A balanced smile is mostly about proportion. Teeth, lips, and gums share the stage, and when one part dominates, your expression can feel off even if everything is technically healthy. A gummy smile, where several millimeters of gum show above the front teeth, is a common example. Some people also notice that the corners of their mouth sit low at rest, which adds a tired or downturned look in photos. Neither of these is a medical problem, yet both can shape how you feel in social moments. That is where precise use of botox, specifically for a gummy smile and smile lift, can make a small, strategic difference.
I have treated thousands of smiles over the years, from actors needing camera-ready tweaks to parents who want to look less stern on school mornings. The right plan starts with anatomy, not trends. Yes, botox for wrinkles across the forehead or crows feet gets the headlines. But the upper lip elevators and the platysma board a seat at the table when your goal is to refine how much gum shows or to nudge up the corners of your mouth. Subtle changes, delivered judiciously, usually read as natural results to everyone except you and your injector.
What creates a gummy smile
A gummy smile typically shows more than 3 to 4 millimeters of gingiva when you grin. Several factors can cause it, and they can stack.
- Hyperactive lip elevators: The levator labii superioris alaeque nasi, levator labii superioris, and zygomaticus minor lift the upper lip when you smile. In some faces, they contract strongly or have a short resting length, which yanks the lip higher than average. Short or thin upper lip: If there’s less tissue to cover the gumline, any smile will reveal more gum. Vertical maxillary excess: The upper jaw can be vertically long, so the gums appear prominent even with a normal lip position. This is skeletal, not muscular. Delayed passive eruption or gingival overgrowth: The gums cover more of the tooth crown than usual, sometimes from genetics or medication. Tooth wear: Shortened incisors expose proportionally more gum.
The reason this list matters is that botox targets muscles. It relaxes hyperactive elevators so the lip does not leap upward. If the primary cause is bone or gum anatomy, you may still benefit, but the effect could be modest or require combination treatment.
How botox softens gum show
Botox is a neuromodulator that blocks acetylcholine release at the neuromuscular junction. It quiets muscle contraction for several months. In gummy smile work, we commonly treat the “Yonsei point” region near the alar base, which influences the levator labii superioris alaeque nasi and its neighbors. Some injectors prefer slightly more lateral entry points where the zygomaticus minor is active. The technique varies by face.
Most patients do well with small doses, often in the range of 2 to 4 units per point on each side, with 2 to 3 total injection points. That produces a predictable 2 to 4 millimeter drop in the upper lip on big smiles. It does not make you expressionless, and you will still show teeth. The difference is that the lip moves like a dimmer switch instead of a light switch. We are not chasing a frozen grin. We are aiming for muscle balance that supports a youthful, easy smile.
A quick vignette from clinic: a wedding photographer came in after reviewing her own test shots. Great teeth, healthy gums, but 5 to 6 millimeters of gum show in full laugh. We placed 8 units total across two points per side, revisited at two weeks, then added 2 units each to reach the sweet spot. Her post-treatment images showed 2 millimeters of pink above the incisors. She kept her big personality. The edit work on her portraits fell by half.
Smile lift with botox: turning corners gently upward
The mouth corners, or oral commissures, droop over time for two reasons. First, the depressor anguli oris (DAO) muscle becomes dominant relative to its elevators. Second, the skin and fat around the perioral area lose support. When you relax the DAO with botox, the elevators reclaim some ground. The corners no longer pull down as much when you talk or rest, so your neutral expression reads less stern.
Placement sits several millimeters lateral to the mouth corner, often along the line from the corner to the mandibular border. The dose is conservative, commonly 2 to 4 units per side. Go slow here. Too much product can affect lip function or create an unnatural smile. botox near me In lean faces, superficial placement can bruise easily, so steady pressure and a fine needle matter. I often support this with filler in the marionette shadows or a touch of botox for the mentalis if chin tension is producing a pebbled look.
Natural results depend on restraint
Anyone can inject. Judgment separates a good result from a stiff one. Two properties guide us with a gummy smile and smile lift: dose and distribution. Micro-dosing across several points tends to look better than a heavy bolus. It allows the lip to move naturally while reducing peak pull. The effect has a curve over time too. You will see early changes within 3 to 5 days, with a full effect at 10 to 14 days. If we need a touch more, a micro-top-up at the two-week visit is the safest way.
When someone asks how it compares to botox in forehead lines or the glabella, I describe lip elevators as higher-precision work. Forehead treatment tolerates a wider range because the frontalis is broad. The upper lip elevators are small and sit near vessels and the smile’s wiring. The margin for error is thinner, which is why experience matters.
