Botox for Gummy Smile: A Simple Fix for Excess Gum Show

1. A gummy smile can be charming, and for many people it is part of their signature look. But if you find yourself pressing your lips together in photos or feeling distracted by the amount of gum that shows when you smile, there is a practical, low-commitment option: targeted Botox injections. When placed precisely, Botox treatment can soften the upper lip’s elevation so less gum shows, while preserving your natural expression. It is not a cure for every cause of excess gingival display, yet for the right patient it works predictably, looks natural, and requires little downtime. I have treated hundreds of gummy smiles over the past decade in both dental and aesthetic settings. The best outcomes come from careful diagnosis, conservative dosing, and a thoughtful conversation about trade-offs. Below, I will walk through what causes a gummy smile, how Botox works in this context, who is a strong candidate, what to expect during a Botox procedure, and what outcomes look like week by week. I will also compare Botox therapy to alternatives like lip lifts, veneers, orthognathic surgery, and even orthodontics, because knowing your options helps you choose with confidence. What actually causes a gummy smile “Gummy smile” is a catch-all phrase. Clinically, we usually define it as more than 3 to 4 millimeters of gingival show above the upper teeth during a full smile. The most common causes cluster into a few buckets. For many people, the upper lip elevates more than average when smiling, thanks to strong elevator muscles, chiefly the levator labii superioris alaeque nasi, levator labii superioris, levator anguli oris, and zygomaticus minor. Think of a taut window shade that pops upward easily, revealing more window. Botox for gummy smile targets this muscular overactivity. An overly short upper lip at rest can also expose more gum, independent of muscle strength. Skeletal patterns play a role too. Vertical maxillary excess, a fancy way of saying the upper jaw is longer in the vertical dimension, can push gums into view. Orthodontic factors contribute as well, like a high smile line or delayed passive eruption where the teeth appear shorter because the gum tissue covers too much crown. Lastly, periodontal health or crown length may change the frame of a smile, exaggerating gum exposure. Why the cause matters: Botox addresses the muscle-driven component. If bone, tooth size, or gum position are the primary issues, Botox alone may improve but not fully correct the gummy appearance. That does not mean you cannot try it. It does mean your Botox provider should examine you with these possibilities in mind and tailor expectations. How Botox works for gummy smile, and how it differs from Botox for wrinkles Botox cosmetic, a purified botulinum toxin type A, works by temporarily blocking the nerve signals that tell muscles to contract. In the forehead and crow’s feet, we soften dynamic wrinkles by relaxing the frontalis and orbicularis oculi. For a gummy smile, we reduce the hyper-elevation of the upper lip by relaxing the key elevator muscles, particularly the levator labii superioris alaeque nasi near the sides of the nose. Small, precise doses lower the apex of the smile just enough to cover excess gum, without flattening your expression or affecting speech. Two principles guide dosing: Microtargeting, not blanket paralysis. We want the upper lip to move, just not quite as high. Symmetry over intensity. A little on both sides is almost always better than a lot on one side. Typical dosing ranges are modest, often 2 to 4 units per injection point per side, depending on the product used and the anatomy. Some providers use a “three-point” pattern around the nasolabial fold and alar base when needed. Others prefer a two-point approach for a leaner look and a lower risk of flattening the smile. The exact units and locations vary by brand, facial structure, and smile dynamics. Compared to Botox for frown lines, the risk profile is similar, but the margin for error with gummy smile can feel tighter because millimeters matter. A half-millimeter too much relaxation can translate into a smile that looks a touch heavy. This is why experience and restraint are crucial. What a skilled assessment looks like During a Botox consultation, your provider should examine your smile at rest and during animation. We often take photos and short videos, because motion reveals what still photos miss. A good assessment answers a few questions:

2. How high does the lip rise? Is the elevation symmetric? Do the teeth look short, which could suggest altered passive eruption? Is there vertical maxillary excess? Is the upper lip short at rest, or is it full and mobile? We also look for asymmetries between sides, the presence of a “bunny line” crease on the nose, and the way your philtrum columns lift. If you have a periodontal or orthodontic history, bring it up. If you ever plan to do veneers, a lip lift, or a gum-lifting periodontal procedure, the treatment sequence matters. Sometimes we stage Botox first to preview what a subtle change in lip position does to your smile. Other times, especially where skeletal or dental factors dominate, we refer to a dentist, periodontist, or orthodontist for co-management. Who is a good candidate Strong candidates have hyperactive upper lip elevation with otherwise proportionate teeth and gums. They typically show 3 to 5 millimeters of gingiva above the central incisors during full smile that disappears or improves with the finger test: gently holding the upper lip down and smiling to see if reducing lift alone improves the look. These patients usually get excellent mileage from Botox therapy. Patients with pronounced vertical maxillary excess, very short clinical crowns, or periodontal issues may still benefit, but we frame the result as an improvement rather than