Gummy Smile Correction: How Botox Creates a Balanced Grin

1. Most people notice a gummy smile only in photographs. The upper lip lifts, the gumline shows more than a couple of millimeters, and the eye goes straight to pink rather than teeth. It is common, harmless, and often genetic. It can still make someone hide their smile, tighten their lips for photos, or shy away from laughing freely. When that self‑consciousness outweighs the charm of a wide grin, Botox can be a precise, conservative way to bring balance. I have treated dozens of gummy smiles a month in a busy clinic, and the same pattern repeats: patients want subtle improvement, not a frozen or droopy lip. They want to understand where the injections go, how many units are typical, what the risks look like, and how long results last. This guide explains the anatomy, botox treatments nearby the procedure, the experience between before and after, and how to decide if Botox is the right tool compared with surgery or other injectables. What creates a gummy smile A gummy smile happens when more than about 2 to 3 millimeters of gum shows above the upper teeth during a full smile. Several variables can contribute, usually in combination: Hyperactive elevator muscles of the upper lip. The levator labii superioris alaeque nasi, levator labii superioris, and zygomaticus minor can pull the lip up more than average, especially in thin lips. Vertical maxillary excess. The upper jaw may be positioned lower relative to the face, so even a normal lip lift reveals more gum. Short upper lip or thin vermilion. Less lip tissue means less coverage. Erupted tooth and gum proportions. Sometimes the teeth are smaller or the gum has not receded to adult proportions. Dental or orthodontic factors. Malocclusion, open bite, or lip incompetence can exaggerate gum exposure. Botox cannot change bone position or tooth size. What it does well is quiet overactive muscles so the upper lip lifts a little less. In the right candidate, that small change transforms the smile. How Botox corrects a gummy smile Botox, short for onabotulinumtoxinA, temporarily reduces muscle activity by blocking acetylcholine at the neuromuscular junction. For gummy smiles, we target the lip elevator complex so the lip rises 1 to 3 millimeters less on smiling. That often translates to a visible reduction of gum display without changing your natural expression at rest. The technique focuses on a few precise injection points near the nose and upper lip. Some injectors use the “Yonsei point,” a landmark that influences the levator complex. Others prefer a two or three point approach along the nasofacial groove where the lip elevators converge. A fraction of a millimeter in placement matters, and so does dose. Too little, and you will not notice a change. Too much, and the lip can feel heavy or speech can sound slightly different until the early effect settles. Expect most practitioners to recommend a conservative first treatment, then fine tune at a follow up. The aim is natural results, not a dramatic drop. What to expect during a gummy smile Botox appointment A standard appointment runs 20 to 30 minutes. New patients should allow time for a full consultation, photographs, and informed consent. Your provider will watch you talk and smile from several angles, then map your anatomy. They will palpate along the alar base and nasolabial area to feel muscle movement. If you have a thin upper lip or a history of a Botox lip flip, they will plan doses that respect both goals. The actual injections take a few minutes. We typically use a 30 or 31 gauge needle, and the volume per point is tiny. Patients describe the discomfort as a quick pinprick with a mild sting from the preservative in the saline. You can apply ice immediately after. Makeup can go on later the same day, as long as the skin is clean and the injection sites are not rubbed. Dosage ranges, units, and placement details Doses vary with anatomy, gender, and the product used. With onabotulinumtoxinA, an average starting range is 2 to 4 units per side at one to two points near the alar base or slightly inferior. Some injectors add 1 to 2 units at a central point

2. for symmetrical lift control. Total dose for a first session typically falls between 4 and 10 units. Those numbers are guidelines, not rules. A petite patient with a subtle gummy smile might need 2 units total. Someone with strong levator activity might need closer to 8 to 10 units. Repeated treatments often trend toward the lower end once the muscles decondition slightly. If you are comparing products, remember that unit potency differs between brands. Botox vs Dysport vs Xeomin vs Jeuveau use different units and diffusion profiles. The choice depends on injector experience and your prior response to any of these. All are FDA approved for certain facial indications, and off‑label use for gummy smile is common practice among trained providers. Timeline of results, duration, and maintenance You will not notice a change the same day. Early effects appear around day 3 to 5, with the full result at day 10 to 14. The first two weeks are the adjustment period. If any small asymmetry appears, that is the window to evaluate and consider a touch up. A realistic answer to how long it lasts: 8 to 12 weeks is the most common range for gummy smile correction. Some patients hold closer to 14 weeks, others fade by week 8. Activity level, metabolism, and dose influence the duration. Maintenance every 3 to 4 months works well for most. Over a year or two, you may find the dose can be lowered while maintaining the same effect. Before and after: what changes, what stays the same Photographs taken at rest often look almost identical before and after. The change shows when you break into a full smile, especially in candid shots. Patients report fewer comments about “gummy” appearance, and more willingness to smile without thinking about it.

