A big laugh that shows a strip of pink above the teeth can feel charming on some faces and distracting on others. If your upper gums dominate photos or pull attention in conversation, you might have wondered whether a couple of carefully placed Botox injections could calm the lift and balance your smile. Used well, Botox for a gummy smile is less about freezing expression and more about tuning the mechanics so your lip moves in harmony with your teeth and gums.
I first learned to evaluate gummy smiles in a facial aesthetics clinic attached to a periodontal practice. That pairing mattered. Many “gummy” smiles were not really Botox problems at all. Some had excess gum tissue over the teeth that needed laser contouring. Some had short clinical crowns after orthodontic relapse. Others had an overactive upper lip and hyperactive levator muscles, the perfect case for Botox. The art lies in sorting who benefits from neuromodulators, who needs dental or surgical care, and who might combine approaches for the most natural result.
What creates a “gummy” smile in the first place
A balanced smile usually shows 1 to 2 millimeters of gum when you grin hard. More than 3 to 4 millimeters tends to read as “gummy,” especially if the exposure stretches across the front four to six teeth. The causes fall into a few well-known categories:
- Lip dynamics and muscle pull. The main elevators of the upper lip, including levator labii superioris alaeque nasi, levator labii superioris, and zygomaticus minor, can over-contract. The lip then rides high, like a window shade pulled too far up. This is the group most responsive to Botox for gummy smile. Tooth and gum anatomy. Delayed passive eruption or excess gingival tissue can make teeth look short. A periodontist can correct this with gum contouring and sometimes minor bone recontouring to expose more tooth with a healthy margin. Skeletal and dental positioning. Vertical maxillary excess, often identified by an orthodontist or oral surgeon, means the upper jaw sits lower in relation to the face. These cases can be mild and responsive to Botox, or more significant and better treated with orthognathic surgery or camouflage orthodontics.
Mapping the cause is step one. A quick Learn here chairside test I still use: ask the patient to say “eee” softly and then smile gently. If the gums show early and rise sharply as the smile grows, muscle dominance is likely. If the gums seem present even at rest with short visible teeth, gingival excess or tooth length may be involved.
How Botox calms the upper lip lift
Botox works by blocking acetylcholine at the neuromuscular junction, reducing a muscle’s ability to contract. In gummy smile treatment, we target the muscles that elevate the upper lip. Two compact injections on each side, just off the nose, can soften the peak lift so the lip still moves but doesn’t sprint upward.
The most common points are often called the “Yonsei points,” located where the levator labii superioris alaeque nasi converges with the adjacent elevators. A precise injector uses surface landmarks rather than guessing. I palpate the alar base, trace the nasolabial fold upward, and mark a point a finger’s breadth down from the medial canthus along the muscle bellies. These are small muscles. A shallow depth prevents diffusion into unnecessary areas.
Typical dosing sits in the range of 2 to 4 units per side with standard onabotulinumtoxinA, adjusted for muscle strength and gender. Thin lips or delicate smiles do best with a conservative first session, sometimes 1.5 to 2 units each side, then a touch up at two weeks if needed. When I see an overactive “bunny line” scrunch, I might add 1 to 2 units into the nasalis to maintain harmony, but I avoid scattering product unless the assessment supports it.
You should not lose your smile. You should keep animation and be able to say words that require lip lift. The goal is a reshaped arc, not a straightjacketed mouth.
What the timeline really looks like
Botox does not change your smile overnight. Expect a quiet ramp.
- Day 2 to 3, the edges of the lift start to soften. Most people notice less gum flash when they grin in the mirror. Day 7, the effect reaches its stride. Photos often look different by the end of the first week. If a touch up is needed, this is a good moment to assess. Week 2, the final look settles. If symmetry or lift still feels heavy on one side, a tiny add-on dose can refine the result. Month 3 to 4, the effect eases. Most gummy smile patients return in the 3 to 4 month window, though some stretch to 5 months. Athletic individuals or patients with fast metabolisms sometimes wear off sooner.
If you are searching “how long does Botox take to work” or “Botox results timeline,” gummy smile follows the same principles as forehead or crow’s feet, but the face perceives small shifts around the mouth more acutely. Check progress in video, not just selfies. A short clip of your laugh captures dynamics better than a still photo.
How many units does it take for a gummy smile
Numbers vary by product and face, but you can expect a total of 4 to 10 units of onabotulinumtoxinA for both sides combined, with many landing at 6 to 8. Some experienced injectors use even smaller “micro” doses and layer results over two visits in one month. Baby dosing can be smart if you are a first timer or prone to spreading.
If you’ve asked “how many Botox units do I need” for other areas, note that gummy smile dosing is modest compared to the forehead or masseters. It is also less forgiving. One extra unit in the wrong spot can weigh down the upper lip, especially in patients with a lip flip already in place. If you are stacking treatments like a Botox lip flip, discuss timing so the combined lift and relaxation does not tilt the balance.
The session: what to expect in the chair
No numbing cream is necessary. The skin disinfects quickly and the injector places two to four micro-injections. Each prick feels like a small sting, similar to a lip flip or bunny line treatment. Total chair time is often under ten minutes, with the real minutes spent in assessment and photos from different smiles: closed-mouth grin, half smile, full smile, laugh.