a fix. Some combine Botox with conservative dental work or a gum lift for a balanced outcome. A few choose a lip lift instead, which lengthens the visible upper lip at rest but can also increase tooth show during smile, so we weigh that carefully. The Botox procedure, step by step Expect a measured process rather than a rushed appointment. After consent and photos, we clean the skin and map injection points. Most patients skip topical anesthetic because the injections are quick and feel like a small pinch. The entire Botox procedure typically takes 5 to 10 minutes. The injection technique aims at specific elevator muscles alongside the botox locations nearby nose. The goal is not to chase every wrinkle, but to intercept the vector that lifts the upper lip too high. If you also plan Botox for frown lines, crow’s feet, or a subtle lip flip, your provider may sequence those in the same visit but keep doses conservative to see how you respond. You can go back to work or errands immediately. Makeup can go on after a few hours. We ask you to avoid heavy workouts, massage, or facials on the same day. Applying ice can reduce minor swelling. Small marks or tenderness fade within a day. What the results feel and look like over time Botox results do not appear instantly. Most people begin to notice a change around day 3 to 5, with the full effect at about two weeks. This timeline is typical for Botox around the eyes and forehead as well, though the perception of change in the smile can feel dramatic because a few millimeters make a visible difference.

3. Early on, you may feel slightly less “lift” when you smile widely. Your smile should still reach your eyes, and your upper lip should still rise, just not as high. Friends might comment that your smile looks more balanced without being able to pinpoint why. We sometimes aim for a 1 to 2 millimeter reduction in gingival show on the first session, then adjust on a touch up if needed. When in doubt, start low. It is easier to add a unit than to wait out an overcorrection. How long does Botox last in this area? Expect about 8 to 12 weeks for a first treatment, sometimes up to 16 weeks as the muscles respond. Longevity varies with metabolism, dose, and muscle strength. Many patients schedule maintenance every 3 to 4 months to keep the result consistent. Over time, repeated treatments can modestly “train” the pattern, so you may need fewer units. Dosing philosophy and avoiding the overdone look If Botox is overdone around the lip elevators, you can wind up with a flattened or heavy smile, sometimes described as looking “relaxed” in the wrong way. This is avoidable with good technique. We respect how the levator muscles overlap and share function with the zygomatic complex, which provides the upward and lateral pull that makes a smile lift the cheeks. `botox` near me When doses are placed too medially or too deep, you can blunt genuine expression. When doses are placed too laterally, you can reduce the cheek pop that signals a joyful grin. The right dose is the smallest amount that creates a visible improvement without calling attention to itself. Think of it as a nudge rather than a hold. People who also do a lip flip Botox along the vermilion border should be conservative. Combining a gummy smile correction with a strong lip flip can make the upper lip feel less mobile for sipping through straws or articulating p and b sounds during the first week. Safety, side effects, and recovery time Botox is a well-studied anti-wrinkle and therapeutic injection with an excellent safety profile when performed by an experienced Botox specialist. Expected effects include pinpoint redness at injection sites, minor bruising, or mild tenderness that resolves quickly. Headaches are uncommon but possible. Risks include asymmetry, overcorrection, undercorrection, or rare spread to adjacent muscles that can alter facial animation temporarily. Allergic reactions are rare. People who are pregnant or breastfeeding should defer cosmetic Botox. Certain neuromuscular conditions or medications can interact with botulinum toxin products, so disclose your full medical history at the consultation. Recovery is simple. There is no true downtime, and most people feel fully comfortable in public the same day. If there is a small bruise, a dab of concealer solves it. How Botox for gummy smile compares to other options For a purely muscular gummy smile, Botox is quick, adjustable, and reversible. It is also affordable compared to surgery, though it requires ongoing maintenance. Patients who want a one-time structural change or who have skeletal contributors may consider other approaches. A surgical lip lift shortens the philtrum to show more upper lip at rest. It can be beautiful on the right face, but it does not reduce gum show during smiling. In fact, because more lip shows at rest, some people see more tooth and potentially more gum with a full smile, depending on muscle behavior. This option demands thoughtful planning. Periodontal crown lengthening can raise the gum line to reveal more tooth. This helps when teeth look short because gum covers too much enamel. It does not address overactive lip elevation, so it is often paired with Botox or orthodontics. Orthognathic surgery addresses vertical maxillary excess by moving the upper jaw. This is the most definitive fix when skeletal length is the root cause, but it involves braces, surgery, and significant downtime. Ideal for severe cases, not for mild to moderate gummy smiles. Veneers or bonding can alter tooth proportions to balance the smile frame. This can work beautifully in mild cases with short-looking teeth, especially when combined with conservative Botox. Dysport, Xeomin, and Jeuveau are alternatives to Botox with similar mechanisms. Some providers prefer one brand for certain areas, but for gummy smile, the technique matters more than the label.

