Botox® For Gummy Smile

In a smile most people would describe as balanced, only small triangles of gum show between the teeth. A gummy smile is when the upper lip rises high enough to expose a band of gum above them, and patients who have it are usually acutely aware of it, often to the point of learning to smile with a closed mouth in photographs.

The cause is frequently muscular. The muscles that lift the upper lip are simply stronger or shorter than average, and they pull it higher than the smile requires.

Sam Assassa, MD is a member of the American Academy of Aesthetic Medicine and the American Academy of Anti-Aging Medicine and has practiced non-surgical facial aesthetics in Los Angeles since 1995. He is board certified in Internal Medicine and has performed more than 25,000 aesthetic procedures.

“A gummy smile is usually two or three units and thirty seconds of work. The reason people live with it for twenty years is that nobody ever told them it was fixable without surgery.” — Sam Assassa, MD

Why Gummy Smiles Happen

Three causes produce a similar appearance and they are not treated the same way.

Overactive lip elevator muscles. The muscles lifting the upper lip contract more forcefully than average, raising the lip too high during a smile. This is the most common cause and the one that responds to Botox®.

A short upper lip. Where the lip itself is anatomically short, there is less tissue to cover the gum regardless of muscle activity. Botox® helps only marginally here.

Excessive gum tissue or dental proportion. Where the gums extend further down the teeth than usual, or the teeth are short relative to the gums, the issue is dental and a periodontist or dentist is the appropriate referral.

Many patients have a combination, and examination establishes the dominant cause before treatment.

How Botox® Treats a Gummy Smile

A very small amount is placed into the muscles responsible for lifting the upper lip, usually near the base of the nose. Relaxing them reduces how high the lip travels during a smile, so less gum is exposed while the smile itself remains natural.

The dose is tiny, often only a few units per side. This is one of the treatments where the margin between an excellent result and a visible problem is smallest, since these muscles also participate in normal speech and expression.

Please note: treatment of a gummy smile is an off-label application. These products carry FDA approval for indications that do not include the perioral region. Off-label use is legal, common in aesthetic practice, and discussed at your consultation.

What to Expect

Treatment takes only a few minutes. The effect develops over three to seven days and is fullest at about two weeks. Results generally last three to four months.

There is no downtime, though mild swelling or bruising near the nose is possible. Most patients return to normal activity immediately.

Because dosing here is so small and the muscles so specific, treatment is generally started conservatively with a review at two weeks and adjusted upward if the change is insufficient.

Risks and Safety

The muscles treated participate in normal expression, so overtreatment produces recognisable problems: an asymmetric or flattened smile, difficulty with certain sounds, or an upper lip that appears heavy or elongated. These resolve as the effect wears off, over several weeks.

Asymmetry can occur if the two sides respond differently and is usually correctable with a small adjustment at follow up. Common effects include mild swelling, bruising, and tenderness at the injection sites.

The reason to be selective about who performs this is straightforward: the treatment involves a few units in a very specific location, and the consequences of getting the location wrong are visible every time you smile for the next several weeks.

Individual results vary and no outcome can be guaranteed.

Frequently Asked Questions About Botox® for Gummy Smile

How long does gummy smile treatment last?

Three to four months, consistent with Botox® elsewhere, though sometimes slightly shorter because the muscles around the mouth are highly active. Many patients find that after several rounds the interval lengthens, since repeatedly treated muscles gradually weaken. Most settle into treatment three times a year.

Will it change my smile?

The intent is to change how high your lip lifts, not the character of your smile, and at correct dosing that is what happens. Overtreatment is a different matter and can flatten the smile or make it asymmetric, which is why the dose is small and conservative to start. If you have had this treated elsewhere and disliked the result, describing what happened is useful, because it usually points to exactly what to avoid.

Does Botox® work for every gummy smile?

No, and this is worth establishing before booking. It works well where the cause is overactive lip elevator muscles, which is the most common cause. Where the upper lip is anatomically short, the improvement is limited. Where the issue is excessive gum tissue or the proportion of the teeth, it is a dental matter and a periodontist or dentist is the right referral. Examination determines which applies to you.

How much Botox® does a gummy smile need?

Very little, often only a few units per side, which makes it one of the least expensive injectable treatments available. The small dose is not a cost-saving measure, it is a clinical requirement, since these muscles are involved in normal speech and expression and overtreating them produces visible problems for weeks.

Is there an alternative to Botox® for a gummy smile?

Yes, depending on the cause. Surgical lip repositioning shortens how far the lip can rise and is permanent. Where the cause is dental, gum contouring or orthodontic treatment may be appropriate. Botox® is the least invasive option and is reversible in the sense that it wears off, which makes it a reasonable way to see whether you like the change before considering anything permanent.

How much does gummy smile treatment cost in Beverly Hills?

Among the least expensive treatments offered, given how few units are required. Pricing is confirmed at consultation and current figures are on the fees page. Several payment options are available.

Why Patients Choose Beverly Hills Aesthetics

• Cause Established First: Muscular, anatomical, and dental causes distinguished before treatment.
• Minimal Dosing: A few units by design, since this is where precision matters most.
• Physician Performed: Dr. Assassa places every treatment himself.
• Conservative With Review: Started low and adjusted at two weeks rather than dosed to maximum.
• Honest Referral: Patients whose cause is dental are directed to the right specialist.

Schedule a Gummy Smile Consultation in Beverly Hills

If you have been smiling with your mouth closed in photographs for years, this is frequently a few units and a few minutes. Dr. Assassa will establish whether your cause is muscular and tell you plainly if it is not. Beverly Hills Aesthetics serves patients from Beverly Hills, Los Angeles, West Hollywood, and Century City. Request a consultation or schedule your appointment online.

BEFORE & AFTER

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