3. The improvement is measured in millimeters. One to three millimeters of gum coverage can feel substantial in the mirror. Because the treatment targets the pull of the lip rather than the bulk of the tissue, you keep your natural smile shape, just with less gum exposure. That is why the best botox NY botox results look subtle and real rather than “done.” Who makes a good candidate The best candidates have hyperactive lip elevators as the primary driver of gum exposure. If you pinch your upper lip at the sides while smiling and the gummy look improves, Botox is likely to help. If vertical maxillary excess is the main factor, or if your upper lip is very short, Botox alone will not fully correct the gummy smile. In those cases the conversation includes gum contouring, orthodontic options, or orthognathic surgery. A thin upper lip might benefit from lip filler or a conservative botox lip flip combined with gummy smile injections to balance lift and volume. Medical history matters. Pregnancy, breastfeeding, certain neuromuscular disorders, and active skin infections are typical contraindications or reasons to postpone. A good injector will screen for these and discuss botox safety, botox contraindications, and realistic expectations. Risks, side effects, and how we avoid them Every injectable carries risks. With botox for gummy smile, they are usually minor and temporary. The most common side effects are small injection‑site bruises, tenderness, and a mild headache. Bruising happens in 5 to 10 percent of cases in my experience, and fades in a few days. Swelling is typically minimal. Undesired effects are uncommon but worth knowing: Overcorrection, where the upper lip barely lifts and your smile feels constrained. This is dose dependent and usually improves as the toxin wears in the first 1 to 2 weeks, then wears off gradually over the usual duration. Smile asymmetry if one side was dosed differently or if pre‑existing asymmetry was not fully accounted for. Speech changes for certain consonants if the lip feels heavy. This is rare and mild. Botox migration is uncommon when placement is superficial and precise, but rubbing or massaging the area right after treatment can increase spread risk. We reduce these risks by using conservative doses, careful technique, and by warning patients not to manipulate the area for at least 6 hours. No facials or aggressive exfoliation for 24 hours. No strenuous workouts for the rest of the day. Those small choices improve outcome predictability. The procedure compared with other options People often ask about botox vs fillers for gummy smile. They do different jobs. Botox reduces muscle pull. Filler adds volume to the upper lip, which can lengthen the red lip and improve coverage. In a thin lip with a gummy smile, a touch of filler plus low‑dose botox can look natural and balanced. In a full lip with hyperactive elevators, Botox alone is usually enough.

4. Botox vs surgery is a question of goals and downtime. Surgical lip repositioning or orthognathic surgery can give larger, more permanent changes, but they involve recovery and higher risk. Botox is a low‑downtime test drive. If you love the change, you can maintain it. If you want more, you can explore gum contouring with a periodontist or surgical options with an oral and maxillofacial surgeon. What the appointment feels like, step by step Think of it as a three‑part visit: evaluation, injections, aftercare. In the chair, you will smile and animate repeatedly while your injector marks subtle points. They will clean the skin with alcohol or chlorhexidine. A tiny needle places a drop or two per site. Most patients feel three to six quick pricks total. You sit for a minute with a cold compress to reduce swelling. The skin may show a small bump at each site that flattens within 10 to 20 minutes. If this is your first time, your provider will probably schedule a check at two weeks. That is when botox expectations meet botox results. If more lift reduction is needed, a 1 to 2 unit touch up may be all it takes. Price, value, and how to think about cost Botox cost varies by region and clinic type. In large US cities, the botox unit price ranges from 10 to 20 dollars per unit at a medical spa or dermatology practice. A gummy smile treatment might use 4 to 10 units, so the botox price typically lands around 60 to 200 dollars depending on dose and geography. Some clinics price by area rather than unit. Ask how they structure fees so you can compare fairly. Watch for botox specials and botox offers from reputable clinics, but be cautious about deals that look too good to be true. The cost of the product is fixed enough that very low pricing often means over‑dilution, inexperienced injectors, or non‑authentic product. Good value comes from precise technique and safe practice, not the lowest sticker. If you are searching “botox near me,” read botox reviews with a discerning eye. Pay attention to comments about natural results, communication, and follow up care, not just the number of stars. Before you book, ask about the injector’s credentials and experience with botox for gummy smile specifically. Pre‑care and aftercare that make a difference A few small choices improve outcomes and reduce bruising. Avoid alcohol, high‑dose fish oil, aspirin, or other blood thinners for a day or two before, unless prescribed for medical reasons. Come with clean skin and skip active skincare acids that morning. After injections, do not massage the area. Stay upright for 4 to 6 hours. Keep workouts light for the rest of the day to minimize early spread. You can resume normal routines the next day. Makeup can go on later that evening if the skin looks calm. If you notice botox swelling or a bruise, use a cool compress as needed. Arnica can help some patients bruise less, though results vary. The role of the lip flip and balancing the lower face A botox lip flip can complement gummy smile treatment, but it needs careful dosing. The lip flip relaxes the orbicularis oris, letting more vermilion show at rest and during a gentle smile. If you already plan to reduce the elevator pull, adding a lip flip can increase the apparent fullness without filler. The trade‑off is that very high doses can make sipping through a straw or pronouncing certain sounds feel different for a week or two. Keep it subtle, especially on your first round. If jaw clenching or hypertrophic masseters widen the lower face, botox masseter injections can slim the jawline and harmonize facial proportions. While not directly related to a gummy smile, facial balance often improves when the lower third is softened. That conversation belongs in a tailored plan, not a bundled menu, because botox for jawline contouring uses larger doses and follows different longevity patterns. Men, women, and first‑time patients Men often need slightly higher doses than women due to muscle mass, but the principle of conservative dosing still applies. For botox for men, aim for subtle results and test response over one to two visits before committing to maintenance plans.