4. What the investment looks like Botox prices vary by region, provider expertise, and brand. Some clinics charge per unit, others per area. For a gummy smile, doses are typically modest, so the Botox cost often falls lower than a full forehead and crow’s feet session. You may see Botox deals or specials advertised, but do not chase the lowest price. Precision work around the smile demands training and experience. Ask for a Botox consultation, review Botox results photos for this specific indication, and make sure the injector has a portfolio showing diverse facial types and realistic, natural outcomes. If you are comparing a per-unit model, expect a range that reflects both the product and the injector’s skill. Affordable Botox does not mean cheap; it means an honest, transparent plan that gives value. Many patients choose the same clinic for ongoing Botox maintenance so the provider can track response over time, fine-tune dosage, and keep your expression consistent. Before and after, what to watch for We document a neutral expression, a social smile, and a full Duchenne smile that engages the eyes. Two weeks later, we repeat those shots. The cleanest “Botox before and after” comparisons use the same lighting and angle. What you want to see is a natural smile with less gum display, maintained symmetry, and no odd flattening around the alar base. If you had asymmetry at baseline, we want it closer to even. If there is undercorrection, a small Botox touch up can polish the result. If there is overcorrection, it will soften as the product wears off. Most corrections live squarely in the sweet spot. Combining gummy smile Botox with other facial treatments Many people address multiple facial zones in one session. Frown lines, crow’s feet, and a subtle brow lift are popular pairings with gummy smile work. Masseter Botox for jawline slimming is also common, especially in people who clench or grind. If you plan fillers for the lips or midface, the sequence matters. I prefer to set muscle tone first with Botox therapy, then return for filler once we see how the smile settles. That way we avoid overfilling to counter a muscle effect that could have been adjusted. For skincare, an anti-aging routine that includes sunscreen, a gentle retinoid, and barrier support complements Botox rejuvenation by keeping skin quality high. The lips benefit from hydration and non-irritating balms. Because Botox will not tighten skin or change pigmentation, pairing it with good skincare brings the whole look together. My workflow for first time Botox in a gummy smile When someone finds me by searching “Botox near me” or comes by referral for a gummy smile, I start with a detailed smile analysis and short videos. We discuss their goals in plain language: “I want less gum, but I do not want to look different.” I show examples of subtle, moderate, and strong corrections and ask which looks most like their target. I explain the likely number of units and the specific points I intend to treat.

