Gummy smile Botox and lip asymmetry: why do your gums show when you smile?

If your gums show widely when you smile or your smile tilts to one side and bothers you in photos, it is worth first checking whether muscles are the cause. Gummy smile Botox is a procedure that injects a small amount of botulinum toxin into the muscles that pull the upper lip up when you smile, reducing the contraction signals to those muscles.

Gum exposure and lip asymmetry can be addressed with Botox when muscle strength is the cause, but if the cause is structural, such as the upper jawbone or tooth length, Botox makes only a small difference. At our Suwon clinic, we look at both your relaxed and smiling expressions in front of a mirror, first separate how much muscle factors contribute, and then decide whether to use Botox and which muscles to inject.

In this article, we outline in turn why the gums show, the types of lip asymmetry, how Botox balances muscle strength, recovery and care, side effects, and what to check before treatment.

Gummy smile Botox: key points

• A muscle-type gummy smile occurs when the muscles that pull up the upper lip are strong or move over a wide range.
• Lip asymmetry is assessed by separating whether it comes from a difference in left-right muscle strength or a difference in bone.
• A small amount of Botox is injected into the muscles that pull strongly, and more is added only where needed after observing progress.
• Movement gradually decreases starting a few days after the procedure, and how long it lasts depends on how much you use your facial expressions.

Why do the gums show a lot when you smile?

When you smile, the muscles running from beside the nostrils to the upper lip contract, lifting the upper lip. If these muscles are strong or move over a wide range, the upper lip rises high above the front teeth and the gums show widely; this is called a muscle-type gummy smile.

If the upper jawbone has grown long downward, the teeth look short, or the gums cover much of the teeth, the gums show regardless of the muscles. With this structural type, Botox makes only a small difference, so it is appropriate to look into dental care as well. If there is a big difference in gum exposure between a relaxed face and a broad smile, muscles play a larger role, and if the gums show even at rest, structure plays a larger role.

Faces with a mix of both are common, so in consultation we first determine which plays the larger role. Gum Botox and gummy smile Botox are different names for the same procedure.

How is lip asymmetry identified?

If only one corner of the mouth rises higher or only one side of the upper lip lifts more when you smile, it is a sign that the left and right muscles differ in strength. It arises from a combination of chewing on only one side, expression habits, and left-right differences in facial bones, and the smile can also tilt to one side when square-jaw Botox spreads to muscles near the corners of the mouth. Lip asymmetry also occurs when the muscle that pulls the corner of the mouth downward is stronger on one side.

Asymmetry that comes from differences in bone length is outside the range Botox addresses, so we distinguish it separately in consultation. Procedures searched for under the name lip Botox also involve a mix of concerns such as the corners of the mouth, fine lines above the lips, and gum exposure, so we first ask what bothers you and in which expressions.

How does gummy smile Botox work?

How Botox balances muscle strength

Botulinum toxin blocks the contraction signals going from nerve endings to the muscle, so that muscle moves less. For a gummy smile, small amounts are divided between the muscles on both sides beside the nostrils, and for lip asymmetry, it is injected only on the side that pulls strongly or with different doses on the left and right. If only one corner of the mouth droops, a small amount is injected into the muscle below that corner to ease the downward pull.

The muscles around the mouth are small and close together, so we do not inject a large amount from the start. Movement gradually decreases starting a few days after the procedure, and after observing progress, we refine the balance by adding small amounts only where needed.

Treatment range and schedule

Special-area Botox in the Suwon clinic's treatment information is performed in about 10 minutes after numbing cream (except for some areas); results last 3 to 6 months, and retreatment is based on 3- to 4-month intervals. The toxin is chosen from Korean-made, Korean-made low-resistance, and German-made low-resistance options. Whether to use Botox for a gummy smile or lip asymmetry, and if so, which muscles and how much, is decided in consultation after examination.

View special-area Botox treatment information

Recovery and care after gummy smile Botox

• You may wash your face and wear makeup starting 2 to 3 hours after the procedure.
• Small bumps that swell up at the injection sites subside within 2 to 3 hours, though depending on the skin they may last 1 to 2 days.
• For 3 to 7 days after treatment, avoid heavy drinking, smoking, saunas and Korean bathhouses, hot baths, and strenuous exercise.
• Avoid intense massage or meridian massage for a month, and do not rub hard around the mouth.

When movement returns depends on how much you use your facial expressions and on your lifestyle habits. When your upper lip begins to rise high again when you smile, we reassess the left-right balance at that point and decide the timing of the next treatment in consultation.

Side effects and precautions of lip Botox

After the procedure, redness at the needle sites, small bruises, and mild swelling may occur, and most soon subside. Effects and recovery vary from person to person, and because the area around the mouth is where expressions are delicate, your smile may feel unfamiliar for the first few days.

In rare cases, the upper lip may look awkwardly less lifted when you smile, the two sides may look temporarily different, or pronouncing sounds like b and m or using a straw may become uncomfortable. These changes tend to return as the drug wears off, and after observing progress, we consider adjusting the opposite side to match. If you are pregnant or breastfeeding, have been diagnosed with a condition that weakens muscle strength, or recently received Botox in another area, be sure to tell us before the procedure.

If you have difficulty swallowing, feel short of breath, your eyelids droop, or swelling and heat at the injection sites gradually worsen, contact the clinic right away.

What is checked before gummy smile Botox?

If these apply to you, start by checking for muscle factors

• Your gums show widely only when you smile broadly and are hardly visible with a relaxed expression.
• When you smile, only one corner of your mouth or one side of your upper lip rises higher.
• Your smile looks tilted to one side when you take photos.
• Your smile has changed after previous square-jaw Botox.

If two or more apply, it is best to first check how much muscle factors and structural factors contribute before deciding on Botox. Whether to proceed, and the method and extent of treatment, are decided together in consultation after the medical team's examination.

In short, the key with a gummy smile and lip asymmetry is first determining whether it is the muscle type or the structural type, then balancing it with small amounts.

FAQ

Q. Are gum Botox and gummy smile Botox the same procedure?

A. Yes, they are different names for the same procedure. It reduces the signals to the muscles that pull up the upper lip when you smile, lessening how far the upper lip rises, and before the procedure we first check whether it is the muscle type or the structural type.

Q. When does gummy smile Botox start to make a difference?

A. Starting a few days after the procedure, the movement of the upper lip gradually decreases. The left-right balance is checked again after the movement has settled, and if one side is less matched, we refine it by adding a small amount only where needed.

Q. Won't my smile look awkward after gummy smile Botox?

A. Your smile may feel unfamiliar for the first few days, so we start with a small amount and add more later only where needed. Changes that look temporarily awkward tend to return as the drug wears off, and after observing progress, we adjust the opposite side as well.

Q. If I have lip asymmetry, can I get Botox on just one side?

A. If the cause is a difference in left-right muscle strength, we inject only on the side that pulls strongly or set different doses for the left and right. Asymmetry caused by a difference in bone length changes only slightly with Botox, so in consultation we first determine which is the cause.

Q. If my gums show even at rest, will gummy smile Botox work?

A. If your gums show even at rest, structural factors such as the upper jawbone or tooth length may also be involved. In consultation, we first check how much muscle factors contribute, and if structural factors are significant, we advise you to also look into dental care.

Q. How can I find out the cost of gummy smile Botox?

A. The cost depends on the treatment area and type of toxin. We explain it after deciding through examination and consultation which muscles to inject and whether to use Korean-made or low-resistance toxin, and you can also check special-area Botox items on the treatment information page.