Smile Confidently: Botox for Gummy Smile Correction

A smile should light up a room, not make you self-conscious. When more gum than tooth shows with each grin, many people learn to smile with their lips pressed together, crop photos above the mouth, or dodge laughter in public. I see this often in practice, from brides-to-be to executives who live on camera. They come in asking for options that are subtle, quick, and reversible. For many of them, carefully placed botox injections can be the difference between hiding and smiling without a second thought.

Gummy smile, sometimes called excessive gingival display, has more than one root cause. That is why the best outcomes start with a proper diagnosis and a treatment plan that respects facial balance. Botox cosmetic injections can help when the elevator muscles of the upper lip are the main culprits, lifting the lip too far and exposing a band of gum. With experience and restraint, a provider can dial those muscles down just enough so your lip rests in a more flattering position, while your expression stays lively and natural.
What a “gummy smile” really means
Dentists and facial aesthetic specialists generally define a gummy smile as 3 to 4 millimeters or more of gingival display above the upper front teeth when smiling. Some patients have 2 millimeters and feel bothered, others show 5 and barely notice. Perception matters. Beauty norms vary by culture and face shape, so the goal is not a measured number, but harmony between teeth, gums, and lips.

The drivers fall into a few categories. There can be vertical maxillary excess, where the upper jaw sits lower and contributes to a longer midface and more gum exposure. Sometimes the upper lip is thin or short and simply lifts higher than average. Often the lip elevator muscles, particularly the levator labii superioris alaeque nasi, levator labii superioris, and zygomaticus minor, are hyperactive. Tooth size and position, delayed passive eruption, and gingival overgrowth from medications can add to the picture. These tend to overlap, which is why one-size advice misses the mark.

In real terms, here is how that looks in clinic. A young professional in her late twenties, no orthodontic history, healthy gums, but a short, strong upper lip that flips up dramatically when she laughs. Another patient in his thirties with long midface proportions from a skeletal pattern, mild gum inflammation, and a wide smile. A third, post-braces, with excessive gum cover on the teeth due to delayed passive eruption. Each of these cases can present with similar photos, yet the right treatment differs.
How botox adjusts the smile mechanics
Botox cosmetic is a purified neuromodulator used for targeted muscle relaxation. In the context of a gummy smile, the goal is not paralysis. It is to soften the upward pull of the lip elevators so the upper lip lands a few millimeters lower at peak smile. Because these muscles fan out from the sides of the nose and upper cheek, small doses can produce a large visual change. The artistry lies in where, how deep, and how much.

The most common approach focuses on the Yonsei point, a soft-tissue landmark that influences the levator labii superioris alaeque nasi complex. Many providers also affect the levator labii superioris and zygomaticus minor laterally for broader smiles. In practical terms, this means two to six microinjections per side with a very fine needle, placed with the patient smiling so the provider can map the precise vectors of pull. The aim is symmetry, lift preservation, and natural movement when speaking.

Results are not immediate. Early effects begin around day three, soften further by day seven, and reach a stable peak near two weeks. At that point, a careful assessment guides any micro touch-up if needed. Expect the effect to last 8 to 12 weeks for this indication, sometimes stretching to 14 weeks if the dose is optimized and facial activity is average. Because gummy smile dosing is conservative, most patients notice a gentle fade around the two-month mark and book their next botox appointment at 10 to 12 weeks to maintain the result.
Who is a good candidate, and who should consider alternatives
Botox for gummy smile works best when the primary issue is hyperactive elevator muscles with otherwise proportionate teeth and gums. Good candidates often describe a smile that looks normal at rest but jumps higher than they like when they laugh or pose for photos. They want a reversible, non surgical treatment that can be fine-tuned over time.

