A gummy smile has a clinical name, excessive gingival display, but that phrase misses the human piece. People often describe it as cheerful yet distracting. The upper lip lifts high, several millimeters of gum show, and attention shifts away from the eyes and teeth. If you feel self‑conscious in photos or you habitually cover your mouth when you laugh, you are not alone. Botox injections can soften a gummy smile without surgery, and when it is done right, the change is subtle yet meaningful. The goal is not to freeze a smile. The goal is balance.
What a gummy smile really is
Teeth, gums, lips, and the underlying jaw structure all play a part in what you see when you smile. A “gummy” look can stem from one or more of these factors:
- A hyperactive upper lip that elevates too far Short clinical crowns where gums cover more tooth than average Vertical maxillary excess, where the upper jaw is longer than typical Orthodontic issues like an open bite or proclined incisors
Botox treatment addresses the first cause, a hyperactive upper lip. It relaxes the elevator muscles so the lip still rises, just not quite as high. That is why you hear practitioners talk about injection points like the levator labii superioris alaeque nasi, the levator labii superioris, and the zygomaticus minor. If that sounds like anatomy class, that is because Botox works by quieting those muscles’ signal, measured in units, not by adding bulk or weight.
When the core problem is skeletal or dental, like vertical maxillary excess or excess gum tissue, Botox can still help with symptom management, but it will not fix the underlying structure. In those cases, your options expand to orthodontics, gum contouring, or orthognathic surgery. The art is matching the treatment to the driver of the gummy smile.
How Botox helps, in practical terms
Botox is a purified neuromodulator. Injected in tiny amounts, it reduces muscle contraction in a controlled way. For a gummy smile, that means dialing down the lip elevator muscles so the lip does not hike up as much when you grin. The effect shows when you smile, laugh, or talk, and it rests naturally when your face is at ease.
Patients often expect either no change or a dramatic one. In most cases, the change is about 2 to 4 millimeters less gum show. That may sound small, but 2 millimeters is the difference between “I notice my gums first” and “I see my teeth and eyes.” When I review Botox before and after photos with patients, we focus on how the lip meets the gumline rather than searching for a different face. Most people want natural results that simply look like them on a rested day.
The benefit of Botox for gummy smile is that it is reversible, adjustable, and quick. The trade‑off is that the effect is temporary. If you love the result, you will need maintenance.
Who makes a good candidate
If your main issue is a high‑rising upper lip and you want a non‑surgical option, you are likely in the sweet spot. Your injector will check a few things during a Botox consultation:
- How many millimeters of gum show at a full smile Lip length at rest and on animation Tooth display at rest, ideally 1 to 3 millimeters of upper incisors Bite and jaw position, because severe skeletal discrepancies limit what Botox can do safely
Good candidates have healthy gums, stable dental work, and a clear goal: less gum show with a smile, not a heavy or droopy lip at rest. If you have a short upper lip with minimal incisor display at rest, aggressive dosing can create a flat smile or a sense that your upper lip is “stuck.” That is avoidable with conservative technique.
Certain conditions call for caution or deferral. Active oral infections, pregnancy, breastfeeding, and specific neuromuscular disorders are common contraindications. Disclose any blood thinners, antibiotics like aminoglycosides, and medical conditions so your injector can weigh Botox risks and benefits.
What the appointment is really like
A gummy smile treatment takes about 10 to 15 minutes in a typical medical spa or clinic. I like to begin with a full smile test in a mirror. We mark the injection points, often near the sides of the nose where the lip elevators originate, and sometimes along the nasolabial edge. Most plans use 2 to 4 units per point, with a total dosage in the 4 to 10 unit range per side, depending on muscle strength and gender. That is smaller than what you might see for a Botox forehead treatment or Botox for frown lines, because we are refining movement, not freezing it.
Needle size is tiny, usually 30 to 32 gauge. Patients rate the Botox pain level as a 2 or 3 out of 10, more like a quick sting than a shot. Ice or topical numbing can help, but many people skip it because the process is fast.
I prefer a staged approach. We start conservatively, reassess at two weeks, then decide on a touch up if the gummy show is only partly improved. Over‑treating causes more problems than under‑treating, and it is much easier to add units than to wait out a heavy upper lip.
Onset, duration, and what to expect
Neuromodulators do not work instantly. You will likely notice early change at day 3 to 5, with full effect by day 10 to 14. Expect your lip to lift less when you smile and laugh while still moving in a natural arc. Speech and eating should feel normal. You can sip from a straw and pronounce “p,” “b,” and “m” sounds without issue if the dosing is correct.
Botox duration varies. For gummy smile, results typically last 8 to 12 weeks for first‑timers and 10 to 16 weeks with maintenance. The more active your lip muscles, the faster the return. Some people metabolize Botox faster than others. If you use Botox for other areas, like Botox for crow’s feet or a Botox brow lift, you may already know your personal cadence. Budget for 3 to 4 sessions a year if you want consistent results.
