A smile should look effortless. When the upper lip lifts too high and reveals more gum than tooth, many people feel self-conscious. Dentists call it excessive gingival display. Patients call it a gummy smile. As a clinician who treats facial aesthetics and bite-related issues, I see a spectrum of causes, from overactive lip elevator muscles to vertical maxillary excess and altered tooth eruption. Not everyone wants surgery or orthodontics. For a large group of people, Botox injections provide a predictable, conservative way to soften gum show and keep the smile looking natural.
This guide explains where Botox fits, how it works for gummy smile correction, and what results to expect. I will also share practical details from the treatment room, including dosage ranges, how to prepare, how long it lasts, and when Botox is not the right tool.
What makes a smile look “gummy”
Most smiles show 1 to 3 millimeters of gum above the top teeth. Once gum display pushes beyond 3 to 4 millimeters, it draws the eye upward and the smile can look unbalanced. Several factors can create that appearance, and they often overlap:
- Lip elevator muscle activity. The levator labii superioris, levator labii superioris alaeque nasi, zygomaticus minor, and depressor septi nasi can overpower the resting length of the upper lip and hike it high on smiling. This is the most common pattern that responds to cosmetic Botox. Lip length and mobility. A short upper lip at rest or a hypermobile lip that travels far on smiling can reveal more gum than tooth even when teeth and jaw structure are normal. Tooth and gum relationships. Delayed passive eruption keeps more gum covering the crowns of teeth. Even a normal lip can expose excess gum if tooth proportions are short. Skeletal factors. Vertical maxillary excess, a deep overbite, or a steep palatal plane can show more gum. These are structural issues, sometimes better treated with orthodontics or orthognathic surgery, though mild cases can still benefit from Botox therapy.
Understanding the root cause matters because it guides treatment. Informative post A careful exam can tell you whether cosmetic Botox injections alone will help or whether we should coordinate with a dentist or orthodontist for a more comprehensive plan.
Why Botox works for gummy smiles
Botox, or botulinum toxin type A, temporarily relaxes targeted muscles by blocking acetylcholine release at the neuromuscular junction. In the upper lip, small doses reduce the pull of the elevators when you smile. The lip still lifts, just not as aggressively, so the gum line stays lower and the teeth take center stage.
This is a classic example of facial botox used for balance rather than freeze. The goal is subtle botox, not a stiff look. When placed precisely, cosmetic botox injections address the muscles that over-lift without flattening the smile or muting expression.
The same principle explains why we use anti wrinkle botox for forehead wrinkles, botox crow feet, or a botox brow lift: targeted relaxation, natural movement preserved. For gummy smile, the “targets” are simply different.
Mapping the injection points
Technique determines outcome. Over the years I have settled on a few reliable patterns, adapting dose and location to anatomy:
- Yonsei point. This point lies where the levator labii superioris, levator labii superioris alaeque nasi, and zygomaticus minor converge, often about 1 centimeter lateral to the ala of the nose, slightly upward. A tiny dose here reduces the elevator complex without flattening the midface. Alar base/depressor septi area. When the nasal tip dips and the columella tethers on smiling, a micro-dose near the depressor septi nasi can help. This prevents an exaggerated upper-lip curl and nasal tip drop. Midline variations. For patients who show more gum centrally than laterally, a small additional unit near the philtral columns can even out the lift.
Needle placement and depth matter. A few millimeters too low and you risk diffusing into the orbicularis oris, which can affect articulation or straw usage for a few days. Too high and you might not reach the intended muscle bellies. This is why experience counts. An expert botox injections approach keeps doses low, concentrates product, and respects facial planes.
Typical dosage ranges and symmetry checks
Most first-time patients do best with a conservative starting dose. I usually start with 2 to 4 units per Yonsei point and 1 to 2 units at the depressor septi area if indicated, per side. That means a total of 4 to 8 units for both Yonsei points, sometimes plus 2 more units if the central dip is a problem. Some patients need as few as 2 to 4 units total. Others need 10 to 12 units to tame strong lift.
We calculate botox dosage based on muscle pull, lip length, and your aesthetic goal. Shorter lips and petite faces often need less. I assess symmetry at rest and in a full Duchenne smile, then photograph for reference. Photos help us adjust at a botox follow up if needed.
