Botox for a Gummy Smile

  • The condition known as “gummy smile,” when a person’s smile reveals far more of the gums than is considered attractive. 
  • A lot of things may cause the condition:  small teeth, too much gum tissue, and a thin upper lip can each be a cause. In all cases of gummy smile, genes are at fault.
  • The rule of thumb when smiling is two millimeters of gum showing is ideal. Anything over three to four millimeters of gum showing starts to look ‘gummy’.
  • About 7% of men and 14% of women have this type of smile.
  • Cosmetic surgery; either a crown lengthening procedure, which takes away gum tissue, or severing certain muscles that lift the upper lip, so that it reveals less of the gums; was the only option previously. This can be very expensive and painful.
  • In certain circumstances Botox can now be used to fix gummy smile. It only works if the lip is the problem. If the bone is the issue, then orthognathic surgery is still required to fix it and the simpler Botox treatment can’t help.

Muscles involved gummy smile

Elevator muscles of the upper lip. To decrease upper lip retraction in people with so-called “gummy smiles”, by weakening the Levator Labii Superioris Alaeque Nasi muscle.This inhibits its ability to rise all the way, blocking out more of the gums and eliminating a gummy smile.

Treatment - What to Expect

  1. The patient sits back on a bed with the backrest up.
  2. The area is cleaned.
  3. The skin overlying the muscles to be injected is marked out with a skin marker.
  4. The Levator Labii Superioris Alaeque Nasi muscles are injected.
  5. It takes about 60 seconds.
  6. Light pressure is applied to the area to prevent bruising.
  7. The skin marker marks are wiped off.

Botox dosage:

To decrease upper lip retraction in people by weakening the Levator Labii Superioris Alaeque Nasi muscle. Botox injection for gummy smile:

  • in females: 2-3 units per side
  • in males: 2-4 units per side


  • Slight bruising can occur, but can be concealed with make-up. It resolves in a few days.
  • The effect will kick in after 3-10 days and last between 2 and 7 months, depending on the Botox dosage used and the patients physiology. Some patients dissolve Botox faster than other patients.
  • First time patients will sometimes be requested to return after 2-3 weeks for a check-up and top-up if required.
  • Most patients have the injections repeated once or twice a year.
  • Download the LK Aesthetics Botox Aftercare Factsheet here