first week, it typically settles as you adapt, and a conservative approach on subsequent visits solves it.
Botox before and after photos can be striking for those with marked elevator overactivity. A person showing 5 millimeters of gum might land at 2 or 3, which is a comfortable sweet spot. For milder cases, results are more subtle, visible mostly to the person in the mirror and their photographer. I advise patients to take their own photos at rest, half smile, and full smile before the session, then repeat at day 14 and day 60. The camera is honest about small changes our eyes adapt to quickly.
Safety, side effects, and how to avoid pitfalls
Botox safety in experienced hands is strong, but the perinasal area sits near functionality you care about. The main risk is over-treatment, which creates a heavy or flat upper lip that feels unexpressive. Occasionally, the asymmetry of baseline anatomy reveals itself after treatment if both sides were not precisely balanced. Mild swelling or pinpoint bruises can occur and resolve in days. Headaches are uncommon and usually self-limited. True allergy to botulinum toxin is exceedingly rare.
There is also the question of spread. If product diffuses into the orbicularis oris in unintended ways, you could experience slight changes in lip competence or articulation. Technique reduces this risk: tiny doses, correct depth, and avoiding massage. If you use nasal sprays or have significant allergies with habitual nose rubbing, be careful the first 24 hours as friction could redistribute the product.
For the medically curious, interactions with aminoglycoside antibiotics or certain neuromuscular conditions deserve caution. Share your full medical history during the botox consultation. A transparent discussion with a botox specialist, dermatologist, or nurse injector experienced in facial dynamics is the best safety step you can take.
Cost, value, and how to think about pricing
Botox cost for gummy smile is generally lower than large-area treatments like botox for wrinkles across the forehead or glabellar lines. Most clinics charge either by unit or by area. In unit-based pricing, you might see a range that totals 4 to 10 units, depending on anatomy and plan. By-area pricing bundles the expertise and touch up. The overall fee often falls below a standard upper face botox aesthetic session. Geography matters. A botox medical spa in a large metro tends to charge more than a small city practice. There are occasionally botox specials or botox deals, typically seasonal. Value comes from the injector’s judgment, not just the syringe. A $50 savings disappears quickly if you dislike the result for two months.
If you are comparing a botox clinic, ask who injects, how many gummy smile cases they treat per month, and how they handle adjustments. A trusted provider will show representative botox before and after images of their own patients and be candid about limits.
When Botox is not enough
There are cases where botox therapy plays a supporting role or is not the right choice. If you have short clinical crowns or uneven gingival margins, a periodontist can perform crown lengthening or gingival contouring, which changes how much gum shows without affecting lip muscles. If skeletal vertical maxillary excess drives the smile, orthodontic camouflaging or orthognathic surgery is the definitive path. Some patients benefit from a botox and dermal fillers approach, especially if a thin upper lip collapses when smiling. A discreet hyaluronic acid filler can support the vermilion without the pronounced pout of a full lip augmentation. In select cases, a small botox lip flip complements gummy smile correction by rolling the lip slightly outward, though this requires even greater finesse to avoid speech changes.
Comparing Botox with fillers and surgery
People often ask about botox vs fillers for gummy smile. They solve different issues. Botox weakens the muscles lifting the lip too high, reducing gum display. Fillers add structure or volume; they can prevent the upper lip from tucking inward but will not stop an overly keen lift. Surgery, from gingivectomy to orthognathic repositioning, changes the physical architecture. The trade-offs are clear: Botox is non-surgical, fast, and reversible, but temporary. Fillers last longer in the lip, roughly 6 to 12 months, but must be placed carefully to stay natural when smiling. Surgery is permanent and comprehensive, but it requires downtime and carries higher risk.
The appointment flow at a well run practice
A good botox doctor or certified injector does not rush this visit. The process includes a thorough review of medical history, medications, and previous botox results elsewhere. The face is photographed from multiple angles at rest and on animation. We discuss other areas you might be considering, such as botox for frown lines, brow lift, or smile lines, because treatment interactions matter. If you routinely receive botox for masseter reduction or jawline contour, for instance, we plan timing to avoid cumulative changes that subtly alter smile symmetry.
With consent and plan confirmed, injections take minutes. You leave with clear aftercare, a realistic sense of when the result will bloom, and a follow-up slot to check symmetry. This cadence mirrors the best practices of botox facial treatment across upper and lower face zones.
Aftercare that preserves your investment
Aftercare for a gummy smile is straightforward. Keep the area clean, avoid vigorous rubbing or facials the same day, hold off on intense workouts until the morning after, and skip saunas that evening. Smiling is fine. You do not need to “exercise” the area. If you notice tiny bruises, a cold compress for a few minutes at a time helps. If you wear makeup, apply gently after 4 to 6 hours. Give the result the full two weeks before judging the outcome. Many patients forget that a slight asymmetry at day four often evens out by day ten as diffusion and muscle response settle.
Will it look natural
Natural means your personality remains intact. The goal is a botox natural look that keeps spontaneous smiles, softens the extremes, and preserves speech. When you watch TV hosts or journalists with effortless smiles, the best results do not announce themselves. They simply frame the teeth and eyes without extra gum. A heavy-handed approach is easy to spot. The upper lip looks disconnected from the rest of the face, and laughter seems constrained. That is why conservative dosing and a touch up strategy outperform a single aggressive pass.
