Draper and Lehi, Utah
Three causes, one gummy smile, and only one of them is muscle
A gummy smile can come from a lip that travels too far up, from teeth that are short, or from the length of your upper jaw. In a photograph they look much the same. Only the first one answers to neurotoxin, so the first job is working out which one you have.
So which one do you have
- Muscular. Your upper lip travels a long distance upward when you smile fully. This is the one I can treat, and a very small dose can make a marked difference.
- Dental. Your teeth are short relative to the gum, often because of how they erupted or because of wear. The lip is behaving itself. That is an orthodontic or restorative conversation, not mine.
- Skeletal. Your upper jaw is long, so gum shows whatever the lip does. Surgical territory, which means you get a referral from me rather than a treatment.
- Mixed. Common. A muscular component sitting on top of a dental one can still be worth softening, as long as we are both clear that it is a partial answer rather than a fix. Individual results vary.
Why the dose is small
The margin here is a couple of millimeters
The muscles that lift your upper lip sit close together and close to the surface, and they do not only produce the gum show. They shape your smile too. Relax them slightly and the lip comes down. Relax them too much and you get a smile that looks stiff on one side, or an upper lip that reads as long and flat.
Both of those wear off on their own, which is the saving grace, and both are entirely avoidable. Treat conservatively, look again at two weeks, and stop trying to finish the whole thing in one visit.
Related: the lip flipRead first
Before you book
Your first Botox appointment, start to finish
What happens in the room, what it feels like, and the one thing a good injector does before drawing anything up.
How many units of Botox do I need?
Typical ranges by area, why two people with the same lines can need very different doses, and how to verify what you actually received.
Does Botox hurt?
Brief and minor for most people, but not identical everywhere on the face. Here is what differs and what reduces it.
Straight answers
Gummy smile questions I get asked
Does Botox fix a gummy smile?
It fixes one of the three causes. If the reason is a strong upper lip elevator pulling your lip too far up when you smile, then relaxing that muscle lowers the lip and the gum show reduces. If the reason is the length of your teeth or the position of your jaw, no dose of neurotoxin changes either. Individual results vary.
How do I know which cause I have?
By being watched while you smile, not by being looked at with your face still. A muscular cause shows as a lip that travels a long way upward. A dental or skeletal cause shows as gum visible in proportion to short teeth or a long upper jaw. The assessment takes thirty seconds and it decides whether this treatment is worth doing at all.
How many units does it take?
Very few, and this is an area where precision matters far more than quantity. A unit or two too much, or a couple of millimeters off, gives you an uneven smile or a flattened upper lip for as long as it lasts.
What are the risks?
An asymmetric smile and a heavy or elongated upper lip are the two to know about. Both are temporary and both come down to dose and placement, which is exactly why I start conservatively rather than chase a full correction on the first visit.
How long does it last?
Generally shorter than upper face treatment, because these muscles are small and you use them constantly. Three months is optimistic for a lot of people.
Will you tell me if I am not a candidate?
Yes. A meaningful share of gummy smiles are dental or skeletal, and in those cases the right answer is a referral to an orthodontist or an oral surgeon. Being sold neurotoxin for a problem it cannot reach is the worst outcome available here, and I would rather not be the person who does that to you.