Some smiles show more gum than teeth. If you recognize your own grin in that description and it bothers you in photos or in daily conversation, you are not alone. A gummy smile is common, and for many people it is driven by muscle activity rather than tooth or gum problems. That is why carefully placed Botox injections can soften the lift of the upper lip, reveal less gum, and keep your smile looking natural. When done well, the change is subtle in a way that reads as confidence rather than cosmetic work.
I have treated hundreds of gummy smiles over the years, from barely there to dramatic, and the thread running through the happiest outcomes is restraint. Small doses, tailored to your anatomy, do more than high-volume fixes. Below is how to think about Botox for a gummy smile, what to expect, the numbers that matter, and the judgment calls an experienced injector makes to keep you looking like you.
What a gummy smile really is
A gummy smile, in clinical terms, is excessive gingival display. More than 2 to 3 millimeters of visible gum above the upper teeth during a full smile often stands out. That number is not a rule, it is a guideline. Some faces suit a little more gum, others do not. Ethnicity, lip length, tooth size, and facial proportions all influence what looks balanced.
The most common driver is muscular. The elevator muscles of the upper lip, primarily the levator labii superioris alaeque nasi and the levator labii superioris, lift the lip higher than average when you smile, which exposes the gum. Less often, a short upper lip or altered passive eruption of the teeth and gums plays a role, and sometimes the upper jaw itself sits forward or downward, a skeletal pattern called vertical maxillary excess.
Why does this distinction matter? Because Botox treatment relaxes muscles. If your gummy smile is mainly muscular, Botox can help. If the cause is lip length or bone position, you may need a different strategy, such as a lip repositioning procedure, gum contouring with a periodontist, or orthodontic and surgical approaches. A proper assessment at a Botox consultation should screen for those.
How Botox changes the smile
Botox blocked the nerve signal that tells a muscle to contract. Injected in small doses into the upper lip elevators, it reduces how high the lip lifts during a smile. Less lift equals less gum showing. The trick is to hit the right muscles, not the ones that stabilize the smile or raise the corners. Precision matters.
A standard injection pattern targets two to four points near the base of the nose and along the nasolabial fold, sometimes called the Yonsei points in academic literature. There are variations for asymmetry, a high gum line in the canines versus the central incisors, or a strong pull along the sides of the nose known as bunny lines. In practice, I often start conservatively at the central points and add a micro dose laterally if needed during a touch up.
You should still look animated. The goal is a natural Botox look, not a frozen upper lip. When the dose is right, friends will comment that your smile looks softer or your teeth seem longer, but they will not quite know why.
What a real appointment looks like
A first visit begins with photographs and a quick set of expressions: at rest, a small smile, and a full smile showing teeth. I measure gum display in millimeters on a tablet screen. I also check lip length, tooth height, and how the corners move. If you have a history of lip filler or a planned lip flip Botox, we factor that in to avoid over-relaxing the area.
After discussing expectations and the small risk of an overcorrection, the actual botox procedure is quick. We clean the skin, mark the injection sites, and use a tiny needle to place the botox injections just under the skin. The sensation is brief and sharp, then it fades. The entire botox treatment for a gummy smile usually takes 5 to 10 minutes.
Most people return to work or errands right away. There is almost no botox downtime. A faint bump or redness at each point settles within 20 to 30 minutes. Makeup can cover residual pinkness after a couple of hours.
Doses, units, and timelines
You will see wide ranges online for botox number of units. For a gummy smile, the typical dose is small. Many patients do well with 2 to 4 units per side, or 4 to 8 units total. A petite patient with a delicate lip may need only 1 to 1.5 units per side. Someone with strong elevator muscles might land at 3 to 5 units per side. If you also have pronounced bunny lines, the injector may place an additional unit or two near the nose.
Botox does not work instantly. When does botox kick in? Expect the first fade in muscle pull at 2 to 4 days, with full botox results around 10 to 14 days. We normally schedule a botox touch up at two weeks for first timers, where we compare your botox before and after photos and, if needed, add 0.5 to 1 unit per point to polish the result.