Integrating gummy smile treatment into a broader aesthetic plan
If you are already seeing a provider for botox for forehead lines, crow’s feet, or a subtle botox brow lift, mention your smile goals. Many faces gain the most from balanced changes across zones rather than a single, isolated tweak. A gentle approach in the glabellar lines can reduce a stern look at rest, while gummy smile correction improves warmth on animation. For patients pursuing botox wrinkle prevention or prejuvenation, a small gummy smile plan two or three times per year is easy to fold into a maintenance plan. The long lasting results many people want are really about repeated, minimal treatments timed before the muscles fully regain strength.
On occasion, I pair gummy smile Botox with a micro-dose filler at the philtral columns in patients whose lip collapses inward. In others, a light treatment of marionette lines or mentalis dimpling restores balance in the lower face, which makes the smile read more cohesively. Coordination matters to avoid cumulative stiffness.
Special considerations for men
Botox for men around the smile area follows the same rules with two differences. First, men often have stronger perinasal elevators, so dosing can be slightly higher, and plans frequently require meticulous symmetry checks to avoid uneven lift. Second, male smiles vary widely in tooth display preference. Some men want more tooth showing than women at rest, and they react sensitively to any sense of a “done” upper lip. The antidote is a fractional approach with a two-week review and the option to add one or two units if desired.
Can Botox help related concerns around the mouth and midface
Yes, within reason. While gummy smile is the focus, micro-dosing Botox can also address chin dimples from an overactive mentalis, soften downturned corners linked to the depressor anguli oris, and relax subtle neck bands from platysma that pull on the lower face. Each of these requires careful assessment. Over-relaxing the lower face muscles can impact smile line balance. Your injector should plan them together so the final expression remains lively.
What to ask during your consultation
Use your consultation to align expectations. Here is a short checklist that keeps the conversation focused and productive:
- Based on my anatomy, is my gummy smile primarily muscle-driven, or are dental and skeletal factors significant? How many units and injection points do you anticipate, and will you stage the result? How do you handle asymmetry or overcorrection if it happens? Can I see before and after photos of cases similar to mine that you personally treated? If I am planning other treatments, such as a lip flip, fillers, or botox for migraines or hyperhidrosis, how should we coordinate timing?
Who should inject you
Select a botox trusted provider who treats smiles routinely. Titles vary by region: dermatologist, facial plastic surgeon, oculoplastic surgeon, dentist with facial aesthetics training, or an experienced botox nurse injector operating under medical supervision. What matters most is consistent case volume, anatomical fluency, and a style you trust. If you search “botox near me,” vet beyond proximity. Read reviews that mention smile outcomes, study photo galleries, and ask about their philosophy on subtlety versus dramatic change.
A note on maintenance
Because gummy smile results last around two to three months for many people, plan your calendar. If you have a wedding or on-camera project, schedule initial treatment six weeks before the event, then consider a small touch up at the two-week check if needed. For ongoing botox rejuvenation therapy, three to four visits per year is typical. Over time, many patients find they can maintain with slightly fewer units as the exaggerated contraction pattern quiets.
Where this fits within the larger conversation about youthfulness
A youthful appearance is not only about smooth skin. It is about expression that matches intent. Too much gum exposure can make a serious message seem overly casual, or a confident grin look a touch juvenile. By modestly lowering the upper lip, Botox aligns your expression with how you feel, without chasing every line or freezing character. If you also care about fine lines, pairing gummy smile treatment with conservative botox for fine lines around the eyes or a small dose for glabellar lines can lift the overall look. If texture or radiance is a concern, address skin quality with sunscreen, topical retinoids, and well chosen treatments such as light peels or energy devices. Botox smooth results do not replace good skin health, they complement it.
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When not to proceed, at least not yet
If you are pregnant, breastfeeding, actively fighting a sinus infection, or taking new medications that could alter bleeding or neuromuscular function, wait. If you are preparing for major dental work, align timing to avoid overlapping swelling or frequent mouth manipulation in the first few days after injections. If you have a history of unsatisfying outcomes from overly aggressive lip interventions, make sure your injector understands your priority for a natural, refreshed look rather than a dramatic change.
A brief reality check on marketing language
Botox is a powerful wrinkle relaxer and smile calibrator, but it is not a cure-all. Beware ads that push instant results or one-size-fits-all formulas. The best outcomes come from a careful read of your anatomy, tiny doses, and a two-week follow-up. That is not flashy marketing, but it is dependable medicine.
The bottom line for patients considering gummy smile Botox
If your smile shows more gum than you prefer and your upper lip tends to vault upward when you laugh, small, precise botox injections can lower the curtain slightly and harmonize your smile. The procedure is fast, the recovery time is minimal, and the effect is reversible. Results look most natural when delivered by a seasoned injector who respects facial dynamics, uses conservative dosing, and adjusts based on your individual response. Pair it with thoughtful dental and skin care, and your smile reads warm, confident, and authentically yours.