Botox for a Gummy Smile: A Confident, Balanced Grin

A smile that shows more gum than you would like can feel distracting in photos and in conversation. Many people learn to suppress their smile or tilt their chin downward, which steals warmth from their face. When I first began treating gummy smiles, what struck me was how often clients thought their teeth were the problem. In many cases, the teeth were beautiful. The issue sat higher, in the upper lip and the muscles that lift it. Small doses of Botox can relax those overactive elevators, letting more lip drape over the gums and revealing a more balanced grin without altering who you are.

This is a targeted use of a medication better known for forehead lines and crow’s feet, but the principle is the same. Botulinum toxin type A softens muscle activity. In the upper lip, that translates to less lift when you smile. The art lies in using just enough to lower gum show without flattening expression. Done well, the result looks natural, not frozen. You still smile widely, the lip just doesn’t spring upward as far.

What causes a gummy smile

“Gummy smile” is a descriptive term, not a diagnosis. Most people mean that 3 millimeters or more of gum shows above the top teeth during a full smile. Several anatomical patterns can lead to that look. Some are dental or skeletal, some are muscular. Sorting this out during a Botox consultation sets expectations and steers the plan.

The most common muscular driver is hyperactivity of the levator labii superioris alaeque nasi, levator labii superioris, and zygomaticus minor. These are the muscles that pull the upper lip and the corners of the mouth upward. In a hyperdynamic smile, they yank harder and higher than average. If the teeth are average length and the jaw alignment is normal, easing those muscles can be enough to transform the smile.

Other contributors include short or worn teeth, a short or thin upper lip, vertical maxillary excess where the upper jaw is longer vertically, and altered passive eruption in which gums cover more tooth than usual. These cases can still benefit from Botox, but the effect might be modest or serve as a trial before longer term options like gum contouring, crown lengthening, lip lift, veneers, or orthognathic surgery. Honest conversations about the root cause help avoid overpromising.

Where Botox fits, and where it doesn’t

Botox treatment for a gummy smile is best for people whose gum show increases dramatically when they grin, especially at the sides of the nose and above the central incisors. When I see that “snap” upward of the lip in slow motion videos, I know small, well-placed injections can soften it. If the gums show even at rest, or the upper lip is very short, toxin alone will not lower the lip enough. If the bite is open or the upper jaw sits forward and long, dental or surgical care might be more appropriate.

Why choose Botox? It is quick, reversible, and adjustable. The dose can be titrated over a couple of visits to find your sweet spot. It is also a useful diagnostic step. If Botox gives a pleasing change, you can continue with maintenance. If you love the concept but want longer term change, this trial can guide a referral to periodontal or surgical colleagues and clarify the level of correction you prefer.

How the procedure actually works

Most gummy smile protocols target the “Yonsei point” or modified versions of it, which sit near where the levator labii superioris alaeque nasi originates along the side of the nose. In practice, that means one to four tiny injection sites per side, depending on how the lip moves. For central gum show, I focus closer to the nose. For lateral exposure, I shift slightly outward. Men’s heavier muscle mass can require a touch more than women, but doses remain small.

An appointment usually takes 15 to 20 minutes. The botox injections themselves last seconds. I use a fine insulin syringe and let the skin cool with an ice pack before the first prick. You will feel a pinch and a small pressure. Most people rate it a two or three out of ten. There is no need for numbing cream. I have clients smile and relax repeatedly so I can watch the vectors the lip takes. That dynamic mapping matters more than dots on a template.

Because gummy smile dosing is light, I prefer to start conservatively and bring people back at two weeks for a touch up. Small adjustments, even one or two units per point, can be the difference between a perfect smile lift and a smile that feels a bit restrained. It is always easier to add than to subtract.

What to expect after treatment

You can drive yourself home, go back to work, and eat as usual. The immediate aftermath is unremarkable: a few tiny bumps that settle within an hour and, occasionally, a small bruise that can be covered with concealer. I advise avoiding strenuous exercise, upside down yoga, or deep facial massage for the rest of the day. These aren’t strict bans, but they stack the deck in favor of clean diffusion.