" width="560" height="315" frameborder="0" allowfullscreen="" >
Aftercare that actually matters
You will see long lists online about what to avoid after Botox: no hats, no makeup, no wine, no exercise for a week. Most of that is noise. The essentials are straightforward. Keep your head upright for four hours, avoid heavy sweating workouts and face‑down massages that same day, and do not rub the injection sites. Makeup is fine after a few hours with clean brushes. If you bruise, a small dot the size of a lentil is common, and arnica gel can help. Mild swelling fades over the first day. You can go back to work immediately, and that is why people refer to it as minimal downtime.
Safety, side effects, and real risks
When performed by a trained professional, Botox for gummy smile is considered safe. The most common side effects are short‑lived: pinpoint bruising, swelling, and tenderness. Headaches are possible for a day or two. Rarely, you might feel your upper lip is heavier than expected, especially if the dose was on the higher side. That heaviness softens as the effect settles in during the first two weeks. If your smile looks uneven, a small touch up can balance it.
Allergic reactions are extremely rare. Infection is also rare, but any injection carries a small risk. Technique matters, which is why the experience of the Botox specialist or nurse injector matters. Proper spacing and depth of injection reduce the chance of unintended spread. If Botox migrates too low, it can affect the orbicularis oris and make it a little harder to purse your lips for a week or two. Conservative dosing and precise injection points keep complications uncommon.
How it compares to other options
Botox is not the only tool. It just happens to be the least invasive with the fastest gratification.
- Lip lift surgery shortens the distance between the base of the nose and the upper lip. It is powerful for lip lengthening and tooth show at rest, but it does not selectively control gum display on smile the way neuromodulation does. It is permanent and has a scar at the base of the nose. Gum contouring removes excess tissue to lengthen the visible tooth. This is ideal when the crowns are short. Periodontists and cosmetic dentists can use a laser or scalpel. Healing takes days to weeks, and the change is structural. Orthognathic surgery addresses vertical maxillary excess by moving the upper jaw. It transforms facial balance but requires orthodontics and months of recovery. Lip filler can support the vermilion border and, in careful hands, reduce the relative gum show by adding subtle volume. Used alone, filler rarely solves a true hyperactive elevator pattern. Combined with Botox, it can refine the smile arc.
Think of it this way: if your gummy display appears only when you smile and your face at rest looks balanced, Botox is the simplest way to test a change without commitment.
Dosing philosophy and technique notes from the chair
The average dosage for a gummy smile tends to land between 4 and 10 total units, though stronger muscles may need 12 to 16 units split across sites. I evaluate smile on three counts: symmetry, height of upper lip movement, and the curve of the smile line. If the central gums show most, I prioritize the LLSAN along the nose. If the lateral gum shows more, I include the LLS and zygomaticus minor slightly lower. Two injection points per side, sometimes three, is typical. A micro dose along the depressor septi nasi can soften a downward nose tip pull that sometimes exaggerates gum exposure when smiling.
People ask about brands. Botox is a brand name, and there are peers like Dysport, Xeomin, and Jeuveau. In practice, all are FDA‑approved neuromodulators with subtle differences in spread and onset. Dysport may kick in a day earlier for some, Xeomin lacks accessory proteins which some clinicians prefer for repeat users, and Jeuveau can be cost‑competitive. Your injector’s comfort with a product matters more than the label. If you have strong loyalty to a brand, share your history and note how long it lasted and how it felt.
Cost, value, and the reality behind “deals”
Botox cost varies by region and provider skill. Clinics price by unit or by area. A fair unit price in many US cities ranges from 10 to 20 dollars per unit, with coastal metros skewing higher. For a gummy smile, that puts a typical session between 80 and 300 dollars depending on dose and the market. Packages, memberships, and Botox specials can bring down the per‑unit number, but do not chase the lowest Botox price you find online. Technique and judgment are the real product. Cheap units in inexperienced hands cost more in the long run when results need frequent New York NY botox clinics corrections.
If you are searching “botox near me,” filter results by licensure and experience. Look for a Botox clinic or medical spa that shows specific gummy smile before and after photos, not just foreheads and crow’s feet. Read Botox reviews with an eye for detail, like mentions of conservative dosing, follow‑up care, and symmetry. During your Botox appointment, ask who is injecting you, their training, and what their plan is if you need a touch up.
Setting expectations like a pro
The best results start with a shared picture of success. I like to ask every patient to rate their gum show from 0 to 10 in a full smile photo on their phone. Then we agree on a target, often a two‑point shift. This keeps us grounded in what is achievable in a single visit.
Botox does not change tooth color, lip texture, or alignment. It will not fix chapped lips or thin vermilion borders, that is filler and skincare territory. It will not treat TMJ, although Botox for bruxism or masseter slimming is a separate approach focused on the jawline. The win we are after is simple: the upper lip stays down just enough.