What the appointment is like
A botox appointment for gummy smile correction is brief. Plan around 15 to 25 minutes in the chair, including images and injection time. Most people schedule during a lunch break. After a botox consultation, we mark the injection points, cleanse the area, and apply a cool pack or a dab of topical anesthetic if you prefer. The injection itself is quick. You may feel a pinprick and a slight pressure. Many patients say botox shots around the nose tickle rather than hurt.
Expect minimal pinpoint redness for 10 to 20 minutes and possible tiny bruises that fade in a few days. Makeup can cover small marks. There is effectively no botox downtime beyond avoiding strenuous exercise, facials, or heavy rubbing for the first 4 to 6 hours.
How quickly you will see results
You will not leave the botox clinic with an instant change. Botox how it works involves gradual onset. Most patients notice early softening around day two or three. The full effect lands at day 10 to 14. This timing holds across other areas like botox forehead wrinkles, botox frown lines, and botox neck bands as well.
I ask first-time patients to return in two weeks. That botox touch up visit lets us fine-tune if the smile still lifts a touch too high or if the central area needs an extra unit. Small additions go a long way.
How long the results last
Botox duration varies with metabolism, dose, and muscle strength. For gummy smile correction, most people enjoy 8 to 12 weeks of ideal effect, with soft fade by three to four months. Lighter “baby botox” doses may wear off closer to 8 or 10 weeks. Using a few more units can push longevity further, but more product is not always better if it over-relaxes the smile. A personalized botox treatment plan aims for a natural look during the months that matter most to you, such as wedding season or professional photo sessions.
Patients often ask about repeat botox treatment. When you maintain results with a steady schedule, some find they can extend intervals after a year because the muscles learn a less forceful pattern. This is not guaranteed, but it is common with consistent botox maintenance treatment.
Safety profile and side effects to consider
In skilled hands, botox for gummy smile is a low-risk, minimally invasive botox procedure. The most common issues are minor:
- Small bruises or pinpoint swelling at injection sites. A day or two of mild tenderness. Slight asymmetry if one side absorbs differently, which is easily corrected at a botox follow up.
Less common but important to review: transient upper lip heaviness, difficulty with whistling or using a straw for a few days, or an overly flattened smile if the dose is too high or diffusion spreads to surrounding muscles. With careful placement and conservative dosing, we avoid these problems. In my practice, we treat conservatively for first-timers, reassess at two weeks, and add only what we need.
Medical contraindications include infection at the injection site, active neuromuscular disorders, and allergy to botulinum toxin components. Discuss pregnancy and breastfeeding with your provider, as cosmetic botox is typically deferred in those situations. If you are taking anticoagulants, you can still receive botox therapy with appropriate precautions, but bruising risk rises.
Botox safety has decades of data behind it, including beyond aesthetics. Medical botox is used for migraines, cervical dystonia, blepharospasm, and spasticity. In facial aesthetics, the safety profile is strong when the injector understands anatomy and dose. The key risks come from inexperience, poor hygiene, or counterfeit product. Choose a botox certified injector or a licensed botox physician who can verify the source of the product and is comfortable managing rare complications.
When Botox alone is not enough
Some gummy smiles are primarily skeletal or dental. When tooth crowns are short from altered eruption, a periodontist can perform a crown lengthening procedure to reveal appropriate tooth length. This often pairs beautifully with subtle botox. When the upper jaw is vertically long, orthodontics or orthognathic surgery might be the definitive correction. For a hypermobile but otherwise balanced smile, a small filler bolus to the upper lip can complement botox and add a tiny bit of lip length.
Think of botox as a reversible, adjustable tool. It is ideal for soft-tissue dominance and muscular overactivity. It is not a cure-all. A good botox provider will tell you when it makes sense and when another route will deliver more stable, long-term balance.
The art of looking natural
Over-relaxing the smile can dampen expressiveness. Patients worry about a “frozen” look, especially if they have seen heavy-handed results elsewhere. The botox alpharetta remedy is a conversation about goals and careful planning. I ask patients to show three smiles: polite, social, and full laugh. The dose must accommodate all three while keeping the upper lip from vaulting excessively. A slightly stronger lift laterally than centrally often looks the most natural. Photographs from the botox before and after set of images help us fine-tune your next visit.
For men, the injection pattern sometimes differs because of thicker skin and stronger perioral muscles. The principle is the same, but botox for men might require an extra unit per side. For women with delicate features, baby botox levels may be perfect. Either way, subtlety wins.