Some clinics will book a quick follow up at two weeks. If you are searching “Botox appointment near me” or “same day Botox appointment,” gummy smile is among the fastest visits, but the best outcomes come from a provider who slows down to study your expressions. Walk in Botox near me ads pop up often. For gummy smiles, I still recommend consultation before treatment, even if on the same day.
Side effects, risks, and how to avoid an overdone look
Bruising is the most common nuisance, a small dot near the alar base. You can reduce risk by avoiding aspirin, ibuprofen, high-dose fish oil, and alcohol for 24 to 48 hours before injections when medically appropriate. If you bruise, it is usually minor and coverable with makeup after 24 hours.
Atypical outcomes include uneven smile, lip heaviness, or difficulty showing upper teeth when you speak. These occur when product spreads too low or dosing exceeds what your lip dynamics can handle. In my practice, the safety net is twofold: start low, and place high. A measured hand is better than chasing a perfectly “no gum” smile that looks flat.
There are also contraindications. If you are pregnant or breastfeeding, defer treatment. If you have certain neuromuscular disorders, discuss risks in detail. Anyone with a history of severe allergy to a botulinum product or formulation component should not receive it. These are the same cautions you hear for forehead or frown line areas.
Will Botox fix every gummy smile
No. Think of Botox as a dimmer switch for muscle activity. If your gummy display comes from excessive gingival tissue or vertical maxillary excess, Botox can reduce gum show by a millimeter or two, but the structural cause remains. Patients with skeletal drivers often prefer a combination: small-dose gummy smile Botox to control the lip plus dental solutions like crown lengthening or orthodontics.
A useful anecdote: a 29-year-old with 5 to 6 millimeters of gum show across the anterior teeth. We tried 3 units per side at the Yonsei points. The improvement was meaningful, about 2 millimeters, but he still felt “toothy.” A periodontal consult led to crown lengthening for teeth 6 to 11. After healing, we dropped the Botox dose to 2 units per side and kept a natural, lively smile with almost no gum show. Botox alone would never have matched the final result.
Smile balance tips that work in real life
Balance beats erasure. The aim is symmetry, proportion, and natural movement. A few practical points, based on cases where small adjustments made the biggest differences:
- Keep the philtrum in mind. A very short philtrum, especially in thinner lips, exaggerates gum display when the lip lifts. These patients respond to lower doses. Pairing a light gummy smile treatment with a micro lip flip can be risky if both relax the same vectors. Stagger them by two weeks and reassess. Watch the zygomaticus muscles. A heavy hand near the alar base can blunt the early phase of the smile and redirect pull toward the sides, creating a “cat-like” arc. If you see this trend in your follow-up photos, adjust injection height rather than chasing with more units. Do not ignore nasal scrunch. Bunny lines reflect nasalis activation. If that scrunch nudges the lip up, you may need a tiny addition there, often 1 unit per side, to smooth the pathway without flattening expression. Consider dental display at rest. If you show a millimeter of upper incisors when your lips are at rest, aim to preserve that aesthetic. Over-relaxation can rob youthful incisor show and make the face look withdrawn. Soft tissue hydration helps. Dry, thin lips can look longer when the upper lip is relaxed by Botox. A conservative hyaluronic acid lip hydration, not a volumizing filler, can maintain structure without making the smile look heavy. Time it several weeks apart from Botox so you can see the impact of each.
Costs and how to think about value
Pricing varies with geography and product. Most clinics charge by unit. If you are searching “how much is Botox per unit” or “Botox price per unit,” typical ranges are 10 to 20 dollars per unit in many markets, sometimes higher in major cities. Because gummy smile dosing is low, the total fee is often modest compared to a forehead or masseter session.
Be cautious with “Botox deals near me” and steep “Botox specials near me.” A discounted per-unit price is only helpful if the product is genuine, the injector understands perioral anatomy, and sterile technique is sound. I have corrected more than a few discounted gummy smile treatments that left patients with asymmetric movement or dropped upper lips. If you want affordable Botox near me, look for transparent pricing and before-and-after photos of actual gummy smile cases.
If cost is your deciding factor, call clinics and ask two questions: how many gummy smile cases do you do each month, and do you book a two-week follow-up with included touch up if needed. The answer tells you more about value than the sticker price.
Who makes a good candidate
Good candidates can cover their upper gum with a fingertip press at the philtrum and see their smile calm to a more balanced display. Their tooth length looks normal, and gum shape around the front teeth has natural scallops rather than a flat, thick band. They can flare their nostrils without the lip riding dramatically higher, which points to isolated levator overactivity rather than a global lift pattern.
Less ideal candidates have very short clinical crowns, a long midface with 5 or more millimeters of gum show, or a history of upper lip surgery that altered mechanics. These patients might still benefit, but expectations should shift toward moderate improvement rather than full correction.
