Botox Units Needed to Correct Gummy Smile?

How many units of Botox is needed to reduce the amount of lifting of the upper lip when smiling, so as to correct a gummy smile?

Doctor Answers 9

Botox of the upper lip

Botox can work very well to correct a gummy smile. Caution must be taken, however, as excessive Botox in the lower face may have very obvious cosmetic and functional impairment. I always start conservatively in this area - you can always add more if needed. I usually use a dose of 2 units on each side and ask the patient to return to my office in a week to evaluate. I strongly urge you to go to someone who has experience injecting the lower face with Botox and feels comfortable dealing with muscle denervation in this area. Good luck.

San Diego Dermatologic Surgeon
4.3 out of 5 stars 7 reviews

Go Away Gummy Smile!!

I think I agree with everyone who said just a little Botox will lessen the problem. When you make the appt with the derm or plastic surgeon just ask if they have done that before...

Good luck and keep on smiling either way!

Beverly Johnson, MD
Silver Spring Dermatologic Surgeon
4.9 out of 5 stars 7 reviews

Take the Gummy out of the Smile

I start very conservatively. I always tell my patients that when we were kids, we studied addition before subtraction and that holds true especially with Botox, where no antidote other than time is available.

I start off with 3-5 units on each side and would see the patient again in a week's time, if a touch up is needed, it is injected then. Also the extent of the gummy smile is also taken into consideration. There are people with such a significant gummy "show" that more should be injected from the first setting. In any case, patients should be told that the effect lasts about 4 months and that they may feel funny when smiling as the lack o movement can come as quite a surprise to some of them.

Hassan Galadari, MD
Dubai Dermatologist

Botox Units for Treating the Gummy Smile

 Good Day Oz Girl,

It takes about 5-6 units of Botox to treat the gummy smile, even in Aussies.  Make sure that you choose a physician who is experienced in this area of injections.  

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Gummy smil and botox

If you have a true gummy smile, then surgical impaction of the maxillae may be the best and permanent result you are looking for.  Botox injected into the upper lip may improve the gummy smile , but also may cause a lip droop.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Dear Ozgirl

Botox is very good for treating the 'gummy smile'. It is placed in the muscles that are beside the nose- weakening the upward pull and thus the amount of lift of your lip. If too much is place then you may have an incomplete smile.

Usually 1 to 2 units are placed per side. You should have a check at 2 weeks.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 118 reviews

Botox around mouth and lips

I do not treat these areas with Botox because of the risks. Several dermatologists do and I would only recommend going to those dermatologists that treat the mouth regularly and have good consistent results.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Not much

I usually start with 1-2 units per side in just the right spot. Warning: be sure you have full lips. If your lips are thin, or your upper lip is long, you will not like how you look. The injection into this levator results in a slight lip drop.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Botox for gummy smile

If you truly have a gummy smile, Botox is not the definitive treatment for you. Although it may be temporary, it could distort your smile slightly and create some asymmetry while you are at rest.

The treatment of a gummy smile is surgical, and I recommend consulting with a plastic surgeon and/or an oral surgeon trained specifically in orthognathic surgery, which is they type of surgery involved in treating you condition.

Best wishes.

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.