Are Botox injections near nostril the only way to treat gummy smile or can injections across top lip help as well? (Photo)

I had Botox a second time for gummy smile. The first time, 8 units were injected close to my nose in 2 spots. This time, 8 units were injected across top of my lip in 4 spots (diff Doctor). It has been 1 week and I can't drink through a straw, whistle, pucker my lips, or rub them together. No change in my smile! I want to know if where I was injected this time will help with my smile? Will I notice a change in my gummy smile or must I wait to get Botox injected closer to the bottom of the nose?

Doctor Answers 14

#Botox for #GummySmile

Dear rmm34:

By injecting a small dose of Botox in the levator labii superioris alaeque nasi muscles just to the side of the nasal alae, one can relax the muscles that pull the lip up and improve a gummy smile.  Botox can also be injected in the perioral muscles to evert the lips, making your lips appear fuller, and to smooth lip lines, but this would not help gummy show very much if at all.

I hope this is helpful!  Dr. Clark


New York Dermatologist
5.0 out of 5 stars 7 reviews

Gummy Smile -- Botox/Dysport/Xeomin Around Mouth

Precise placement of botox around the mouth is the best treatment for gummy smile.  I suggest you see an expert for a consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Gummy smile

Hi rmm34, The best way to treat a gummy smile is surgically.  Botox injections are used sometimes as a temporary treatment but these wear off relatively quickly.  The surgical procedure involves removing a small strip of attached mucosa of the upper gum and is very simple, straightforward and successful.Best,Dr Nettle

Are Botox injections near nostril the only way to treat gummy smile or can injections across top lip help as well?

Thanks for your question and photo and it appears that you have two different experiences in trying to treat the same concern.  The first injector was much more correct than the second and so therefore, make sure that you are consulting with a board certified dermatologist or plastic surgeon as we are the group that best understands the anatomy in the area that needs to be treated and understands the areas which should be injected.  It appears the second injector did not know what exactly to inject, and made things worse from a drinking point of view.  See an expert each and every time you want facial injections.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Are Botox injections near nostril the only way to treat gummy smile or can injections across top lip help as wel

Thank you for your question.  Botox injection that helps with the gummy smile is an injection just lateral to your nostril.  An injection across the top of the lip will not drop the upper lip but it will affect the orbicularis oris muscle.  An injection in this muscle will weaken your ability to purse your lips (affect drinking out of a straw).  Make sure you go to a Board certified plastic surgeon for your injections.  Best Wishes

Gummy smile injection

The muscle that causes the gummy smile is the levator superioris labii alaeque nasi muscle. This is not treated with the injections you received. The injections you just got treat the orbicular oris muscle. That is why you are having trouble closing your mouth around things. I use a maximum dose for this injection of about 5 units of Botox. I use about 2 units are either side of the nose to help gummy smile. I don't think your doctor was experienced enough to know how to do this or the anatomy.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Gummy smile

the correct injection was more like the first and the second will not really work for what you want, but there is a trick not known to all and that is to inject the pyriform sulcus at the top of the Nasolabial fold in addition to under the nose. Be sure you see a board certified dermatologist or plastic surgeon

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Botox injections for smile and wrinkles

it sounds like you got Botox injections like we use to treat wrinkles.  The first ones you got sound more like the ones to treat a gummy smile.  Did you like the effects of the first treatment?  If so, you can communicate that to future doctors you may see to help get the results you want. 

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 15 reviews

Botox for gummy smile

To treat gummy smile Botox is placed just to the side of each nostril to relax the muscle that is pulling up the lip.  Injections in the upper lip itself are used to treat vertical lip lines like "lipstick lines" and "smoker's lines". They have the unfortunate effect, sometimes, of making it hard to pucker the lip or use a straw. You can still have the appropriate injections performed, however, while you wait for the lip effects to wear off. Good luck!

Justin Cohen, MD
Washington DC Otolaryngologist
5.0 out of 5 stars 21 reviews

Gummy smile Botox...

Thank you for your question.  Botox for a gummy smile should be injected near the nostrils.  Injecting into the area above the pink part of the lip will serve to relax vertical lip lines, but will have no effect on your gummy smile.  Please be evaluated and managed by a board certified Dermatologist with experience injecting for gummy smiles.  You may still have this injected even though you had your lip lines injected originally.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 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.