Would Botox and lip fillers be best for a gummy smile with thin, uneven lips? Can they be done at the same time? (photos)

Question

My lips are much too thin and uneven for my liking and I've got a slight gummy smile. I've heard of fillers for plumping and Botox for gummy smile. Can these be done at the same time or close together? I'd like to have my smile settled by Oct. 11th I've included pictures of myself and a few different "goal smiles" that I love. And yes, I am looking to fix my hanging columella, which is a result of rhinoplasty in 2014.

Edward Buckingham, MD · Answer

Neuromodulators and intradermal fillers can be performed at the same time to help you achieve your desired goals. It is recommended a discussion be had with your treating provider on different options. Several treatments may be required to achieve your desired results.

Kian Karimi, MD, FACS · Answer

Thank you for sharing your question and photos. Yes, both Botox for the gummy smile and lip fillers can be done at the same time. Depending on the degree of gummy smile you are noticing, an experienced injector should be able to inject a small amount of Botox in the proper locations near the nose to give you more tooth coverage when smiling. For lips, I recommend a hyaluronic acid filler such as Restylane or Juvederm using the microcannula technique. This technique is essentially bruise-less and allows filler to be injected evenly for a natural result. When it comes to lips, it is very important to keep them looking natural so I always recommend my patients start with a conservative amount of filler initially and add more if necessary. I recommend consulting with an injector experienced with the microcannula technique for your treatments. Good luck!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs. Though your pictures do not demonstrate a gummy smile, Botox can be used to lower the upper lip to increase coverage of the upper teeth.  That said I would recommend you first seek use of a thicker hyaluronic acid dermal filler, such as Juvederm Ultra Plus, to achieve your desired increase in lip size and then assess your mouth appearance.  Oftentimes with the added volume to the lips this will improve any subtle gum show.

Robert M. Tornambe, MD · Answer

First off, while your lips are somewhat thin, I do not believe you have a gummy smile (from your photos). I would first try lip augmentation with filler like Juvederm ultra plus. If you like the look, then you may want to consider fat transfer, as it is more permanent. Be sure to consult with a board certified plastic surgeon. Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you are a great candidate for lip fillers.  You are also a good candidate to revise your hanging columella.  The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jason Emer, MD · Answer

I find that fillers, (Restylane, Juvederm) are good to create a symmetrical lip.  Please see an expert for a formal consultation.  Best, Dr. Emer.

Camille Cash, MD · Answer

Botox for a gummy smile can be done at the same time as HA fillers.  However it doesn't appear from the submitted photos that Botox would be needed.  Fillers should be able to achieve the volume enhancement you are wanting.

Dean P. Kane, MD, FACS · Answer

Dear BabyGauchette:A gummy smile is improved with Botox to relax the upper lip muscle fibers of the levator labii superioris muscle.Tight, thin lips are enhanced with both Botox to weaken the inner ring of lip muscles and filler to volumize the lip.Both techniques require advanced skill and talent. Seek a Board Certified Plastic Surgeon or Facial ENT to evaluate for and perform these procedures. All the best!

Jeanine B. Downie, MD · Answer

Hi there,  I regularly do Botox and lip filler on the same day. I would recommend that you seek the help of a board certified dermatologist would have experience with Botox in this area.  Additionally, because your lips are on the thin side the doctor will have to go slowly. I recommend only one syringe of Juvederm at a time. That way, you will not get so much swelling and or bruising. Good luck. Dr. Downie

Essie Kueberuwa Yates, MD · Answer

I do not appreciate any evidence of a gummy smile in your pictures. You are a good candidate for lip fillers (augmentation) based on the pictures you posted of your "ideal" lip shape and size. I would recommend restylane or juvederm. Start conservatively and add more if you need it once the swelling goes down. - Dr Yates

Would Botox and lip fillers be best for a gummy smile with thin, uneven lips? Can they be done at the same time? (photos)

Answers (17)

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