EXPLORE
Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Botox for the Gummy Smile

 

While a smile is a critical human expression that exposes one’s pearly whites, too much tooth and gum show is deemed undesireable. Known as a gummy smile, it is technically defined as any gum show that exceeds more than 2mms above the tooth line when smiling. While that is a good quantitative measurement of it, many people with that amount of gum show are not bothered by it. When the amount of gum show when smiling exceeds 5mms or more, almost everyone is bothered by it.

When one has excessive gum show it appears that one has a longer face. Often times this is true and some degree of vertical maxillary bony excess exists. But the amount of vertical maxillary excess may not be significant enough or the patient may not want to go through a maxillary impaction osteotomy to make the formal correction.

Alternative soft tissue strategies for treatment of the gummy smile is directed towards either lengthening the upper lip, decreasing the upward muscle pull of the smile muscles or a combination of both. I have successfully used the surgical approach of a V-Y mucosal advancement, transaction of the levator  superior labii elevator muscles and a shortening vestibuloplasty to lessen the amount that the upper lip elevates which then decreases the amount of gum exposure seen. Even though this approach works, and is a fairly easy surgery to undergo, not every gummy smile patient wants to have surgery to treat it.

In the September 2012 issue of Plastic and Reconstructive Surgery, an article was published on ‘A Simplified Method for Smile Enhancement: Botulinum Toxin Injection for Gummy Smile’. In a non-surgical method, Botox injections were placed into the levator labii superior nasalis muscle using 2 to 4 units per side. Over a 15 month period, 52 patients (smiles) with excessive gum show were treated. The outcomes of the injections were evaluated by photographs and questionnaires. Average patient satisfaction on a 10 point scale was 9.75. In all patients, the positive effects of the injections (decreased gummy smile) persisted for 3 or more months.

Having used this injection technique myself, the sheer simplicity of this approach makes it the first treatment that a gummy smile patient should have.  At just 4 to 5 units per treatment, this makes its $100 price tag (or less) very affordable. That is roughly 1/3 the cost of treatment of the glabellar furrows (the most commonly done facial Botox treatment) to improve an aesthetic problem which is equally distracting. Even though its effects last the usual Botox time of 3 to 4 months, two quick injections on each side of the nose restores the smile improvement.

My recommendation for gummy smile patients is to give Botox a try and judge the benefits themselves. If eventually they want to move to a more permanent and profound correction then a soft tissue surgery approach can be done.

Dr. Barry Eppley

Indianapolis, Indiana

Tags: , , ,

Leave a Reply


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

Read More


Free Plastic Surgery Consultation

*required fields



Pricing

The cost of any type of elective plastic surgery plays a major role in the decision to undergo the procedure(s).

Get Your Quote Here


My Plastic Surgery Story

Military Discount

We offer discounts on plastic surgery to our United States Armed Forces.

Find Out Your Benefits


Categories