If you have significant vertical maxillary excess, severely short upper lip anatomy, or gummy exposure driven mostly by dental eruption patterns, botox can still help, but it may act as a bridge rather than a full solution. In those cases, pairing botox with dental crown lengthening, orthodontics, or, in rare instances, orthognathic surgery produces more complete symmetry. People with active gum disease, untreated bruxism that destabilizes bite, or unrealistic expectations should start with dental health and a full smile analysis before thinking about botox.

I also pay attention to speech, lip function, and dryness. Over-relaxation of the upper lip can slightly change the way you pronounce labial sounds, or increase tooth exposure at rest if the lip becomes too lax. This is preventable with tempered dosing and a conservative first session, especially for a first-time patient.
Visit flow, from consultation to results
The first botox consultation feels part orthodontic, part dermatology. I photograph at rest, half-smile, peak smile, and with various phonetics like “Eee” and “Pee,” because the lip behaves differently with different movements. We measure gingival display to the millimeter at the central incisors and canines. I ask what level of change would feel right. A patient might say, take it down by half. Another might say, just a whisper less gum.

Treatment planning covers dose and placement. Typical starting doses for gummy smile correction range from 2 to 4 units per injection point, with a total between 6 and 12 units per side in many practices, though exact numbers vary by product and patient. For narrow smiles, two core points near the alar base may suffice. Wider smiles often benefit from additional points laterally to keep the arc smooth. I would rather under-treat on day one and add a micro touch-up at two weeks than overshoot and ask you to wait out the effect.

The actual botox procedure takes less than 10 minutes. After cleaning the skin, I ask you to smile so I can see the vectors, then relax. The needle is thin. Stings are brief. Pressure and icing help prevent bruising. You sit for a few minutes while we review aftercare, schedule a check-in, and take a quick post-procedure photo for your botox before and after record.
Aftercare that actually matters
Most aftercare advice is common sense. Do not rub or massage the treated area for the rest of the day. Skip hot yoga, vigorous workouts, or saunas for 24 hours. Keep your head elevated for a few hours after the botox session. Gentle facial expressions are fine, but avoid exaggerated lip movements for the first day. Makeup can go on after several hours if the skin looks calm.

Bruises are uncommon but possible, and small bumps at injection sites usually settle within an hour. A mild headache can occur. If you feel a heavy nose or a strange tightness when smiling over the first week, that usually reflects muscle adjustment and improves as the brain recalibrates your smile pattern. True complications are rare when dosing and placement are correct.
Safety profile and side effects, explained plainly
Botox has been used medically for decades, in doses far beyond aesthetic applications. In the face, small amounts are placed superficially with a track record that is reassuring when a trained provider administers it. For gummy smile correction, the main risks are aesthetic rather than medical. Overcorrection can drop the lip too far, reducing tooth show and altering articulation. Asymmetry can happen if one side’s muscles are stronger or if the needle placement is off by a few millimeters. A slight smile stiffness is possible in the first week.

On the medical side, minor bruising and swelling are the most frequent issues. Infection is very rare with clean technique. Allergy to the product is exceptionally uncommon. If you are pregnant, trying to conceive, or breastfeeding, delay treatment. If you have a neuromuscular disorder or are taking certain antibiotics that affect neuromuscular transmission, disclose it during your botox consultation so the plan can be tailored or postponed.

The best safety filter is conservative dosing with a provider who performs this indication routinely. When in doubt, start lighter, reassess at two weeks, and layer in a small touch-up if the gum show still feels high.
How results look and feel in real life
Most patients notice something subtle by day three, like needing to smile a fraction harder to see the same gum line. By day seven the arc smooths out, with 2 to 3 millimeters less gingiva visible at peak smile being a common range. Friends seldom identify the change unless you point it out. Photos look more balanced. People often report that their top lip feels a bit calmer, not tense or jumpy.

By the second or third botox maintenance treatment, many patients find we can reduce the dose slightly while keeping the same effect. Muscle memory adapts. On the other hand, very expressive speakers, fitness instructors, and performers who live in big smiles may metabolize the effect faster, closer to eight weeks. Planning your botox injection appointment around life events helps, as the peak window sits between two and eight weeks after treatment for most.
Botox versus other options for gummy smile
You have choices, and knowing when to pick which tool is worth a frank discussion.

