What can I do as my teeth do not show when I smile as my upper lip covers it? (Photos)

Question

have the worst smile. What can I do to fix it? My upper lip covers when my teeth when I smile. My teeth do not show. Please let me know what I can do to fix it.

Gary Linkov, MD · Answer

There are surgical and non-surgical approaches to lip augmentation. Non-surgical approaches include botox (slight lift, reducing gum show) and filler (volume restoration). Surgically, you can have two separate incisions under the nose (italian), one incision under the nose (bull horn), one incision at the red/white upper lip junction (gull wing) or two separate incisions at the corners, or a combination, depending on your desired look and anatomy. My preferred surgical technique is called the Elelyft, which is a version of the bullhorn approach. The ideal candidate for the Elelyft, or upper lip lift, is someone with a philtral length of 13mm or longer, no upper dental show, and/or a thin upper lip. The nasal base to mouth width ratio needs to be taken into consideration to avoid leaving the lip corners down. In your situation, an upper lip lift would definitely help increase upper tooth show. Consult with an experienced lip surgeon for a complete range of options that are appropriate for your situation. Gary Linkov, MD - Lip Specialist - Manhattan

Brian E. Rosett, MD · Answer

Hard to say based on your pictures. Given the amount that the pics are cropped its hard to analyze your facial and dental aesthetics. Going to a well trained board certified plastic surgeon who can evaluate your face and teeth at rest and smiling will allow them to give you options.

Kyle Kimura, MD · Answer

Thanks for the great question and the associated photos! I think you have alot of potential options to improve dental show (how much teeth are showing when smiling). 
It is hard to know the exact reason you have little dental show, whether the muscles that pull the upper lip up are just not strong enough or if the orbicularis muscle is too much to overcome. I would consider starting out with a neurotoxin like botox to perform a lip flip by weakening the orbicularis muscle slightly and see if that improves how much teeth are showing. I like this as a first option as it can help us understand the anatomy behind your issue and it is also reversible over time. 
If this is not effective or you are looking for longer term options, surgery would be the next step. I would want to see if you had any benefit by removing skin/mucosa on the inside of the central lip, however difficult to tell based on photos. The other option would be lip lift which involves incision underneath the nose to remove skin and lift the lip with focus on more removal centrally for more of a lift in this area. 
I hope this helps and best luck with your journey! Kyle Kimura, MD

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. There are different ways to address this type of concern, from using neuromodulators to relax the muscles and lift the lip, to a surgical procedure that offers permanent improvement. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and create a customized treatment plan that meets your needs and goals best.

Barry L. Eppley, MD, DMD · Answer

You have an upper lip mucosal redundancy which pushes down when you smile, thus preventing any upper tooth show. That can be solved by a horizontal mucosal excision of your upper lip.

What can I do as my teeth do not show when I smile as my upper lip covers it? (Photos)

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