A gummy smile — where more than 2-3mm of gum tissue is visible when smiling — is a concern that affects a meaningful proportion of patients, often more so than any other facial aesthetic issue. It is also one of the quickest, most straightforward, and most satisfying corrections we perform at our clinic using botulinum toxin. Understanding how it works demystifies a treatment that many patients don’t realise exists.
What Causes a Gummy Smile
Several anatomical factors can contribute: a hyperactive upper lip elevator muscle (levator labii superioris alaeque nasi) that pulls the lip too far upward when smiling; a short upper lip; excessive vertical growth of the upper jaw (dentoalveolar protrusion); or small teeth relative to the gum tissue. In the majority of patients presenting to us, the cause is a hyperactive upper lip elevator — and this is the form most effectively treated with botulinum toxin.
How the Treatment Works
Small doses of botulinum toxin are injected into the upper lip elevator muscles on each side of the nose. By partially relaxing these muscles, the upper lip does not elevate as high during smiling, reducing gum exposure. The injection points are precise and the doses are small — the goal is to reduce the lip elevation by a few millimetres, not to prevent natural smiling movement entirely. A natural, proportionate smile is always the target.
What to Expect
The treatment takes under 10 minutes. Results develop over 5-7 days. Duration is typically 3-4 months — slightly shorter than other botulinum toxin treatments because the lip muscles are highly active. Most patients return for maintenance at 3-4 month intervals. The treatment requires precision — too much product or incorrect placement affects the smile asymmetrically. This is a procedure where experience and anatomical knowledge matter significantly.
If a gummy smile has affected your confidence when smiling or in photographs, this is a genuinely simple, effective treatment with minimal downtime and consistently high patient satisfaction.
Book a consultation: wa.me/919381218003
— Dr. Nishita Ranka | Consultant Dermatologist | Dr. Nishita’s Clinic for Skin, Hair & Aesthetics, Hyderabad
