A gummy smile can be charming, but if you find yourself holding back your grin in photos or pressing your lips together when you laugh, you are not alone. Many people feel that too much visible gum tissue distracts from their teeth and lips. Surgery used to be the default solution. Today, a well-placed set of Botox injections can relax the upper lip just enough to reveal more teeth and less gum, without changing how you look at rest. When done thoughtfully, the result feels like your smile, simply more balanced.
What “gummy” really means
Dentists define a gummy smile as showing more than about 3 to 4 millimeters of gum above the top teeth while smiling. But a number does not capture the whole story. What matters is proportion: lip length and mobility, tooth size, gum contour, and how your upper jaw sits in relation to the rest of your face. In the chair, I look at three things. First, how far the lip lifts from rest to a full laugh. Second, how much gum is visible in the middle compared with the corners. Third, whether the upper lip rolls inward when you smile, which hints at muscle dominance.
The most common contributors are a hyperactive levator labii superioris complex, a short upper lip, altered passive eruption where the gums cover too much of the tooth crown, and, less commonly, vertical maxillary excess. Botox works best when the main driver is muscular.
How Botox changes the smile mechanics
Botox is a purified neurotoxin that temporarily relaxes targeted muscles. For gummy smiles, the focus is the elevator muscles of the upper lip: levator labii superioris alaeque nasi, levator labii superioris, and zygomaticus minor. When you smile, these muscles contract and pull the lip upward. Calming them slightly reduces the upward lift, so less gum shows.
This is not about freezing your smile. With correct dosing and placement, you still smile, laugh, and speak naturally. The lip simply does not hike as high. The technique can be tailored: more support in the center for people who show gum above the two front teeth, or a touch more laterally if the corners over-retract. Good providers study your smile in motion, mark the muscle vectors, and deliver micro-doses to shape, not suppress.
Who is a good candidate
The best candidates are people with:
- A mobile upper lip that travels upward more than about 6 to 8 millimeters on smiling, with healthy gum tissue and normal tooth proportions.
If you have a short upper lip at rest or significant skeletal imbalance, Botox can still help, but likely as a bridge or complement to other care. Patients with altered passive eruption often benefit more from gum contouring done by a periodontist, then minor Botox to refine the result. For vertical maxillary excess, orthodontic or surgical options provide structural correction, and Botox may soften the edges afterward.
As for age and gender, I treat men and women across a broad range. Men sometimes need slightly higher doses due to muscle mass. Beginners often prefer lighter dosing first. If you are pregnant, breastfeeding, or have certain neuromuscular conditions, you should avoid treatment. A thorough medical history matters.
What a skilled appointment looks like
The botox consultation sets the tone. Expect to discuss your goals, what bothers you about your smile, and when you notice it most. I ask for photos of your natural laugh with friends, because staged smiles during a consultation can be tentative. We review prior botox treatment if any, response to botox for wrinkles, and Website link whether you have had a lip flip, fillers, or dental work. A mirror helps us align expectations: Are you aiming to show zero gum or simply reduce from 5 millimeters to 1 or 2?
The botox procedure itself is quick. I assess your smile at rest and in motion, palpate the muscle groups, and mark two to four injection points per side depending on anatomy. Most gummy smile cases use a total of 2 to 6 units across the central elevator complex, sometimes up to 8 to 10 units in stronger muscles. These are small volumes placed superficially. The needles are fine, and discomfort is a brief pinch. The entire botox process takes under 10 minutes once we agree on the plan.
Navigating dose, placement, and natural results
Getting this right is about nuance. Too little, and nothing changes. Too much, and the upper lip may feel heavy or speech might sound different for a few days. I favor conservative first sessions. We review botox before and after photos together at the two-week mark to gauge the effect at full onset. That check-in informs future dosing.
On placement, I avoid diffusion into the levator anguli oris, which can flatten the corners of the smile. I stay lateral to the nasal ala to prevent an asymmetric nose flare. For patients who also want a subtle lip eversion, a micro lip flip can be paired with gummy smile treatment, but the combined effect must be balanced to avoid an overly rolled lip. If you are also getting botox for frown lines or botox for crow’s feet on the same day, I map treatments so that cumulative doses stay within safe limits.
What to expect after treatment
Most patients notice a hint of change within three to five days. The botox results mature around day 10 to 14. Your first big laugh in that window can be a revelation. You feel the lip lift, but it stops earlier, and the gum line stays mostly hidden. Friends might say you look “refreshed” without pinpointing why. You can eat, speak, and work right away.
Common after-effects include tiny red marks or mild tenderness at injection sites for a few hours. Bruising occurs in a small percentage and fades within a week. Makeup can cover it. Avoid rubbing or massaging the area for a day, and skip intense workouts for 12 to 24 hours. These are standard botox do’s and don’ts shared across aesthetic areas, from botox for forehead lines to botox for eye wrinkles.
If you feel unevenness after the first week, that usually reflects muscle strength differences from side to side. A small touch-up, often 1 to 2 units, evens things out.