What a typical appointment looks like
You can expect a short visit. After photos and animated shots to map your pattern, the skin is cleansed, and a tiny needle delivers the product. Most patients feel a quick sting, no more than a vaccine. I advise skipping makeup in the treated area for the rest of the day, avoiding heavy exercise or sauna for 12 to 24 hours, and keeping your head upright for a few hours. Normal eating, drinking, and speaking are fine. It is a non surgical, low downtime service that fits into a lunch break.
You may notice a small bump at each injection point that settles over 10 to 20 minutes. Bruising is possible but rare with careful technique. If it happens, it usually fades within a week and can be concealed by makeup after 24 hours.
How long it lasts and how it feels
Most people enjoy results for about 8 to 12 weeks in the lip region, sometimes stretching to 3 or 4 months. Botulinum toxin tends to wear off a little faster in high-movement muscle groups like the mouth compared to the forehead or the glabella lines between the brows. Plan on 3 to 4 sessions per year if you want steady control of gum show or a consistent smile lift.
The sensation at rest remains normal. You will not feel numb. When you smile, the first thing you notice is that you are not working as hard to keep the lip from jumping. If you are prone to upper lip tension or a chin that dimples when you speak, easing those patterns can soften perioral wrinkles over time as well, complementing botox for smile lines and fine lines around the mouth.
Safety, side effects, and when to avoid treatment
Botox is a safe procedure when performed by a licensed clinician with a solid understanding of anatomy. The most common side effects are minor and short term: redness, swelling, tenderness, a small bruise. Rarely, diffusion to adjacent muscles can alter smile dynamics more than intended, such as a transient asymmetry or slight speech change on “p” or “b” sounds. In skilled hands and with conservative dosing, this risk stays low, and the effect is temporary.
Certain situations call for caution or deferral. Active skin infection near the treatment area is a hard stop. Pregnancy and breastfeeding are generally excluded in standard protocols due to limited safety data. Neuromuscular disorders or medications that interfere with neuromuscular transmission warrant a careful review with your botox doctor. If you have ongoing dental work or gum surgery planned, time your sessions so healing is not interrupted.
For allergy history, true immunologic reactions to onabotulinumtoxinA are rare. If you have had botox injections before without issue, your risk of an adverse reaction stays low. If you are new to treatment, a conservative first session is wise to learn how you respond.
When botox is not enough
Skeletal and dental contributors, like vertical maxillary excess or short clinical crowns, respond best to other solutions. Your path might include crown lengthening by a periodontist to reveal more tooth and less gum, orthodontics to adjust incisor display, or orthognathic surgery in pronounced cases. Those are bigger steps with longer healing time, but they can deliver a permanent change when the jaw structure is the driver.
For a downturned smile with volume loss, fillers can help more than a neuromodulator alone. Hyaluronic acid placed carefully along the marionette area, the lateral commissure, or the chin-labial crease restores support. Sometimes the best answer is botox and fillers together, a measured approach that relaxes the DAO and props the corner from beneath. Comparing botox vs fillers misses the point. They do different jobs: botox reduces motion lines and hyperactive pull, while fillers replace structure and contour.
Cost, value, and how to think about pricing
Botox prices for smile work vary by region and by who performs the treatment. Many clinics bill per unit, and the total for a gummy smile or smile lift is usually modest compared to a full face session. You might see botox injections cost ranging from the price of 8 to 20 units depending on your anatomy and whether we address related areas like the mentalis or small lines around the mouth. A rough quarterly budget is common, since most people prefer maintenance as the dose wears off.
If you are shopping for botox nearby, prioritize experience over a coupon. You want a botox specialist who treats the perioral area routinely, not just the forehead or the frown lines between the brows. Ask for botox before and after photos that resemble your pattern. Read botox reviews with an eye for natural results and consistent follow up. The best botox treatment is the one tailored to your face by a provider who knows when to stop.
A brief comparison to other facial botox zones
Many people arrive asking for botox for forehead lines and leave with a more nuanced plan. Each zone has its own personality. The glabella, the “11 lines” area, often needs a firmer dose to relax vertical frown lines. Crows feet correction uses delicate, superficial placement around the eye corner, and can be combined with a light botox eye lift for a brighter look. The neck bands from the platysma respond to a “Nefertiti” pattern that also sharpens the jawline marginally. In those regions, the effect can last a touch longer than around the mouth.
