Is Juvederm a Good Choice for Me? Can I Go to Any Experienced Juvederm Doctor? (photo)

I am interested in getting juvederm to enhance my upper lip and make it more even to the bottom.The main reason why I'm interested in this is because I show a lot of gum when I smile.I was told other then surgery I could enlarge the upper lip which will hide some of my gum when I smile. My question is do I have to go to a DR that has used juvederm for this reason before(2 hour drive!) or can I go to my plastic surgeon who has used juvederm 100's of times just not to help conceal a gummy smile

Doctor Answers 11

Improving a "gummy" smile

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I would suggest trying small dose injections of Botox to relax the action of your upper lip elevators during smiling (thus lowering your upper lip and concealing your gums) before you try Juvederm.  I think this will give you a better aesthetic result.  

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Juvederm or Botox for Gummy Smile?

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It appear you already have nice, somewhat full lips. You might add a bit of Juvederm to the upper outer lips only but you could also try 2-3 units of Botox in the Levator labii superioris alaeque nasi muscle (This is the muscle on either side of the nose that raises the upper lip)  This alone can cause the lip to relax downward and show less of the gum line. Any experienced injector should be able to do this for you.

































































































































































Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Is Juvederm a Good Choice for Me?

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You can apply 2-4 units of Botox or Xeomin to help relax the upper lip. Seek a certified physician for further evaluation who can provide the results you wish to achieve

Best regards 

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Juvederm Injections For Lips

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It would be a great idea to check out the Allergan (the makers of Juvederm/botox) website for a referral to an “Expert injector” in your area. It's always important to visit an injector with a specialized knowledge in the treatment you're seeking.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 20 reviews


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You have a few options:

  1. Botox (most bang for your buck).
  2. Filler (may help somewhat but Botox will probably help more).
  3. Surgery (maxillary osteotomies) - I don't think you want to go through this and wouldn't recommend it.

Make sure you see a board certified plastic surgeon in your area that has experience with these products.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Botox Works For A

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After looking at your pictures I think you would be a better candidate for Botox injections instead of Juvederm because you already have nice, full lips. Just a small amount of Botox injected into the hyperactive muscle that controls your upper lip would help relax it so your smile shows less gum and sometimes makes the upper lip appear fuller. When Botox is injected into this muscle it causes it to basically become paralyzed and depending on the amount injected, will do this more or less. These results will last 3 to 6 months. “Dr. D”

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 reviews

Gummy Smiles Respond Well To Botox, Dysport or Xeomin

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In general, what is known as a "gummy smile," i.e. an exposure of the gums whenever the person smiles, is the result of overactivity of certain tiny muscles located to the sides of the nose. These little muscles, known as "levator" muscles because they are responsible for elevating the upper lips, when overactive, give rise to too much exposure of the upper gums with smiling.

The treatment of choice for the gummy smile is to use a neuromodulator, such as Botox, Dysport or Xeomin. These agents, when injected in tiny droplets in the proper location to the sides of the nose, relax the overactive levator muscles so that they do not pull up the lip exaggeratedly with smiling. If the red lips are already properly proportioned, as in your case, adding filler to them would only risk giving rise to a ducky look and would be ill-advised. 

Since treating the gummy smile with neuromodulators requires a great deal of experience on the part of the injector (to ensure that only the tiny levators are injected) and a normal smile is preserved, consultation with an experienced, board certified aesthetic physician is strongly advised.


Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Good smile with some

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Before treating your smile with fillers such as Juvederm, Restylane or Perlane, etc., you should first be evaluated to determine whether the noticeable "gum" exposure is due to muscle movement or lip size.  If it is due to muscle movement then this should be addressed.  A low dose of a neuromodulator, such as Botox, Dyport or Xeomin could be used for this. Would only recommend fillers if deficient lip volume is a significant contributor to the issue.  In the photo this does not appear to be the case.  It appears that you should have good lip volume.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Is Juvederm a Good Choice for Me? Can I Go to Any Experienced Juvederm Doctor?

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Yes try low dose BOTOX to paralyze the upper lip elevators instead of filling the upper lip. You already have a very full upper lip adding more fillers would give you the fish look. 

Gummy Smile

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A bit of Botox will be very beneficial. Placement of a few units (2 is what I use) into the LLSAN  ( Levator labii superioris alaquae nasi), the muslces that run along the side of the nose, will erase the gummy smile. Botox at this site will cause a partial paralysis of this muscle and allow a lengthening of the upper lip so that your smile will expose less of your gums. Be sure this is done by somebody with experience. Placement must be even on each side. Otherwise, you might end up with a Dick Chaney smirk. Whether you agree with Cheney's politics or not, most people do not feel that is a good look.

One other advantage of an injection into this area, is that it will flatten your naso-labial folds to an extent. It appears in your first two pictures, that these might be a bit accented.

In my judgement your lips are quite full and pretty. However, I am quite sure that if your plastic surgeon has done 100's of Juvederm injections, he would be quite capable of adding a touch of Juvederm to make you happy.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

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.