Upper teeth don't show when I smile - Is jaw surgery (maxillary osteotomy) the only solution? (Photos)

When addressing the issue of upper teeth not showing when smiling, there are several potential solutions beyond jaw surgery (maxillary osteotomy), which is indeed a more invasive option. Here are some alternatives to consider:

Lip Lift: A lip lift is a surgical procedure that shortens the philtrum (the space between the nose and the upper lip), which can help expose more of the upper teeth when smiling. Given that your philtrum is already on the smaller side, this option might not be ideal, but it can be considered if a subtle enhancement is desired.

Dermal Fillers: Injectable fillers can be used to subtly enhance the volume of the upper lip, potentially improving the visibility of the upper teeth when smiling. This is a non-surgical option with temporary results, allowing you to assess the changes before committing to more permanent solutions.

Botox: Strategic use of Botox can help relax the muscles around the mouth, potentially altering the dynamics of your smile to show more teeth. This is a temporary solution that can be adjusted over time.

Orthodontic Options: While you mentioned wanting to avoid another round of braces, there are less invasive orthodontic treatments, such as clear aligners, that might help adjust the position of your teeth or bite to improve tooth visibility.

Veneers or Crowns: In some cases, dental veneers or crowns can be used to slightly lengthen the appearance of the teeth, making them more visible when smiling. This option is more cosmetic and involves altering the teeth themselves.

Gingivectomy: If excess gum tissue is contributing to the lack of tooth visibility, a gingivectomy (gum contouring) might be an option to expose more of the tooth surface.

Each of these options has its own set of benefits and considerations. A consultation with a cosmetic dentist or an oral and maxillofacial surgeon can provide a personalized assessment and help determine the best approach based on your specific anatomy and aesthetic goals.

In your 4th photograph you have shown, it appears the corners of your mouth are turning downward. You would benefit from a eccentric lip lift. An eccentric lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.