Botox to fix gummy smile gone wrong please help! Lengthened and flattened top lip. (photos)

I got 2.5 units in either side to fix a 'gummy smile'. I did not notice a big difference so about 6 days later i saw the doctor again and got a further 1 unit in each side. Within 2 days i am unhappy with the results. When i smile the upper lip lengthens and flattens. I am so distressed i have my wedding 10 days from now Are these effects from first course of botox or top up? I've heard botox doesnt last as long around the mouth? Are the effects likely to be the same in 10 days Thank you

Doctor Answers 6

Botox to fix gummy smile gone wrong please help! Lengthened and flattened top lip. (photos)

When using BOTOX for unusual areas, i.e. gummy smile, you need to use a expert Botox injector only. Sounds like the treatments were done correctly. And the results are point on. YES! the lip appears to flatten when the orbicular oris muscle is paralyzed. Thus the longer, flat effect. And NO BOTOX takes months to wear off not 10 days... Sorry. 

Flat Lip

Ouch!  I get that this day coming up is one of the most important of your life and you're concerned now because your lip is not where you want it to be.

The lesson here is patience.  It takes time for Botox to work and probably the second course could have waited.  And, unfortunately, there is no way to stop the effect.

The solution is to realize that ALL brides are beautiful and you will look so lovely in your dress that nobody (except you) will notice ANYTHING at all wrong with your lip.

Please do not let this ruin your wedding day.  The advice I can give you after 45 years of happy marriage, is that what's important here is the marriage, not the wedding.  The memories of the day will, I hope in the future, not be as important as spending the rest of your life with your best friend.

Michael A. Greenberg, MD
Elk Grove Village Dermatologist
4.9 out of 5 stars 16 reviews

Botox For Gummy Smile

The effects you are noticing are most likely cumulative from both treatments.  It's true that Botox effects around the mouth can be of a shorter duration, which can be dose-related, and also has to do with how much motion, function and blood flow there is in the muscles of the lip.  Unfortunately, there is no way to reverse the effects of the product, so they will resolve as the Botox wears off.

Jeffrey Ridha, MD
Saratoga Springs Plastic Surgeon
5.0 out of 5 stars 23 reviews

Botox for gummy smile

sometimes if the Botox is too much for the particular gummy smile problem the lip will lengthen too much and come over the teeth. it will be better with time but 10 days is a little too short.  there is no way to reverse it

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

Gummy no more

I think it's just your not use to it yet, you need to look at it post photos before and after. I believe this doctor gave you exactly what you were looking for "no gummy smile" mission completed! You have to have realistic expectations and understand what will happen when you do something. How did you think Botox was going to get rid of your gummy smile? It does so by relaxing the muscles and contractures. This smooths the upper lip. It hasn't lengthened your lip, it's the same size it's just not going up to your nose anymore. You will be use to it and happy by your wedding my guess. There will be 10 more things that will go wrong by then and make this seem like nothing. You have the cake, photographer, music, food, etc. you will be the only one noticing your lip. Don't tell anyone and see if anyone says anything you are your worst critic. Smile is beautiful, enjoy your new life!!!

Adam Stibich, MD
Hot Springs National Park Dermatologist
3.0 out of 5 stars 1 review

Botox for gummy smile

I'm sorry about your upcoming wedding and this issue. Personally I would have stuck with the initial dosing and not added more. It can take up to 10 days for Botox effects to fully kick in so I would not have added a single unit until that time. I sincerely hope that what happened was from the second treatment and not the first, so that things don't get even worse for you. However, there's really no way to know. Really, you're just going to have to go with how it is now. Botox is not reversible and there's very little you could even try to help correct this within the tiny timeframe you have. Smile, grin, and enjoy your day. Everyone will think you are absolutely beautiful - I promise!

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