How long does botox last? For a gummy smile, botox duration typically runs 8 to 12 weeks. This is a bit shorter than forehead or crow’s feet because the upper lip muscles are active every time you talk, eat, or smile. Botulinum metabolism varies by person, so plan on botox maintenance three to four times per year if you enjoy the effect.
Cost, specials, and value
Let’s talk money. Botox cost is usually quoted per unit. Botx unit cost often ranges from 10 to 20 dollars per unit in the United States, with regional and clinic differences. Because gummy smile dosing is light, the total botox price can be relatively affordable botox compared to larger areas. Many patients spend between 80 and 180 dollars for this indication, though upscale practices in major cities may be higher.
You will see botox deals and seasonal botox offers advertised, along with packages or a botox membership that gives loyalty discounts over time. It is fine to take advantage of botox specials if the practice is reputable, the product is real botox from an authorized distributor, and a qualified medical professional does the injections. Be wary of cheap botox from pop-up events or mobile botox providers without a clinical setting. The cost of fixing bad botox, or worse, a counterfeit product, exceeds any savings.
If you are comparing botox vs dysport or botox vs xeomin, all three can treat a gummy smile effectively when dosed appropriately. Units are not equivalent across brands, so rely on your injector’s experience, not an internet conversion chart. What matters most is the injector’s eye and the time they take to assess your face while you move.
Safety, side effects, and what can go wrong
Is botox safe? In healthy adults, on-label and common off-label cosmetic doses have an excellent safety profile when administered by trained clinicians. The upper lip area contains small muscles that influence speech and eating, so precision and conservative dosing reduce risk.
The most common botox side effects in this area are mild and short lived: tiny injection marks, slight tenderness, botox swelling, or botox bruising. These settle within days. Ice and arnica can help bruising. Avoid fish oil, high dose vitamin E, and ibuprofen the day before if you bruise easily, unless your physician has you on those for medical reasons.
The bigger concern is over-relaxation. If you cannot lift the lip enough to show your upper teeth while speaking, it can feel odd and affect enunciation of sounds like “f” and “v.” Eating a large sandwich might feel messier for a couple of weeks. These outcomes are uncommon when doses are low and anatomically placed, but they are possible. Because botox longevity is finite, even a heavy-handed result wears off, usually within 6 to 10 weeks in this area.
An asymmetry can appear if one side responds more than the other. This is why I prefer a staged approach for first time botox patients, with a low starting dose and a touch up at two weeks if needed. It is easier to add a drop than to wait out an overcorrection.
Botox risks rarely include headache or flu-like feeling for a day. Allergic reactions are exceedingly rare. If you have a neuromuscular disorder or are pregnant or breastfeeding, skip cosmetic botox until it is medically cleared for you.
Botox for gummy smile versus other options
If too much gum shows because the gums cover part of the teeth due to altered passive eruption, a periodontist can sculpt the gum line to reveal more tooth. The change can be dramatic and permanent. If the upper jaw sits forward or downward relative to the face, orthodontic and surgical care can correct the skeletal relationship. Those are bigger interventions with their own timelines, costs, and recoveries.
Botox shines when the problem is muscular, when you want no downtime, and you value reversibility. It is also a good test drive. If you love the way you look with less gum, and a dentist confirms excessive gum tissue, you may later choose a gum lift knowing the aesthetic moves in the right direction for your face.
Lip filler has a role in selected cases. By adding structure to the vermilion border and body of the upper lip, filler can create the impression of less gum even when smiling. The risk is a heavy or stiff look if overdone. Combining a small dose of botox for gummy smile with conservative filler yields better balance than either alone in some faces. A skilled injector weighs botox vs fillers, and sometimes pairs them in staged sessions.
A lip flip botox, which relaxes the orbicularis oris muscle at the border of the lip, can slightly evert the upper lip and show more pink. While it complements gummy smile treatment in some cases, stacking both too aggressively can weaken lip function. If you are considering both, start with the gummy smile points and reassess at your touch up.