How long it lasts and how maintenance works
The botox duration for gummy smile typically runs 3 to 4 months, sometimes up to 5. The muscles gradually regain strength, and the lip lift returns to baseline. People who keep a regular botox maintenance schedule often notice the effect lasts slightly longer after the second or third cycle because the muscles repeatedly relax. As a practical rhythm, many of my patients book a botox appointment every 12 to 16 weeks. Some stretch to 20 weeks if their goals are modest.
As with botox for face in other zones, the botox results timeline follows a predictable pattern: onset by day 3, peak at two weeks, soft decline starting around week 10. If you have an important event, schedule your botox consultation 6 to 8 weeks early, allowing time for any refinement.
Cost, value, and the local landscape
Botox cost varies by geography, provider credentials, and dosage. You will see a botox price quoted per unit or per area. In many U.S. cities, gummy smile treatment might range from the equivalent of 2 to 8 units, so the total often falls below the cost of treating larger zones like the forehead. Budget for a touch-up at two weeks if you are new to treatment and prefer cautious dosing. When comparing “botox near me,” prioritize experience with smiles. A provider who spends most of the day on foreheads may not have the same eye for lip dynamics.
Risks, side effects, and how we prevent them
Botox safety is well established when used by trained professionals, yet this is still a medication with effects on muscle function. The most frequent botox side effects are mild and transient: redness, swelling, tenderness, headache, and bruising. With gummy smile treatment, the most relevant risks are:
- Over-relaxation of the upper lip leading to speech changes on certain sounds or difficulty keeping liquids in when drinking from a cup for a few days.
We reduce this risk with conservative dosing and precise placement. Another risk is asymmetry if one side responds more than the other. That is managed with a small botox touch up after the two-week mark. Infection is rare. Allergic reactions are exceedingly rare. Anyone with neuromuscular disease or on certain antibiotics should be screened carefully. This is where a board-certified dermatologist, facial plastic surgeon, or experienced injector at a reputable botox clinic or medical spa earns their fee.
When Botox is not enough
Botox is a non surgical treatment, not a structural fix. When gum display stems from altered passive eruption, a periodontist can perform crown lengthening to reveal the natural tooth. That alone can transform a smile. For vertical maxillary excess, orthognathic surgery addresses the foundation. Some patients pair orthodontics with minor gum reshaping and then use botox for fine-tuning. If volume loss in the upper lip contributes to the look of retraction, fillers can restore structure. The botox vs fillers question is not either-or. Fillers add support, botox reduces overactivity. In select cases, both improve balance.
The interplay with other areas of the face
Faces are systems, and small changes influence perception elsewhere. Patients who treat gummy smiles sometimes consider complementary areas once they see how subtle adjustments help. Softening strong bunny lines at the sides of the nose prevents creasing that can follow when the central elevators are calmed. If you have pronounced dynamic lines, botox for smile lines around the mouth is less effective than dermal fillers or skin treatments, but gentle dosing on the depressor anguli oris can lift the mouth corners a notch.
Up top, botox for frown lines between the brows or botox for forehead lines can brighten the upper face. Around the eyes, botox for crow’s feet smooths crinkles without flattening expression when done with care. None of these are required. But if you want a cohesive, natural result, consult with a provider who can plan the face holistically, not one area at a time.
How we tailor treatment for men, beginners, and unique anatomies
Men often worry that botox for men will look obvious. With gummy smile cases, the doses remain relatively low even for stronger muscles, and masculine features are preserved. For beginners, I always suggest a test run. We start with the smallest effective dose, review botox expectations, and only add units if needed at two weeks. Several of my patients initially asked for zero gum at full smile. After the first cycle, they preferred a millimeter or two of gum for a lively look. The right answer depends on your face and your taste.
Unique anatomies demand small adjustments. High nasal flares call for careful spacing from the alar base. A deep philtrum might need slightly altered angles to ensure uniform diffusion. Denture wearers and those with recent dental work can need timing coordination with their dentist so that smile dynamics are assessed in a stable state.
Longevity tips and maintenance habits
You cannot “train” the lip muscles to be permanently less active with botox, but you can extend satisfaction between visits. Sun protection and a steady skincare routine keep perioral skin resilient. If you combine treatments, plan intervals: for example, wait two weeks after botox before scheduling a dental cleaning that involves lip retraction, or at least warn your hygienist about recent injections. Avoid pressure-heavy facial massages for the first couple of days. Track your personal botox timeline. A quick note in your phone that you felt peak effect at day 12, and that it softened at week 11, helps set future appointment timing. Many patients schedule the next session as they leave, then adjust by a week or two based on how long the last cycle lasted.
What “natural” actually looks like
People often ask for botox natural results, yet natural means different things in different faces. On a petite face with delicate features, anything more than 2 to 3 millimeters of gum may pull attention upward. On a wide smile with broad teeth, a little gum can look youthful. The goal is not to erase character. It is to remove something that distracts you, then stop. I keep a habit: at the two-week review, we look at a candid laugh from your camera roll next to a current candid. If your eyes still crinkle, your cheeks still lift, and your smile reads as you, we have the balance right.
