Correct gummy smile and deep horizontal crease above upper lip. Surgery or Botox? (photo)

Question

43 y.o. I tried dysport three months ago for first time but minimal results. I have an appointment with an orthodontist surgeon to re-set my upper jaw. It protrudes out what feels like half an inch , creating a "ledge" behind my upper lip. I feel this allows the skin to settle into when I smile. Looking back at pictures from 10 yrs ago, I didn't have crease. It developed over past 3 years. Should I consider surgery to correct gummy smile and horizontal crease or keep trying with Botox?

Anil R. Shah, MD · Answer

Thank you for supplying photos, but unfortunately they are not at standardized angles for proper examination. Botox may be used for a Gummy Smile and can be used to soften the creases above the lip. These treatments relatively inexpensive as they do not require a large amount of units needed for Masseter or Forehead injections. 
If seeking potential treatment, I strongly recommend that you follow up with an experienced injector, preferably a Facial Plastics Surgeon.
Keep smiling! 
Best, 
Dr. Anil Shah

Rupert Critchley, MD, MRCGP · Answer

Hi there! Thank you for your enquiry. Anti-wrinkle injections are very effective in general in the treatment of a ‘gummy smile’ and results usually last up to 4 months. This can vary however from person to person for reasons such as a difference in metabolism. It may be worth revisiting your practitioner for a review to discuss your concerns and re-evaluate your treatment plan before deciding to commit to surgery.
Hope this helps!
Best Wishes,
Dr Rupert

Atul Bembi, DO · Answer

Botox or other neurotoxins can improve gummy smile.   Your injector May need to increase the dose to improve the results.

Mohammed F. Ahmad, MD · Answer

Hello. Thank you for your question. Botox/Dysport/Xeomin would correct your gummy smile. Because this causes the lip to slightly drop, it may also improve the crease under your nose. If the crease is still there, Bellotero is a great option to fill it. Bellotero is very thin and can be placed pretty superficial, which will get rid of the lines but not look too bulky.

Mariale Foley, MD · Answer

Yes, Botox, Dysport, Xeomin and Juveo are all neurotoxins that can be used to treat successfully gummy smiles.  If this was your first treatment, it is possible that your injector tried a low dose to evaluate how much your upper lip would drop.  Also, with low doses the results tend to last less and ultimately, every person metabolizes differently each substance that enters their body.  I would recommend you to go back to your provider for an adjustment in the dose to help you to achieve the desired result.
Best wishes!

Mark Kearns, MBChB, BSc, FRACGP · Answer

Hey there - thanks for the question! I'm really sorry but your photos are not viewable so it's difficult to give you a meaningful assessment but in general terms, yes - botox or dysport can in some cases improve the appearance of a gummy smile. Good luck!

Bushra Ali, MD - Account Suspended · Answer

Hi, 
Thanks for sharing the question and photos.
Botox/ or anti wrinkles in general would help the gummy smile if injected in the correct manner, also augmentation of the upper lip with a soft filler like Belotero, Restylane silk or Juvederm Volbella will help the upper lip crease to become less pronounced
Hope this will help.

Correct gummy smile and deep horizontal crease above upper lip. Surgery or Botox? (photo)

Answers (7)

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