Botox injections: Best for hyperactive lip elevators. Fast, non invasive, reversible, minimal downtime. Needs maintenance every two to three months for this specific indication. Cost per session varies by city and provider, commonly ranging from a few hundred dollars upward based on units used.

Lip flip with botox: A related technique that relaxes the orbicularis oris to evert the upper lip slightly. It can pair with gummy smile treatment when the upper lip is thin, improving tooth-to-lip balance. Longevity is similar or slightly shorter than elevator-targeted injections.

Hyaluronic acid fillers: When the upper lip lacks volume, a subtle filler can improve vertical height and reduce gum display at rest. Filler does not address hyperactive elevators directly, so pairing with botox often gives the most control. Longevity is typically 6 to 12 months.

Gingivectomy or crown lengthening: A dental solution when short clinical crowns are the main issue. By reshaping gum tissue, and sometimes minor bone, more tooth is revealed. This changes the tooth-to-gum ratio permanently. Healing takes one to two weeks.

Orthognathic surgery: Reserved for pronounced vertical maxillary excess with functional bite considerations. This is a major procedure with significant recovery, but it can transform proportion in a way no injectable can. Most people with mild to moderate gummy smiles do not need this route.

In practice, treatment often stacks. For instance, a patient might undergo crown lengthening to address tooth proportions, then add botox aesthetic injections to tame upper lip lift and refine the smile arc. Another might choose low-dose botox now, with the option to consider a more definitive dental procedure later.
The injection map, and why millimeters matter
There is a temptation to share a universal diagram. Real faces botox near me https://www.google.com/maps?cid=7490178029278224225 push back on that idea. The elevator muscles run obliquely and vary by individual. What does stay consistent is the principle: start at the paramedian points near the base of the nose where the levator labii superioris alaeque nasi concentrates, then evaluate lateral pull. When a patient has a wide, high smile, adding small deposits along the path of the levator labii superioris and zygomaticus minor near the mid-cheek helps keep the smile line even. When the central gum exposure is dominant but lateral exposure is mild, stay central and lighten the dose.

Depth is shallow to mid-dermal in thin patients and slightly deeper in those with thicker tissue. Angle and injection volume matter as much as units. I routinely have patients alternate between gentle and full smiles during mapping so we can see exactly how the upper lip skates over the teeth. These small choices separate a natural result from a flat, frozen one.
Costs, value, and maintenance planning
Botox price can be quoted per unit or per area. For gummy smile correction, per-area pricing is common since total units are lower than for foreheads or masseter slimming. In most urban markets, expect botox cost for gummy smile to sit in the lower to mid hundreds per session, shifting with the provider’s expertise and clinic overhead. Deals and packages exist, but reliability and precision matter more here than a discount. A mis-placed injection near the alar base can alter your smile for weeks. This is the wrong place to chase the lowest number.

Think of the first two sessions as calibration. We find the dose and pattern your face loves, document the botox results, and adjust. Once stable, you can space maintenance injections strategically. Some patients pair gummy smile touch-ups with botox for frown lines or botox for crow’s feet to consolidate visits. If you are also exploring botox for forehead, for migraine, or for TMJ and bruxism in the masseter, coordinate with your provider to balance total dose and timing.
Setting expectations for first-time patients
First-timers often ask what they will feel and how much the smile will change. The honest answer is that you will notice a sensation of ease in the upper lip more than a heavy feeling. The gum line will drop modestly, not dramatically, if we have done our job correctly. Plan for a two-week follow-up, whether in person or virtual with photos. If an edge sits a hair higher than the other, a tiny touch-up with one or two units can even it out.