Botox effects unfold in stages. Around day three, many people notice a subtle shift in how their smile feels. By day seven to fourteen, the lip no longer vaults upward. Friends may comment that you look refreshed without being able to pinpoint why. Photos reveal the most, especially side-by-sides that capture a full laugh. If you seek botox before and after comparisons, try to video yourself smiling at baseline and at two weeks with the same lighting and angle.

As with any botox aesthetic treatment, the body slowly metabolizes the protein. For the upper lip elevators, botox duration typically spans eight to twelve weeks before the full power returns, although I have seen the effect persist closer to three or four months in some clients. The range depends on your metabolism, dose, and muscle strength. If you are new to Botox for gummy smile, expect to refine timing over the first one or two cycles.

The right dose is a conversation

There is no one-size dose, and articles that suggest a fixed “4 units per side” often ignore how individual lips move. In my chair, I have careful talk about priorities. Some people want a barely-there tweak, others want a dramatic reduction in gum show. For the careful tweak, we might start with two to three units per side. For a larger change, four to six units per side divided over one or two points can make sense. Rarely do I exceed that for this indication, because higher amounts risk a stiff or heavy smile.

The idea mirrors baby botox, micro botox, and mini botox used elsewhere in the face: small aliquots that preserve natural motion. The more animated your expressions, the more you benefit from subtler dosing. If you are a performer or speak for a living, we lean conservative for the first round and evaluate.

Pairing with other areas

Gummy smile treatment often plays well with other upper face work. If your brows descend with age and you enjoy a subtle botox eyebrow lift, we plan the timing so that the overall expression stays harmonious. If you already have botox for forehead lines or botox for frown lines in the glabella, those patterns influence how the midface reads when you smile. I am careful not to stack treatments that might collectively blunt your expressiveness.

Some clients also address bunny lines at the sides of the nose in the same visit. If we soften those with a couple of units while we treat the gummy smile, the nose crinkles less and the lip lifts less. That combination can refine the central smile in a way that feels polished but not overdone.

Safety, side effects, and the risks that matter

Botox safety is strong when used properly. The medication itself has been studied for decades and used for both cosmetic and medical uses, from migraine treatment to jaw clenching and hyperhidrosis. The difference with gummy smile is proximity to areas that shape speech and eating, so precision matters.

Expected short-term effects include mild tenderness, faint redness, and small bruises. Less common side effects include asymmetry, a smile that feels slightly weak or heavy, or a small dip at the upper lip’s center. These are dose and placement related and usually improve as the botox wears off. True complications, such as spread that significantly affects speech or chewing, are rare at the doses used here. If you have a public event within a week, schedule your botox appointment earlier to allow for adjustments.

If you have neuromuscular disorders or are pregnant or breastfeeding, we do not treat. If you take medications that increase bruising, such as high-dose fish oil, NSAIDs, or certain supplements, be prepared for small marks. I suggest pausing nonessential blood-thinning supplements for several days before your visit, with your physician’s approval.

Comparing Botox to other gummy smile options

Gummy smile is one of those concerns with a wide spectrum of solutions. Botox sits near the low-risk, reversible end. Dental reshaping and gum contouring can add visible tooth length, which reduces gum show in a lasting way when tooth anatomy allows. A lip lift shortens the distance from the base of the nose to the vermilion, but can increase tooth show at rest and is permanent. Orthognathic surgery changes the skeleton and is reserved for significant jaw discrepancies. Fillers can sometimes thicken the upper lip and reduce gum exposure, though I use them cautiously above the lip to avoid heaviness.

Botox vs fillers is a frequent question. Botox reduces motion. Fillers add structure. For gummy smiles driven by strong elevators, botox benefits most people and avoids extra bulk in the philtrum. For thin lips with no gum show problem, fillers or a lip flip approach can improve contour. The botox lip flip shares technique with gummy smile treatment but uses even smaller doses along the vermilion border to evert the lip slightly. It is not a substitute for volume, just a way to showcase what you have.