Cost, logistics, and planning your visit
Pricing varies by geography and by botox provider. Some clinics charge by the unit, others by area. For gummy smile, expect a range that reflects 4 to 12 units used. The botox price per unit commonly falls between modest and premium tiers depending on the market and the injector’s experience. An affordable botox plan is possible without compromising standards by targeting precisely and avoiding waste. Ask about botox specials only after you have vetted quality, product authenticity, and injector credentials.
Booking a botox appointment is straightforward. I prefer a short botox consultation first, especially for first-time botox patients, so we can examine your smile, review candidacy, and set expectations. Bring any questions you have. Good botox consultation questions include: Which muscles are you targeting in my case? How many units do you recommend and why? How long should I wait before photos or events? What is the plan if I feel the result is too strong or too mild?
What to expect the first time
First-timers often carry two concerns. Will it hurt, and will it look fake? The injections are quick, and discomfort is minor. As for the look, we start modestly. By day 10 to 14, you will see whether we need a touch-up. My advice is to time your initial visit at least two weeks before any event that involves photographs. This ensures the botox results settle and any adjustments happen in time.
You might notice that drinking from a narrow straw feels slightly different the first few days. This resolves as you adapt and as the surrounding muscles compensate. Normal speech remains intact with correct placement. Keep your head upright for a few hours after treatment, skip massages and vigorous workouts that afternoon, and avoid pressing on the area.
Combining treatments thoughtfully
In selective cases, I pair gummy smile botox with a micro lip flip for patients who also want a hint more upper lip show without adding filler. The doses are adjusted to maintain articulation. For patients with high gum show and thin lip volume, a small hyaluronic acid filler can lengthen the lip a millimeter or two and complement the botox effect. For those with a plunging nasal tip on smiling, treating the depressor septi nasi further refines the result.
If clenching or jawline hypertrophy is part of your picture, botox masseter can soften the lower face and take strain off the system. Therapeutic botox for TMJ or botox for bruxism reduces grinding-related pain in many patients. While these are separate indications, addressing them can improve overall smile harmony. We map a customized botox treatment plan that respects function.
Longevity and maintenance strategy
Most patients return every 3 to 4 months for botox maintenance treatment. A few prefer seasonal care, for example before holidays or summer weddings. If you find your smile returns to the old pattern right at the 10-week mark, we can adjust to a slightly higher dose or shorten the interval. Some want the lightest possible touch and accept a shorter duration. Others want long lasting botox and are comfortable with a slightly higher dose as long as the smile remains expressive. There is no single best botox treatment. The best plan is the one you can maintain comfortably that gives you confidence.
Who is a good candidate
Ideal candidates are healthy adults who notice 3 to 5 millimeters of gum show when smiling, with a strong muscular component. Age is flexible. I have treated patients in their twenties through their sixties. Botox age requirements generally align with legal adulthood for cosmetic procedures. Preventive botox is not a concept that applies here the way it does for forehead lines, since gummy smile is dynamic and structure-driven. If you are unsure, ask for a test smile evaluation during your botox consultation. A skilled injector can often predict your response by manually stabilizing the elevator area while you smile, mimicking the effect.
Practical pearls from the chair
A few details from routine practice that matter more than they appear:
- Take baseline photos at rest, social smile, and full laugh. Patients forget how far they started. Photos anchor the conversation and help with botox before and after review. Correct asymmetry deliberately. Many people lift higher on the left. Dose the higher side first, reassess, and then match the other side rather than mirroring blindly. Respect diffusion. Small needles, small volumes, and slow injections keep product where you intend. Over-dilution can soften the whole perioral region when you only meant to relax the elevators. Plan around dental work. If you have a dental cleaning or whitening the same day, schedule botox after the dental appointment to avoid pressure on fresh injection sites. Invite feedback at two weeks. Micro-adjustments elevate results from good to great.
How gummy smile botox fits within broader botox services
Many patients come in for botox wrinkle treatment and discover how a balanced smile changes their overall facial impression. We still treat botox forehead wrinkles, botox frown lines, and botox crow feet to calm etched lines. We may use botox neck treatment for platysmal bands, botox chin dimpling for the orange peel look, or a refined botox jawline for downturned corners. The gummy smile correction often becomes the sleeper hit of the visit. It takes little time, it avoids surgery, and the visual payoff is outsized.