Comparing brands and alternatives
The botox vs dysport vs xeomin debate comes up often. All are neuromodulators that relax muscles. Differences are subtle: units are not interchangeable, spread can vary slightly, and onset sometimes feels quicker with Dysport, though experience is mixed. Xeomin lacks complexing proteins, which some prefer for theoretical reasons. For a gummy smile, the skill of the injector matters far more than brand choice. If you have a history of good response with one product for other areas like botox for jawline slimming or botox for masseter reduction, staying consistent is reasonable.
For those uncomfortable with injectables, there are botox alternatives, though none replicate this particular muscle-calming effect. Lip exercises will not change a hyperactive elevator complex meaningfully. Topical skincare and botox skincare myths aside, creams cannot affect muscle motion. If you want structural change without surgery, orthodontics can reposition teeth and lips subtly, but that is a longer commitment.
A quick reality check on myths and facts
A few recurring misconceptions keep patients from treatments that might genuinely help. Botox does not travel to the brain when placed properly, and it does not accumulate year over year in a harmful way. It does not make you expressionless unless the dosing is excessive or poorly targeted. It will not prevent you from kissing, singing, or using a straw after the first day. Your body breaks it down over months. On the fact side, well-placed botox can soften a gummy smile predictably, it is reversible with time, and adjustments are straightforward if you want more or less effect at the next visit.
How I walk patients through decisions
A confident smile is more than aesthetics, it is function and comfort. During a botox consultation, I ask what you notice in the mirror and what others notice in photos. I examine tooth show at rest, the curve of your upper lip, the shape of your gum line, and the strength of the elevators when you laugh. If your gum display stems largely from muscle overactivity, I recommend a light first treatment. We review botox risks, botox side effects, and your schedule. I ask you to avoid major exercise the Chester botox day of treatment and not to lie face down for a few hours. Then I plan a two-week review to assess botox results.
If we identify mixed causes, I involve colleagues. A periodontist can advise on gum contouring, a cosmetic dentist can address tooth proportions, and a dermatologist can integrate botox for under eye wrinkles or nose lines if we are shaping the full smile area. Coordination keeps the plan safe and efficient.
Practical questions patients ask, answered plainly
How much does it hurt? Quick pinches. If needles make you anxious, a cold pack and distraction reduce discomfort.
Will people notice I had botox? They notice you look relaxed and balanced. Most cannot spot why. Friends who know aesthetic treatments might recognize the change in gum display.
Can I chew and speak normally? Yes. Your lip function remains intact. Certain consonants may feel slightly different for a day or two if you received higher doses, but this settles quickly.
What if I do not like it? It fades. We can adjust dosing next time. If you prefer your original smile, you simply wait it out.
Can I combine it with fillers? Yes, especially if you want more lip structure. Sequence matters: I prefer neuromodulator first, reassess at two weeks, then consider modest filler for support.
A brief note on photos and timelines
Before and after images can be helpful, but they can also mislead. Angles, lighting, and smile effort change the impression. I take standardized shots in the same room, with the same prompts for expression. The honest botox results timeline shows subtle change at one week and clear improvement at two. Around three months, you will notice the lip lifting slightly more. At that point, many patients return not because the full gummy smile is back, but because they want to maintain a sweet spot.
Choosing a certified provider and setting expectations
Credentials matter. Look for a botox specialist with documented experience in perioral treatments, not only the forehead and glabella. A board-certified dermatologist, facial plastic surgeon, or well-trained injector at a medical spa with physician oversight is your safest bet. Ask to see varied cases of gummy smile correction, not just the best two. Discuss botox effectiveness, maintenance, and the plan if you need a minor correction. A provider who talks you through trade-offs, not just the benefits, is a provider you can trust.
If you are price shopping, remember that a slightly higher botox price, paired with the right expertise, often costs less over time. The margin of error near the mouth is small. You want precise hands and a careful eye, not the largest discount.
When the smile finally feels like yours
There is a particular moment that happens in the follow-up room. A patient laughs at something silly, then catches their reflection and relaxes. Their eyes meet mine and they say, “This is how I always pictured my smile.” That is the whole point. Not a new face. Not a mask. Just less gum, more teeth, and a grin you do not think about before you share it.
If you are curious, book a conversation. A short, informed visit can tell you whether botox for gummy smile fits your anatomy and your goals. Ask the questions that matter to you. Bring a couple of photos where your smile feels like you. With good planning and a light touch, you can keep your expression, lose the distraction, and enjoy the simple confidence of showing your teeth without second-guessing.
And if you are already a fan of neuromodulators for other zones, such as botox for forehead lines, botox for frown lines, or botox for crow’s feet, you will find the gummy smile treatment follows the same principles: precise targeting, modest dosing, clear aftercare, and realistic expectations. Done well, the changes slip into your daily life without demanding attention. That is the hallmark of thoughtful aesthetic treatment.