When things go sideways and how to fix them
Uneven results happen, especially if one side of your lip is stronger. The remedy is usually a small add‑on dose on the heavier side. If the lip feels too heavy or you struggle to show your upper teeth, patience is the fix. The effect eases every week. In the meantime, a skilled injector may use micro doses in the opposing muscles to rebalance. Warm compresses help with bruising. If you see lumps, they are not from the product itself, because Botox is not a filler. You are likely seeing a small localized swelling that settles within a day.
True complications like infection need medical attention. If you have fever, spreading redness, or significant pain, call your clinic. If your injector is hard to reach after treatment, that is a red flag. Choose practices that schedule follow‑ups and share clear aftercare.
Pairing Botox with other small moves
Subtle changes stack well. A tiny Botox lip flip at the vermilion border can roll the lip edge outward slightly, improving balance without changing the gummy plan. A few units for crow’s feet can lift the smile at the eyes. Gentle whitening and polishing make the teeth catch light more evenly, which reduces the visual weight of the gums. If your upper lip is very thin, a quarter syringe of hyaluronic acid at the border can support structure without a “done” look. The key is restraint. Overfilling a thin lip draws more attention, not less.
If you wrestle with sweating on the upper lip during public speaking, Botox for hyperhidrosis can calm the sweat glands. It is a different injection pattern and dose, but it complements smile work in people who worry about shine and makeup movement around the mouth.
Myths, facts, and the quiet truths
People fear that Botox will age them because it “freezes expression.” That can happen with poor technique in areas like the forehead, but gummy smile dosing is precise and small. You keep expression, you just lift less. Another myth says that repeated Botox makes muscles atrophy permanently. In reality, any atrophy is subtle and reversible. If you stop Botox, your smile returns to baseline within months.
The fact that matters most is this: small millimeter changes can have an outsized impact on confidence. Patients report they laugh more freely, pose for photos without coaching their lips, and stop thinking about their gums in every social interaction. These are not vanity wins. They are quality‑of‑life improvements.
First‑timer checklist for a smooth experience
- Bring a clear smiling photo that bothers you, ideally in good light and straight on. Be honest about medical history, medications, and prior neuromodulator use. Ask your injector to show where they plan to place the Botox injection points and how many units per site. Plan for a two‑week review. Results refine and even out across that timeline. Avoid heavy workouts the day of treatment, then resume normal life.
The role of experience and touch
A syringe is not a plan. Good outcomes depend on an injector who sees patterns and understands how your upper lip behaves. Some people show more gum centrally, some laterally. Some have a strong depressor septi nasi that pulls the nose tip down on smiling, compounding gum show. The map is different for each face. A seasoned Botox doctor or nurse injector will read that map in real time and adjust the dosage and placement. That is why two people can get the same total units and look different. Technique and the anatomy of the smile define the result.
Ask about certification and ongoing training. Botox is FDA‑approved for certain areas, and gummy smile is an off‑label use, common and well studied, but still reliant on professional judgment. Providers who pursue continuing education in perioral anatomy tend to produce more consistent results.
Budgeting and maintenance without surprises
Think in seasons, not weeks. If your Botox lasts three months on average, you will likely schedule treatments three to four times a year. Many clinics offer memberships that spread the cost monthly, making it easier than paying ad hoc. Combine appointments if you also treat forehead lines, frown lines, or crow’s feet. You will spend less time in the chair and can match the refresh cycle across your face for uniform results.
Keep receipts and note your dosage and brand. The next time you book, you can reference what worked and what did not. This simple habit helps you and your injector refine your plan. If you travel or move, that botox NY record also helps a new clinic pick up where the last left off.
When to consider a different path
If you hide your smile because more than 4 millimeters of gum shows and Botox gives only a small improvement, it may be time to meet a cosmetic dentist or oral and maxillofacial surgeon. Crown lengthening, orthodontics, or orthognathic surgery can address the structural causes. Many patients choose a staged plan: start with Botox to test a new look, then pursue a more definitive solution if confidence grows and the desire for permanence remains.
On the flip side, if your gummy display is mild and asymmetrical, a few units once or twice a year may be all you need. You do not have to live on a strict maintenance calendar unless you want a consistent year‑round result.
The quiet power of subtlety
A great gummy smile correction does not announce itself. Friends may say you look more relaxed or that your smile seems “softer.” You will know the difference every time you laugh without thinking about angles and lip control. That is the core promise of Botox for gummy smile: subtle changes that restore focus to your eyes, your expression, your presence. It is not about chasing perfection. It is about clearing one small distraction so the rest of you can show up.
If you are curious, book a consultation and bring your questions. Ask about units, plan for a two‑week check, and start conservatively. Botox is a tool, not a personality change. In experienced hands, it does one thing very well, and sometimes that one thing is exactly what you need.