If you struggle with other functional concerns, such as botox migraine treatment or botox headache treatment, it is possible to coordinate both cosmetic and therapeutic botox. The dosing strategies, landmarks, and clinical goals differ, so make sure your botox medical provider is experienced with both. Scheduling can often be combined into a single botox appointment, sparing you multiple trips. Just be sure to review insurance versus cosmetic billing if medical botox is part of your care, since coverage rules can be strict.
Costs, transparency, and choosing the right injector
Prices vary, but quality should not. Ask whether the clinic uses authentic on-label product and how they store it. A reputable botox clinic will show you the vial and answer questions without defensiveness. If you are comparing botox pricing between offices, look beyond the botox deals. Consider the injector’s credentials, patient portfolio, and their approach to follow-up. A botox specialist who welcomes a two-week check, offers minor adjustments, and tracks your progress is worth more than a bargain that leaves you on your own.
Location matters too. If you search for botox near me, you will find a long list. Narrow it to a botox doctor or botox physician with specific experience in perioral treatments, since the muscle choreography around the lip is nuanced. I have seen patients who came in after heavy-handed botox lip flip elsewhere, complaining of whistling changes and a smile that felt “stuck.” The fix is time and gentler dosing in round two.
Setting expectations with honesty
Most patients want a 2 to 3 millimeter reduction in gum show. That is realistic with botox gummy smile treatment. If you hope for a dramatic 5 millimeter drop, and your cause is structural, we should talk about periodontal or surgical options. Botox is adjustable and reversible, which is a strength. It also means you need maintenance. If you prefer a one-and-done solution, discuss crown lengthening or orthodontic options. Good care matches your goals, your anatomy, and your threshold for downtime.
A brief case snapshot
A 28-year-old professional presented with 4 to 5 millimeters of gum show centrally, tapering to 2 millimeters laterally. Upper lip length at rest was short. She did not want surgery. We treated each Yonsei point with 3 units and added 1 unit at the depressor septi nasi centrally. At day 14, gum show reduced to roughly 2 millimeters centrally and 1 millimeter laterally. She retained a full Duchenne smile with cheek lift. A 1 unit touch-up at the right Yonsei point evened a slight asymmetry. She now maintains every 12 weeks. She also added subtle botox brow lift and botox crow feet treatments six months later for a cohesive, refreshed look.
Aftercare, recovery, and daily life
You can return to normal activities immediately with a few minor precautions. Keep upright for several hours. Skip sauna, hot yoga, and heavy workouts until the next day. Avoid massaging the treated area that evening. Tiny bruises are possible but rarely noticeable to others. If you plan on event photos, give yourself a two-week buffer from injection to final effect. This same timeline applies across botox aesthetic treatment areas, from botox facial rejuvenation zones to targeted botox skin smoothing of dimpling in the chin.
The bottom line on effectiveness
For the right candidate, botox for gummy smile is effective, quick, and repeatable. It reduces excess gum show by toning down the overactive elevator muscles while preserving a natural, warm smile. The botox effectiveness window of three to four months aligns with routine aesthetic maintenance many patients already follow. The botox risks are low when performed by a licensed, experienced injector who understands the anatomy and respects conservative dosing.
If you have been curious but hesitant, start with a consultation. Bring your questions. Ask to see previous botox before and after photos of patients with similar gum show. A professional botox approach should feel tailored, not templated.
A simple planning checklist for your visit
- Take a smiling selfie in good light at rest, social smile, and full laugh to show your goal. Schedule treatment at least two weeks before events with photos. Review medications that increase bruising, such as certain supplements or blood thinners, and follow your provider’s guidance. Clarify unit-based pricing and what is included in a two-week follow-up. Plan light activities after the appointment and skip heavy workouts that day.
The confidence of balance
A balanced smile changes how you feel walking into a room. Gummy smile correction with botox is not about chasing trends. It is about proportion. Teeth, lips, and gums should share the stage in the right measure. When the upper lip lifts a little too high, small, precise botox cosmetic injections can restore that balance without surgery, without long recovery, and without fuss.
If you are ready to explore your options, book a botox consultation with a licensed provider who performs advanced botox around the perioral region. You deserve careful assessment, clear explanations, and a plan that fits your face and your life.