The upper lip and the commissures are among the most technically sensitive botox injection techniques because they sit at the interface of speech, smile, and eating. Choose a botox clinic that appreciates these details, not one that treats every face the same way.
What the first consultation should cover
A good consult is half observation, half conversation. I start by watching you talk and laugh. Sitting upright, we review how much gum shows, whether it is symmetric, and how the corners behave at rest and animation. I gently palpate the elevator muscles to feel their strength. Then we discuss goals. Some patients want to cut gum show by half. Others prefer a minimal shift that no one could guess. Your tolerance for change sets the target.
We also address botox alternatives. If your gumline is high because the teeth are short, a periodontal referral may deliver more of what you want. If your smile looks thin in profile, a lip flip using small doses at the vermilion border can add a soft roll outward, though it is better for lip shape than for gum exposure. If brightness around the eyes is a priority, small adjustments for crows feet or a conservative brow lift take the edge off a tired look. Everything should serve the central goal: a smile that feels like you.
Downtime, aftercare, and the rhythm of maintenance
Call it a 24 hour gentle zone after treatment. Avoid pressing on injection points or having a best botox in SC facial massage that day. Skip hot yoga, saunas, or strenuous workouts for the first evening to reduce the risk of extra diffusion. No need for ice unless tender, and makeup can go back on after a day if the skin is intact. I ask patients to send a smile photo at the two-week mark if they cannot return in person, so we can assess symmetry and consider a micro-top-up.
Maintenance is simple. Plan your sessions around events, and leave a buffer of two weeks before photos or travel. If you layer in other areas, such as botox for the jawline to reduce clenching or botox for migraines if you also suffer from tension patterns, coordinate your schedule so we can observe interactions in how you move. The full face strategy is more about choreography than volume. Restore balance first, then strength where you want it.
Edge cases and lessons learned
Some people have an upper lip that tucks inward when they smile, which makes dental show look narrow. Here, a tiny lip flip can complement the gummy smile plan, but it must be very light. Too much botox under the nose can make drinking from a straw feel odd for a few weeks. I also respect athletes who play wind instruments or singers with demanding schedules. If precise embouchure or labial control matters to your job, we keep doses especially conservative and may prefer fillers or dental options instead.
On the smile lift side, patients with strong masseter activity or bruxism often overuse the chin and DAO as a compensation pattern. Treating the masseters for jaw reduction or tension relief can indirectly help the mouth corners by reducing downward pull. Not everyone wants that, since masseter reduction can slim the lower face subtly over months. This is where shared decision making matters. Your aesthetic north star may be definition rather than slimming, and the plan should reflect it.
How botox fits into long term facial aesthetics
Botox is a tool, not a finish line. Used regularly and lightly, it prevents certain wrinkles from etching deeper by reducing repetitive motion, especially in the glabella and forehead. Around the mouth, it keeps perioral lines softer and the corners less tethered. Think of it as wrinkle control and expression refinement, not a freeze. Over the years, patients who maintain modest botox sessions tend to need fewer aggressive interventions later.
That said, no injection halts the passage of time. Skin quality, sun behavior, hydration, and dental health play as large a role in how your smile reads as any syringe. If your clinic offers complementary care like light resurfacing, collagen-stimulating treatments, or guidance on topical retinoids, take advantage. These measures amplify the returns of every botox session.
Choosing your provider
Credentials matter, but so does taste. A certified doctor or licensed clinician trained in facial aesthetics brings safety to the table. Beyond that, study their aesthetic eye. Do their results favor natural lift over celebrity mimicry. Do they customize dose or push the same template to everyone. A strong injector uses measured language about botox benefits and botox risks, offers clear expectations for botox downtime and healing time, and checks in at the two-week window to fine tune.
If you are a beginner, start small. You do not need a full face plan on day one. Pick the primary concern, whether it is gum show, a slight smile lift, or softening your frown lines, and learn how your face responds. That learning informs every session after it.
What success looks like
Patients often tell me their friends say they look rested or happy. Not younger in a way that overpromises, just more like themselves on a good day. The camera does not catch as much pink above the teeth, selfies look friendlier, and the corners do not fight gravity as hard. For many, that quiet shift is worth repeating every few months.
If you are curious, schedule a consultation and bring your smile in all its versions: a closed mouth grin, a medium smile, a full laugh. The right plan lives in how your muscles move through those gears. With measured dosing, careful placement, and a willingness to adjust, botox for a gummy smile and a smile lift can be one of the most satisfying, low drama changes in facial aesthetics.