The nuances that make results look natural
Faces are stories, not templates. A patient in her twenties with a high-energy smile and strong cheek elevators needs a different approach than a man in his forties with a long philtrum and thin upper lip. Some people have an extraordinary levator pull at the canine teeth, which means a lateral tweak rather than central points delivers the win. Others flatten the middle of the lip when they laugh, so the dose must be feather-light centrally to avoid a stiff upper lip.
I use video at baseline to see the smile unfold. A still photo can mislead. The timing of muscle recruitment matters, especially if you also have botox for crow’s feet, botox for frown lines, or botox for forehead on the same day. Over-relaxing every elevator in the upper third dulls expression. If your goal is a natural botox look, spread treatments across sessions or lower doses in each area.
Another nuance is dental show at rest. If you already show 1 to 2 millimeters of upper incisors when your face is relaxed, which many people find youthful, over-treating the gummy smile can reduce that positive feature. We aim for balance: less gum at full smile while preserving a hint of tooth at rest.
What to do, and not do, after treatment
Aftercare is simple but worth following. For the first four hours, avoid heavy exercise, lying flat, or pressing firmly on the upper lip or nose. Skip facials and saunas the same day. Light washing, gentle skincare, and regular eating are fine. Do not massage the injection sites.
You might feel like smiling looks slightly different by day three. That is normal. By day seven, the change stabilizes. If you see no difference by day ten, a touch up may be indicated. Keep your follow-up appointment, bring your botox before and after photos if your clinic does not take them, and be honest about what you see in the mirror. Feedback sharpens the plan for your next botox sessions.
Results you can expect
The best botox results for a gummy smile are quiet. You see less gum in selfies. Your lipstick sits better along the upper border without disappearing when you grin. People comment on your teeth, not your gums. The change typically reduces gum show by 2 to 4 millimeters, which is often the difference between distracted and balanced.
Botox effectiveness depends on dose and placement, but also on how your muscles behave. The first cycle is a learning period for both of us. By the second or third cycle, we usually have your formula dialed in, and the appointments feel routine.
Common questions, answered candidly
Am I a candidate for botox? If the primary cause of your gummy smile is affordable botox options MI muscular lift, yes. If you have a very short upper lip or a prominent upper jaw, we discuss alternatives or combination plans.
How much botox do I need? Most people need 4 to 8 units total. Small frames and subtle concerns often do well with less. Very strong elevator pull may need more, sometimes staged.
How often to get botox? Expect every 2.5 to 3.5 months for gummy smile maintenance. Some stretch to four months. Plan your calendar around events if photos matter.
Does it hurt? The sensation is a quick sting that fades in seconds. Topical numbing is possible, though rarely necessary.
What about botox for men? Male anatomy responds well. Doses are similar, though men with thicker tissues may need 1 to 2 additional units.
Can I combine this with other areas? Yes. Many patients do botox for eyes or forehead on the same day, along with lip lines or chin dimpling. The injector should coordinate doses to keep your expressions coherent.
Will speech feel different? A heavy dose can affect certain sounds temporarily. Conservative dosing avoids this in the vast majority of cases. If you give public talks or sing, tell your injector.
Is at home botox or DIY botox a thing? It should not be. It is unsafe and illegal to self-inject botulinum toxin. Mobile botox is fine when provided by licensed clinicians in an appropriate setting. Avoid botox deals online from unknown sellers and any product that is not traceable. Fake botox does circulate, and the risk is real.
What if botox goes wrong? If the lip is over-relaxed, we wait and document. Effects usually ease within weeks in this area. Rarely, hyaluronidase can help if filler compounded the issue, but there is no reversal agent for botox. Good news: this is why careful dosing up front is so important.
How gummy smile treatment fits into a broader plan
Most patients do not seek a single-point fix. They want harmony. If you are already exploring botox for smile lines, mouth lines, or a subtle lip flip, consider spacing treatments in a sequence rather than stacking everything in one day. This allows you to judge which change delivers the most return.
