Gummy smile Botox is a quick, non-surgical treatment that reduces how much gum tissue shows when you smile. It works by relaxing the muscles that pull your upper lip too high, and it typically requires only 6 to 12 units of Botox total, making it one of the simplest cosmetic injectable procedures available.
What Causes a Gummy Smile
A gummy smile happens when a noticeable band of gum tissue is visible above your upper teeth when you smile. While there’s no single threshold that makes it “official,” most people seek treatment when the amount of gum showing bothers them aesthetically.
The cause matters because it determines which treatment will actually work. The most common reasons include:
- A hyperactive upper lip: The muscles that lift your lip are overactive, pulling it higher than usual when you smile. This is the type Botox treats best.
- Excess jaw bone growth: The upper jaw grew longer than average vertically, positioning the gums and teeth lower on the face. This is a skeletal issue that Botox can’t fix.
- Excess gum tissue: The gums grew too far down over the teeth, making them look shorter. This is typically treated by trimming the gum tissue surgically.
- A short upper lip: Less lip tissue simply means less coverage over the gums.
Some people have more than one contributing factor at once. A combination of a hyperactive lip and mild jaw excess, for example, might benefit from Botox paired with another procedure.
How Botox Corrects It
When a gummy smile is caused by an overactive upper lip, the muscles responsible are the ones that run from the side of your nose down toward your mouth. These lip elevator muscles contract too forcefully when you smile, pulling your upper lip significantly higher than it needs to go and exposing the gum line.
Botox is injected into these muscles on both sides of the nose to partially weaken them. The toxin blocks the nerve signals that tell the muscles to contract, so when you smile, your upper lip still moves upward but not as dramatically. The result is a smile that shows more tooth and less gum, while still looking natural and animated. The goal isn’t to freeze anything. It’s to dial back the muscle pull just enough.
What the Procedure Looks Like
The treatment itself is fast, often taking under 10 minutes. A practitioner uses a very fine needle to inject a small amount of Botox into a precise point alongside each nostril, targeting the lip elevator muscles at a depth of about 6 to 7 millimeters. Most people receive around 4 units per side for a mild to moderate gummy smile, with total doses ranging from 6 to 12 units depending on severity.
For context, that’s a fraction of what’s used in forehead treatments, which commonly require 20 or more units. Because the dose is so small, the treatment cost tends to be relatively low compared to other Botox procedures, often around $100 to $150 per session depending on your provider’s per-unit pricing.
There’s minimal downtime. You might have slight redness or a tiny bump at the injection site for a few hours, but most people return to normal activities immediately.
Results Timeline and How Long They Last
You won’t see the full effect right away. Botox reaches its peak activity within 10 to 14 days of injection, so the gum reduction becomes most noticeable about two weeks after treatment. Some people notice gradual improvement starting around day 3 or 4.
The results last anywhere from 4 to 7 months, though the timeline depends partly on how much gum was showing to begin with. A longitudinal study following patients for up to four years found that people with less than 5 millimeters of gum display held their results for about 4 months before the gummy smile started returning. Those with more than 5 millimeters of display saw the effect begin wearing off closer to the 3-month mark. Either way, the change fades gradually rather than disappearing all at once.
To maintain results, most people schedule repeat treatments two to three times per year. There’s no evidence that repeated injections cause long-term problems in this area, and some practitioners report that patients need slightly less Botox over time as the muscles gradually weaken with consistent treatment.
Who It Works Best For
Botox is most effective when a hyperactive lip is the primary or sole cause of the gummy smile. If your gums show excessively at rest (with your mouth relaxed and lips apart), the issue is more likely structural, involving the jaw or gum tissue itself, and Botox alone won’t solve it.
A simple way to gauge this at home: look in a mirror with your face relaxed. If your gum display is minimal at rest but becomes pronounced only when you smile fully, overactive muscles are likely the main driver. That’s the ideal scenario for Botox.
If the cause is purely excess gum tissue covering too much of the teeth, a gingivectomy (surgical gum trimming) addresses the problem directly. If the jaw itself is too long vertically, orthodontic work or jaw surgery may be necessary, though these are reserved for severe cases because of the recovery involved.
Botox Compared to Surgical Options
The biggest advantage of Botox is its simplicity and reversibility. There’s no cutting, no stitches, and no recovery period. If you don’t like the result or experience any asymmetry, it wears off completely within months.
The biggest drawback is that it’s temporary. You’ll need ongoing treatments indefinitely to maintain the effect. Surgical options like lip repositioning provide more permanent results. Research comparing the two approaches found that lip repositioning surgery produced stable, lasting improvements at 12 months, while the added benefit of Botox on top of surgery was significant at 3 months but had faded by the one-year mark.
For someone with a mild gummy smile who wants to test the waters before committing to anything permanent, Botox is an ideal starting point. It lets you preview a lower lip line with virtually no risk. For someone with a more severe display or who simply doesn’t want to return for injections multiple times a year, surgical correction offers a one-time fix with predictable long-term outcomes.
Potential Side Effects
Because the dose is so small and the injection site is precise, complications are uncommon. The most frequently reported issues are minor and temporary: slight bruising at the injection point, mild swelling, or a feeling of stiffness in the upper lip for the first few days.
The more meaningful risk is asymmetry. If one side responds more strongly than the other, your smile may look uneven until the effect wears off or a small corrective dose is added to the other side. Choosing a provider experienced with this specific treatment reduces this risk significantly, since the injection point and depth need to be quite precise. An overly aggressive dose can also temporarily affect your ability to purse your lips normally, making actions like drinking through a straw or pronouncing certain sounds feel slightly awkward. Starting with a conservative dose and adding more at a follow-up visit is a safer approach than over-treating on the first session.