How gummy smile Botox compares with other smile-focused treatments
You might have seen “lip flip vs filler” debates, or stacked offers pairing “Botox for smile lines” with perioral filler. These are different tools. A lip flip uses Botox at the vermilion border to evert the upper lip slightly, showing more pink. Filler adds structure or volume, which can steady the upper lip and soften perioral lines but risks heaviness if overdone. Gummy smile Botox primarily addresses vertical lift. When planned together, a minimal lip flip and small gummy smile dose can look elegant. When rushed, they fight each other.
Surgical options exist. A lip repositioning procedure, performed by periodontists or surgeons, anchors the upper lip to reduce elevation. It can be helpful but requires healing time and carries surgical risks. Crown lengthening exposes more tooth to reduce visible gum. Orthognathic surgery addresses skeletal issues. Botox sits at the conservative end of the spectrum with quick onset, reversible effects, and low downtime.
What aftercare matters
You do not need elaborate rituals. Skip strenuous workouts for 12 to 24 hours. Avoid rubbing the injection sites for the rest of the day. Keep your head elevated for a few hours and sleep on your back the first night if you can. Makeup after Botox is fine after several hours, once pinpoints close. Washing your face can resume the same evening with gentle pressure.
Alcohol can raise bruising risk. If you have an event, wait until the next day. If a small bruise appears, cool compresses for short intervals in the first 24 hours help, followed by warm compresses on day two to speed clearing.
If you feel a headache, it is usually mild and short-lived. Over-the-counter options that do not thin the blood, like acetaminophen, are preferred if appropriate for your health status. Most people have zero downtime and return to work immediately.
Preventing the “frozen upper lip” look
The fear of a stiff smile comes up often, especially among first-timers. Natural results depend on dose, placement, and your baseline dynamics. The perioral area is expressive. A clinic that believes in baby Botox near me or micro Botox near me may be a good fit for your first session. Ask your injector to show you before-and-after photos of patients who are smiling, not just at rest. Look for preserved laugh lines at the corners and a soft lift that still reveals the upper incisors.
If you have had “Botox wearing off early” in the forehead or “why Botox didn’t work” feelings in the past, share that history. Faster metabolism or habitual facial movement patterns can inform dosing. Touch up timing at the two-week mark is better than overcompensating up front.
Where to go and what to ask
If you are searching “botox near me,” “botox injections near me,” or “cosmetic botox near me,” filter results by clinical photos and provider training. Dermatology, facial plastic surgery, and dental aesthetics practices with documented gummy smile work are your best bet. “Top rated botox near me” lists help, but read the reviews that mention smiles, lips, or gummy correction specifically.
Bring three photos to your consult: your biggest laugh, a natural smile, and a profile smile. Videos help even more. Ask where they place gummy smile injections, how many units they typically start with, and whether they have experience with the Yonsei points. Clarify what happens if you feel too relaxed at day 7. The best clinics prefer tiny course corrections over heavy-handed first passes.
Related treatments that often come up in the same visit
The mouth is a neighborhood. Neighbors influence each other. Patients who address gummy smile frequently ask about:
- Bunny lines. Small scrunches along the nose when you smile. 2 to 4 units per side can soften them and complement gummy smile work. Downturned mouth corners. Very light dosing into the depressor anguli oris can ease a frown at rest. Proceed cautiously in thin lower lips. Chin dimpling or “orange peel” chin. A few units in the mentalis can smooth texture and improve lower face balance with the upper lip changes. Masseter tightness. If you clench or grind, masseter Botox can slim a square jaw and reduce pain. It does not directly affect the gummy smile, but the overall face shape change can alter how you perceive the smile.
Plan sequence and spacing so you can evaluate each change. If you scatter treatments, it gets hard to see what created what.
Realistic expectations and a simple test at home
Stand in front of a mirror and smile in three stages: gentle, social, and full laugh. Watch when the gum appears and how quickly it grows. If gum shows only at the extreme laugh, Botox can deliver a subtle polish. If gum appears even in a social smile, you will likely see a significant difference, though you might still show a thin band when you laugh hard. That’s often the sweet spot, a natural human expression preserved with better balance.
If you like numbers, measure with a small ruler from the bottom of the upper lip to the gingival margin at the midline during a full smile. Repeat after treatment at day 14. A reduction of 2 to 3 millimeters reads clearly in photos and in person.
Final advice from the treatment room
The best gummy smile outcomes happen when you treat the smile as a moving system, not a static line. Watch how the nose, philtrum, and lip dance together. Favor the smallest dose that achieves the goal. Be patient with tweaks at two weeks. Pair Botox with dental input if tooth length or gum architecture plays a role. If you are new and browsing “botox consultation near me,” invest in that first conversation. You will learn whether your smile is a muscle story, a gum story, or a mix.
And if you are comparing products or costs, remember that the per-unit number is only part of the picture. Expertise matters more than a small discount. Whether you favor Botox, Dysport, Xeomin, or newer options, the principles remain the same: precise placement, conservative dosing, and respect for expression.
A well-balanced smile does not call attention to technique. It lets people see you, not your gums, and it stands up to laughter, conversation, and candid photos. That is the quiet win of gummy smile Botox when it is done right.