Photographs help. We take consistent lighting and angles for your botox before and after series. Reviewing those side by side not only confirms symmetry and dose, it builds your confidence. Many people underestimate the improvement because they adapt quickly to the new normal. The photos remind you of where you started and guide future botox maintenance injections.
Common questions I hear, answered without fluff
Will botox make my smile look fake? When placed and dosed correctly for a gummy smile, no. You should still raise your cheeks and show your teeth. The change is measured in millimeters of gum show, not in expression.

How long do results last? Expect 8 to 12 weeks for this indication, with some variability. Smaller muscles tend to recover faster than larger ones like the masseter.

Can this help lip lines or smile lines too? It can, indirectly. If your upper lip relaxes and does not flip as far, vertical lip lines may crease less. If you are bothered by fine lines around the mouth or bunny lines on the nose, those can be addressed in the same botox session with separate microinjections.

What if I don’t like it? One advantage of botox face treatment is reversibility over time. The effect will fade gradually. We can use less at your next visit, adjust placement, or skip treatment.

Is there downtime? Most people go back to work the same day. If you bruise, light concealer covers it well after a few hours.
The role of experience and restraint
Botox for gummy smile looks simple on video. In practice, it asks for judgment. I have met patients who were over-treated elsewhere and came in anxious, upper lips too still, smiles dulled. Each of them improved with time and corrected dosing. The lesson is the same across botox aesthetic treatment areas: small muscles around the mouth govern identity and speech. Respect them.

Restraint also means knowing when to say no or not yet. If I see inflamed gums or a bite that is flaring from bruxism, botox for bruxism or a dental guard might come first. If the lip is very thin and the patient wants more tooth show at rest, a minimal hyaluronic acid filler or a botox lip flip may complement the plan. If vertical maxillary excess dominates, a consult with an orthodontist or maxillofacial surgeon sets expectations. Patients appreciate honesty and a map, even if the first step is not an injection.
Where this fits within broader facial aesthetics
Many people first meet neuromodulators through botox for wrinkles on the forehead, frown lines, or crow’s feet. Gummy smile correction sits in a different category. It does not chase wrinkles, it rebalances movement. That is closer to botox for masseter in jaw slimming and botox for eyebrow lift, where we nudge vectors rather than erase lines. Because of that, results hinge on muscle mapping more than unit count.

A well-designed plan supports the rest of your face. If you have prominent nasolabial folds, sometimes they soften a touch once the upper lip stops jumping so high. If you are exploring botox for under eyes or for neck lines, sequencing matters so muscles that coordinate expressions are tweaked in harmony. This is where having a single provider manage your botox cosmetic care helps, as they can see the full picture and time each botox session accordingly.
A short, practical checklist before you book Look for a botox specialist with documented gummy smile cases, not just general botox cosmetic services. Ask how they assess candidates. The answer should mention measurements, photos, and muscle mapping. Start with conservative dosing and plan a two-week check-in for fine-tuning. Time your botox appointment two to four weeks ahead of events for peak results. Budget for maintenance, and consider pairing with dental or lip treatments if anatomy calls for it. What success looks like
Success is not a stranger stopping you to ask if you had work done. It is you laughing freely in a candid photo, no reflex to cover your mouth. It is a videoconference where you focus on the conversation, not the camera preview. It is smiling wide without a mental calculation about gum show. That confidence has a way of bleeding into everything else, which is why gummy smile correction, though a small technical tweak, can feel outsized in impact.

When botox is part of the plan, expect subtlety, safety, and predictability. Choose a provider who treats the gummy smile as an expression pattern, not a dot on a map. Expect a thoughtful start, small adjustments, and results that respect your face. If later you want to fold in other goals, from botox for chin dimpling to light filler to balance the lip, you will already have a trusted partner who knows how your muscles behave.

A balanced smile is not about perfection. It is about proportion and ease. If that sounds like what you are after, a careful botox treatment could be your simplest step toward smiling the way you feel.