If you are also considering fillers like Juvederm or Restylane for the lips, do not think in terms of botox vs juvederm as an either-or. They do different things: one relaxes, the other restores volume and shape. Used together, they can lift, smooth, and refine the smile. Compare this to botox vs chemical peel, which treats surface texture and pigment rather than muscle action. The tools are different, so the plan should be layered.
Preventative botox, baby botox, and micro botox are terms you will hear. In the context of gummy smile, baby or micro dosing is essentially the standard approach, because we need only a light touch to see a visible change. Preventative treatment makes less sense here than it does for forehead lines, since gummy display is an active expression rather than a static wrinkle.
What reviews reveal, and what they miss
Botox reviews for gummy smile often read like a before and after postcard: “Love my smile now.” Those are genuine and encouraging, but they do not mention the quiet details that make the difference day to day. For instance, some patients feel their upper lip makeup routine changes because lipstick does not ride up when smiling. Others notice their dental cleanings feel less self-conscious. You will not see those in glossy grids, but they matter.
On the flip side, a negative review sometimes reflects a mismatch between cause and treatment. If the patient needed gum contouring or orthodontic input rather than botox alone, satisfaction drops. This circles back to the importance of a thorough botox consultation, with clear talk about what botox can and cannot do.
Choosing the right injector
The phrase best botox gets thrown around online. What you want is the best injector for your face. Look for an experienced provider who can explain the anatomy in plain language, show you case examples that resemble your features, and start conservatively. If a clinic pushes high-dose packages for every area or emphasizes discount botox over assessment, keep looking.
Searches for botox near me will pull up a long list. Narrow it with specifics: gummy smile experience, conservative dosing philosophy, and follow-up built into the price. Ask whether the clinic uses real brand-name botulinum toxin from authorized suppliers. Simple, direct answers build trust.
Financing options exist. Many practices offer botox payment plans or loyalty points that shave dollars off future visits. If you plan to maintain treatment, a botox loyalty program can be sensible. Just do not let points pressure you into more units than you need.
My approach, distilled
Most gummy smile cases respond beautifully to small, strategic injections. The plan I rely on most often goes like this. First, measure gum show and map the smile in motion. Second, place a conservative dose centrally, with or without a feather lateral point, avoiding the muscle fibers that stabilize the corners. Third, review at day 14, add tiny increments if needed, and record the final pattern. Fourth, maintain every three months, adjusting for seasons, travel, or major life events where photos matter.
I keep a note on speech and eating from the first two weeks, because that informs the next cycle. If a patient felt even a hint of lip heaviness, I shave a half unit and shift the point one to two millimeters. Over time, the pattern becomes yours alone, and sessions feel quick and predictable.
When Botox is not the right answer
There are times to say no. A patient with significant vertical maxillary excess and 6 to 8 millimeters of gum show will only see modest improvement from botox. If expectations are set for a dramatic change, disappointment follows. In these cases, I refer to a multidisciplinary team for imaging and discussion of surgical options or gum recontouring. Another no is the patient seeking cheap botox at a party setting, or who brings a vial purchased online. Safety first, always.
If you are pregnant, planning pregnancy, or breastfeeding, skip botox for now. If you have a history of exaggerated responses to facial botox, proceed with extreme caution or consider alternatives. If your job involves heavy vocal performance or wind instruments, stage the treatment well before a performance and test your comfort during the ramp-up period.
A final word on confidence
Confidence is rarely about erasing features. It is the feeling that the mirror lines up with how you see yourself. For many of my patients, less gum at full smile allows their eyes, teeth, and joy to take center stage. The change is measured in millimeters, the effect in how freely they laugh.
If you are curious, book a proper consult. Ask direct questions about dosing, placement, botox effectiveness, and recovery. Bring a photo where your gummy smile bothers you and one where you like your expression. A thoughtful plan, small doses, and a steady hand can shift your smile from self-conscious to effortless, without announcing that you had anything done.