How many units of Dysport or Botox for gummy smile?

Question

I'm just curious because I got it done for the 5th time today and they wanted to charge me 10x the amount I normally pay. She said she put 30 units in my upper lip (4 pricks) but when they checked my history she only put 4 units at the other appointments. Does this sound right? I feel like 30 units is a lot for that area

Jason Emer, MD · Answer

This is difficult to answer without pictures. The amount needed can be variable to area treated and desired results. If you have any concerns, I recommend following up with your injector. Best, Dr. Emer

Omar Lazos, MD · Answer

Love this simple and effective procedure... Depending on how much the lip goes up I inyect avarege 3 units on each side of the elevator labi muscles, also in the middle of the nose (depressor septi nasi) I place 1-2 units. So in total I only use 7-8 Units for gummy smile

Aldo Guerra, MD · Answer

Hello Jamenta.Gummy smile requires a few units only, but this injector might know better what you need since it's your 5th visit. You should follow up with your injector in two weeks and discuss your concerns.Best wishes, Dr. ALDO :)

Michael A. Zadeh, MD, FACS · Answer

You are absolutely right to be concerned about getting 30 units for a gummy smile. That is way too much for that area. 4-6 units sounds more appropriate. I would make sure you clarify this with your injector. Best wishes.

Darice W. Fadeyi, MD · Answer

A gummy smile can be treated with neuromodulators but this would be considered an advanced injection technique. Injection at one point, Yonsei’s point, will target four key muscles involved in lip elevation - zygomaticus minor, levator labii alaeque nasi, zygomaticus major and the levator labii superioris. I typically start with 2-4 units of Botox or 5-7.5 units of Dysport for the first treatment. Then I will always see the patient back in two weeks and decide whether more neuromodulator is needed. I will not do a touch up before two weeks. Generally, the greater the amount of gingival display, the higher the required dose. I do agree that 30 units is quite a lot but you don’t specify whether this was Dysport or Botox. There’s a three fold difference in the units. I urge you to see a skilled board certified dermatologist. Poor placement or aggressive dosing could lead to a very long upper lip and problems animating. The two week follow up that I mentioned is my way of ensuring that the treatment is optimized with caution and precision.

Richard E. Moore, MD · Answer

The treatment of gummy lines is best left to an expert injector. I typically inject 2-4 units of botox or 6-12 units of Dysport adjacent to each nasal alae. I do not charge by the unit for this area as I consider it an expert area. My charge for the gummy lines is $120 regardless of the number of units. I hope this was helpful - Dr. Moore.

Steven F. Weiner, MD · Answer

Treating a gummy smile should be left to the expert injectors. The muscle treat is the levator superioris labii alaeque nasi. I usually will treat with 2 units of Botox on each side of the nasal alae or 4 units of Dysport. 30 is way too much and will leave a very abnormal smile.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for sharing your concerns.  You are right to be concerned - 30 units is an extremely high dose for this area.  I would recommend following-up with your injector to review your treatment record.  If she did bill you for 30 units in the upper lip, I think it may be time to find a new injector - I generally recommend seeing only cosmetic dermatologists or plastic surgeons for any cosmetic injections.  Best of luck!

How many units of Dysport or Botox for gummy smile?

Answers (8)

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