Botox for a Gummy Smile
Small doses into the levator complex can rebalance an excessive gingival display — precision here is everything.
10 June 2026 · 5 min read
The anatomy
Excessive gingival show on smiling is often driven by a hyperactive levator labii superioris alaeque nasi (LLSAN), sometimes with zygomaticus contribution.
Assessment must distinguish muscular causes from skeletal vertical maxillary excess or short upper lip, which toxin will not correct.
Technique
Typically 1–2 units per side are placed at the Yonsei point, where LLSAN, levator labii superioris and zygomaticus minor converge.
Under-dosing and reviewing at two weeks is far safer than over-dosing an area where asymmetry is immediately visible in every photograph.
Managing expectation
Results last around three months and gum show reduces by a few millimetres rather than disappearing entirely.
Patients with severe skeletal causes should be counselled honestly and referred for orthodontic or surgical opinion.