Botox for a Gummy Smile: Units, Results and How Long It Lasts

A gummy smile is when more of your upper gum shows than you would like when you smile. It is very common and completely harmless, but some people feel self-conscious about it. When the cause is an upper lip that lifts too high, a few units of Botox can soften that lift in a quick appointment, with no surgery and no downtime.

Botox does not fix every gummy smile, though. This guide explains what causes a gummy smile, when Botox works, how many units it takes, how long it lasts, the side effects to know about, and what it costs at our Carlsbad studio.

What causes a gummy smile?

When you smile, it is normal to see a little gum. A smile is usually called “gummy” when roughly 3 to 4 millimeters or more of gum shows. There are several possible causes, and many people have more than one:

Cause	What is going on	What helps
Overactive upper lip	The muscles that lift the upper lip pull it higher than average when you smile	Botox, which relaxes those muscles
Short upper lip	The lip is naturally short, so it covers less of the gum	Sometimes Botox or filler; occasionally surgery
Gum covering the teeth	Gum tissue sits too low on the teeth, so teeth look short (altered passive eruption)	Gum contouring by a periodontist or dentist
Upper jaw growth	The upper jaw grew longer vertically than average (vertical maxillary excess)	Orthodontic or jaw surgery options
Teeth position or wear	Teeth that have moved forward or downward, or are worn short	Orthodontic or dental treatment

Botox works best when the gummy smile comes mainly from an overactive upper lip. A quick check: if your gums show a lot only when you smile broadly, but your teeth look a normal length at rest, the lip muscles are likely to be the main cause. If your teeth look short even when you are not smiling, a dentist should assess you first.

How Botox treats a gummy smile

A few muscles lift your upper lip when you smile. The main one runs down the side of your nose to the upper lip. Your injector places a tiny amount of Botox into these lip-lifting muscles on each side, often at a single point beside the nostril. Relaxing them slightly means the lip does not rise as high, so it covers more of your gum.

The goal is a softer lift, not a frozen lip. You can still smile fully; your upper lip simply sits a little lower over your teeth. The treatment takes a few minutes and needs no numbing for most people, although we can use ice or numbing cream if you prefer.

How many units of Botox for a gummy smile?

Most people need 2 to 6 units of Botox in total, split evenly between both sides. Studies have used doses from about 2 to 5 units per side. We usually start low, because a small change goes a long way around the mouth, and add more at your follow-up if you want a stronger effect. If you have Dysport instead, the number of units is higher because Dysport units are measured differently; see our Dysport vs Botox guide.

When will I see results, and how long does it last?

Botox starts to work in 3 to 7 days and reaches its full effect at about two weeks. A systematic review of gummy smile studies found the effect was steady for at least two months and had not fully worn off at three months. In practice, most people plan a top-up after about three to four months. The doses used around the mouth are small, so some people find the result fades a little sooner than Botox on the forehead.

Side effects and risks

Botox for a gummy smile is a quick, low-risk treatment in experienced hands, but the area is delicate, and small changes are noticeable. Possible side effects include:

• Small bumps, redness or a bruise at the injection points, settling within hours to a few days
• An uneven smile if one side relaxes more than the other, which can usually be balanced with a few units at your follow-up
• An upper lip that looks longer or a smile that feels flatter if the effect is too strong; this wears off as the Botox does
• A slightly different feel when smiling or eating for the first week or two

Botox is not suitable during pregnancy or breastfeeding, or for people with certain neuromuscular conditions. Tell us about any medicines and previous treatments. See our Botox aftercare guide for what to do on the day.

Gummy smile Botox vs lip flip

These are often confused. A gummy smile treatment relaxes the muscles that lift the upper lip, beside the nose, so less gum shows. A lip flip places a few units along the edge of the upper lip so it rolls out slightly and looks a little fuller. Some people have both together. Our guide to popular areas for Botox explains every area we treat.

Other gummy smile treatments

• Lip fillerCan add a little length and volume to a thin or short upper lip; sometimes combined with Botox.
• Gum contouringA dentist or periodontist reshapes excess gum tissue when the teeth are partly covered.
• OrthodonticsCan help when tooth position is part of the cause.
• Lip repositioning or jaw surgeryPermanent options for more significant cases, done by a surgeon.

How much does gummy smile Botox cost?

A minimum visit fee applies when a gummy smile or lip flip is treated on its own; see our Botox in Carlsbad page. Many people combine it with another area in the same visit.

Gummy smile Botox in Carlsbad

At your consultation we watch you smile, check whether the lip muscles are the main cause, and tell you honestly if Botox, filler or a referral to a dentist would serve you better. We see you again at two weeks to check the balance of your smile.

See our Botox in Carlsbad page, or book a consultation at our South Carlsbad studio on El Camino Real.