5. If the person is nervous, I suggest Baby Botox for the first round, using smaller doses to gauge response. We schedule a two-week follow-up for assessment and touch up if needed. Aftercare is simple: avoid heavy workouts and facial massages the day of treatment, be mindful of not pressing deeply on the area for 24 hours, and let the medication settle. The feedback at two weeks drives the next cycle. If the result is perfect, we repeat the same plan every 3 to 4 months. If they want a touch more lift reduction, we add a unit per side. If they experienced speech or straw-sipping changes in the first week, we modify the point placement or reduce dose. Customized Botox is not a buzzword; it is the core of natural results. Botox myths and practical facts People often worry that Botox for gummy smile will make them look frozen. Freezing is the wrong term here. We are not immobilizing the lip; we are easing over-elevation. When done correctly, you will still smile, laugh, and pronounce words normally. Another myth is that Botox stretches the skin or that once you start, you cannot stop. The effect is temporary. Skin does not get looser because of Botox; if anything, repeated use can lessen the muscles’ intense pull on the tissue, which can be kind to the skin over time. If you stop, the muscles gradually return to baseline. A practical fact: Botox for men and Botox for women use the same principles, but men may require slightly different dosing if their muscle mass is greater. Another: Preventative Botox is not really a concept here, since we are not preventing wrinkles but adjusting a movement pattern. Still, early, conservative work can train a more balanced smile and prevent the habit of excessive lift from dominating expression. When Botox is not enough Sometimes the consult reveals that Botox alone will not accomplish your goals. If you have 6 to 8 millimeters of gum show driven by vertical maxillary excess, we can improve the look, but full correction is surgical. If your teeth look small because of gummy coverage, a periodontal evaluation for crown lengthening may be appropriate. If your upper lip is extremely short at rest, surgery or dental strategies may serve you better. The key is honesty, paired with options. You deserve a plan that addresses the true cause, not just an easy injection. Choosing the right Botox provider Look for a Botox doctor or experienced injector who understands dental and facial anatomy, not just wrinkle patterns. Ask how they evaluate gummy smiles. Request to see cases similar to yours. A nurse injector, dentist, or physician with specific training in perioral Botox injections is ideal. The setting can be a reputable Botox clinic, a dermatology practice, a plastic surgery office, or a well-run med spa with medical oversight. The credential matters less than demonstrated judgment and a track record of natural outcomes. If you are scheduling your first Botox appointment, arrive with a clean face, avoid blood-thinning supplements for a few days if your doctor approves, and bring a list of your medications. Be open about what bothers you and what you do not want to change. This conversation shapes your personalized Botox treatment.

6. A note on brands and fine distinctions Botox, Dysport, Xeomin, and Jeuveau each have loyal followings. All are botulinum toxin type A products, and all can work well for gummy smile if the injector is fluent in the nuances. Some patients feel Dysport sets in a day sooner on them. Others feel Botox lasts a touch longer. Xeomin is incobotulinumtoxinA without accessory proteins, which some consider for reduced immunogenicity, though real-world differences are subtle. Jeuveau is often priced competitively and performs similarly to Botox in most areas. I pick the brand that best fits the patient’s history and response pattern, but technique remains the primary variable. Practical expectations and maintenance Think of gummy smile Botox as a subtle wardrobe alteration. It adjusts the hem of your smile. You will likely repeat it three or four times a year. The Botox results timeline is gentle: a few days to start, two weeks to peak, a gradual fade over months. Most people like the flexibility. If a life change shifts your priorities, you can stop without consequences beyond the return of your baseline smile. Budget for periodic treatments rather than seeking one-time fixes if muscle overactivity is the driver. Watch out for aggressive promises or overly low Botox prices that trade precision for volume. The best areas for Botox are those where you can improve function or aesthetics without sacrificing authenticity, and the upper lip elevators fit that profile when handled well. A brief case sketch A patient in her early 30s came in with 4 to 5 millimeters of gingival show and a symmetric, high-elevation smile. Teeth were proportionate, gums healthy, and lip length average. We treated two points per side with a total of 8 units of Botox, avoided a lip flip, and scheduled a two-week check. At follow-up, she showed about 2 millimeters less gum on full smile, with a lively, unchanged eye expression. She felt “more photogenic” without feeling different. Three months later, we repeated the same doses. Over a year, she stabilized with consistent results. This is common. A short, useful checklist for patients considering Botox for gummy smile Ask your provider to identify the cause of your gummy smile and show where they plan to inject. Start with conservative dosing and plan a two-week follow-up for touch up. Avoid heavy workouts and facial massages the day of treatment, and allow 3 to 5 days to start seeing change. If you plan lip filler, sequence it after the smile settles to avoid overcorrection. Reassess every 3 to 4 months, fine-tuning for symmetry and expression rather than chasing maximal change. Final thoughts from the treatment chair Botox for gummy smile is one of those small interventions that can shift how you feel about your face. It does not rewrite your features, it refines a detail. The best Botox results are invisible in the sense that people see you, not your treatment. With a careful exam, a few well-placed units, and honest expectations about Botox duration and maintenance, most patients walk out with a natural smile that shows more joy and less gum. That is the kind of aesthetic medicine I trust and enjoy practicing.