How much it costs, and how to think about price

Botox cost varies by city, injector experience, and the practice model. Two pricing styles are common. Per unit pricing ranges from about 10 to 25 dollars per unit in many North American markets. Per area pricing for a gummy smile often lands in the 150 to 400 dollar range given the small number of units involved. If you see a botox price that seems too good to be true, ask about product authenticity and dilution. Counterfeit or over-diluted toxin is not a bargain.

You also pay for judgment. The best outcomes usually come from providers who do a high volume of facial injections and understand how tiny changes ripple across expression. Photos and a clear botox review from patients with similar concerns can help you choose. Avoid clinics that push large, fixed doses for every face. A careful eye and a light hand give a more natural look and better botox results.

Maintenance, touch ups, and the rhythm of care

Botox longevity for gummy smile is shorter than for heavier areas like the masseter or for neck bands. Expect two to four months between visits for most people. If you are fine letting the effect fade between busy seasons, plan around events or photo shoots. If you prefer steady control, schedule botox maintenance at 10 to 12 week intervals and adjust as needed. The timing that fits your life is the right timing.

A touch up at two weeks is standard practice for precision areas. The upper lip is small, and even a half unit can change the look. If one side lifts higher than the other, or your laugh feels slightly off, a micro adjustment corrects it. Keep communication open. Tell your provider what you notice at home in real life, not just what a mirror shows in clinic lighting.

What a natural result looks like

The phrase botox natural look gets tossed around, but in the context of a gummy smile, it is easy to define. You still reach a full, joyful smile. The lips meet the teeth in a balanced way. Your upper lip’s shape remains yours, with the Cupid’s bow intact and the corners lifting with ease. You do not see “moustache stiffness” or a blank space between your nose and lip.

I often spot this balance in candid laughter. The eyes engage, the cheeks lift, and the lip holds steady just below the gumline. For some clients, this shift makes the face look subtly younger. Not because of wrinkle removal, but because the botox near me smile reads relaxed rather than strained. That is botox facial rejuvenation by way of proportion.

If you are considering your first treatment

If you are new to toxin, keep the plan simple. At the first time botox visit, focus on the gummy smile alone, especially if you also want botox for forehead lines or botox for frown lines. Trying to correct too many areas at once can blur what worked and what did not. Bring photos of your smile. If you have a favorite picture where you like how your mouth looks, it helps me aim.

At the botox consultation, expect a functional exam. I will have you speak, smile gently, then laugh hard, and sometimes whistle or say specific words. That reveals how the lip behaves in motion and where the strongest pull originates. We will discuss trade-offs. Less gum show is the goal, but not at the cost of stiff enunciation if you rely on crisp consonants for work. Most people adapt easily, although the first week can feel a little different as the upper lip recalibrates.

Aftercare that actually matters

A lot of aftercare folklore gets repeated. What matters most is light and common sense. Skip heavy workouts, saunas, and deep face rubbing that day. Sleep as you like. Do not press or knead the treated points. If you see a small bruise, cold compresses help in the first hours. If bruising appears the next day, warm compresses can speed resolution. Makeup is fine after any pinprick closes, usually within minutes.

The rest is patience. Resist judging the result at day two. The botox effects are not mature yet, which is why we schedule check-ins at day ten to fourteen, not day four.

How this intersects with other concerns

People who grind their teeth or clench the jaw often also ask about botox for masseter reduction. Treating the masseter can subtly slim the lower face and may shift how the smile reads overall. If you plan both, it is worth staggering the sessions by a week or two so you can feel each change on its own. For those with prominent neck bands that pull the mouth downward, botox for neck bands can lift the lower face’s energy, which pairs well with a softer upper lip. Again, balance is the theme.