5. First‑time patients sometimes fear looking “overdone.” That usually comes from over‑treating multiple areas at once. For beginners, start with the main concern. If gummy smile correction is the goal, address that first. Evaluate botox before and after photos taken in your provider’s standardized lighting. If all looks natural and you want more, you can add botox for frown lines, botox forehead, or botox for crow’s feet later. Safety, certification, and choosing the right injector Choose a clinic that treats botox as a medical procedure, not a quick sale. Look for a botox specialist with formal training and a track record. Physicians, nurse practitioners, and physician assistants with injection certification who perform these treatments daily tend to deliver more consistent results. A well run botox clinic keeps lot numbers, handles emergencies, and knows when to say no. Do not hesitate to ask botox consultation questions: How many gummy smile cases do you handle monthly? What is your typical dose range? How do you manage asymmetry? What is your policy on touch ups? If you are weighing botox vs Dysport vs Xeomin vs Jeuveau, ask why they recommend one over another for your case. Differences in diffusion and onset can influence choice near the mouth. Combining with dental and periodontal care Botox is part of a larger toolkit. If your dentist notes altered passive eruption or excessive gingival display from the gum itself, a periodontist can reshape gum margins to show more tooth. Mild contouring combined with low‑dose botox can deliver a cleaner smile line with minimal downtime. If malocclusion drives the gummy appearance, an orthodontic plan may change lip dynamics as teeth move. Expect a collaborative approach to produce the most stable results. Myths, facts, and fine print A few common misconceptions deserve a quick correction. Botox does not fill anything. It relaxes muscle. It does not travel far if placed correctly, and migration that changes expression is uncommon with precise technique and sensible aftercare. It does not build up permanently. Muscles return to baseline over time if you stop treatment. For anti aging benefits, repeated injections can soften dynamic lines, but that is a side benefit rather than the goal here. Onset is not instant. When patients call the next day worried that nothing changed, I ask them to wait until day 10. That is when botox results stabilize and a fair assessment is possible. If there is a genuine under‑correction, a small touch up fixes it more predictably than guessing high at the first visit. Managing expectations and avoiding mistakes The biggest disappointment happens when expectations do not match the anatomical reality. If your gummy smile is primarily skeletal, a full fix with botox alone is unlikely. In that scenario, frame the treatment as a partial improvement. One or two millimeters less gum can still matter, but it is not a surgical outcome. This map was created by a user Learn how to create your own

6. From the injector’s side, the common mistakes include chasing symmetry without accounting for natural differences in muscle pull, ignoring a thin lip that would look better with a touch of volume, or repeating the same dose despite evidence that less would look better. Good records, standardized photos, and honest conversations prevent those errors. Recovery time, downtime, and life after treatment Daily life does not stop. Botox downtime is minimal. Most people go back to work immediately. You may see a small red dot at the injection site for an hour or two. Makeup covers it easily. No special recovery time is needed beyond avoiding pressure and heavy workouts the first day. At the two week mark, take fresh photos and compare to your baseline. The difference is usually clearest in a big laugh or smile, which means you may notice it most in social settings or candid photos. That is the moment most patients schedule their next appointment, because the value feels obvious, not theoretical. When Botox is not enough If you have tried two well planned sessions without the change you wanted, step back. Reassess with your injector, and consider a dental evaluation. Orthodontic treatment, gum recontouring, or lip repositioning surgery may be the right next move. It is better to pursue a definitive solution than to keep increasing botox units past the point of benefit. A practical path forward Here is a simple way to approach the decision. Book a consultation and bring a few photos of your widest smile. Ask for a conservative first dose and a two week review built into the plan. Follow pre‑care and aftercare closely for the first round so you can judge the technique without confounders. If you are happy, schedule maintenance for 3 to 4 months out. If you want more, discuss adding a small lip flip or a touch of filler, or explore dental options if anatomy calls for it. Final thoughts from years in the chair The most satisfying gummy smile correction is the one no one can spot. Friends say you look happy. Photos look better without any obvious change in your face at rest. When patients share their botox before and after selfies, the wins are subtle, yet they make a real difference in confidence. Botox is not the answer for every gummy smile, and it should not be sold that way. Used with judgment, it is a low‑risk, high‑reward tool that buys time, tests what balance looks like on your face, and can be maintained with short visits and little disruption. If you are weighing the pros and cons, consider your goals, your anatomy, your tolerance for repeat visits, and your budget. Ask clear questions at your botox consultation, choose a provider who values restraint, and start small. A balanced grin is less about chasing perfection and more about letting you smile without thinking twice.