Those who struggle with oily skin or large pores sometimes hear about botox facial or micro botox. These techniques address the superficial muscle fibers and sebaceous activity, not the gummy smile itself, but can refine skin texture on the nose and cheeks that frame your smile. Keep doses low and targeted to avoid flattening expression.

Questions I hear often

• Will it affect how I speak or eat? In the small doses used, most people notice zero impact on speech or eating beyond a brief period of awareness that the upper lip moves less. I advise practicing reading aloud on day three or four if you are on stage soon. Your brain adapts quickly.

• How long will it last? Expect eight to twelve weeks of peak effect, with soft return of movement after that. Some maintain results closer to three months. If you metabolize toxin quickly elsewhere, assume similar timing here.

• Can I combine this with a lip flip or filler? Yes, but choose sequence carefully. A light lip flip can enhance eversion and pair well with a gummy smile plan. Filler above the lip risks heaviness and should be used sparingly. If you want both, perform toxin first, reassess in two weeks, then add small filler amounts only if needed.

• What if I do not like it? The effect reverses as the botox wears off. You can also adjust at the two-week mark if the change is too strong. That is one reason I suggest gentle dosing at the first visit.

• Is it safe long term? There is no evidence that periodic, appropriate dosing in facial muscles causes harm. Muscles return to baseline function as the medication wears off. Some people notice that over several cycles, they can maintain the same look with slightly fewer units as habits shift.

Realistic expectations and edge cases

Two scenarios merit extra care. First, vertical maxillary excess. If more than 4 to 5 millimeters of gum shows with a relaxed half smile and the upper lip is short at rest, toxin can improve photographs but will not fix the proportion at rest. Discuss dental and surgical options too. Second, asymmetric smiles from previous dental work, facial nerve history, or scar tissue. These are absolutely treatable, but mapping and follow up become even more important. Sometimes micro doses in three or four points per side are necessary to balance the smile without creating new asymmetries.

Another edge case is very thin lips. Botox cannot add fullness. It can reduce the upward pull, which may make the lip look slightly longer, but if your priority is more vertical vermilion, you will likely be happier with a small filler treatment and a conservative lip flip.

A note on broader Botox use

Many clients arrive after hearing about botox for wrinkles and decide to tackle the gummy smile during the same season. Forehead lines, 11 lines in the glabella, and crow’s feet respond well to standard dosing patterns. These areas tend to last longer than the upper lip. If you want a synchronized refresh, plan the gummy smile a week or two later so the check-ins do not collide. If you are interested in preventative botox for early aging prevention, gummy smile corrections can be part of that plan without committing to high dosing elsewhere. The watchwords remain subtle results and smooth integration with your natural motion.

The value of measured change

The best cosmetic work fades into your identity. People who know you well should see you as rested and confident, not “post procedure.” When gummy smile treatment hits the mark, the first feedback you hear is often that you look happy in photos. Not that you look like you had work done. That tells me the dose, placement, and your own muscle patterns met in a good place.

If you are considering it, take control of the variables you can. Choose an injector who understands smile dynamics, not just static anatomy. Share what bothers you most and what you want to preserve. Start conservatively. Use honest before and after photos, in similar lighting and with authentic expressions, to guide tweaks. And give it a couple of cycles. The second round is typically the most dialed in, because we build on real data from your face, not from averages.

A quick pre-visit checklist

• Capture a natural laugh photo or video in good light.
• Pause nonessential blood-thinning supplements after clearing with your doctor.
• Schedule your session at least two weeks before important events.
• Plan light activity the day of treatment.
• Set a two-week follow up for review and touch up.

The bottom line

A gummy smile is not a flaw, just a proportion that can be tuned. With careful, low-dose botox injections placed at the right points, you can lower gum show and keep all the spontaneity of your expression. The botox procedure is brief, the downtime minimal, and the adjustments reversible. Success looks like you, just a little more at ease with your grin. If that is your goal, a thoughtful consultation is the best next step.