Gummy Smile Surgery

Q: Dr. Eppley, Would gummy smile surgery consist of all four elements below? Or sometimes only some of them?
1.  V-Y procedure
2. Muscle release / levator muscle transection
3. Using a premaxillary implant after muscle release
4. Vestibular shortening.
I understand (1), (2) and (3). However, I am not sure I understand (4) Vestibular shortening. What is that?
Do you need to examine my mouth before you can determine whether an operation is possible?
How long will I have swelling after surgery? 
Is the swelling visible to others after 4-5 days?
Success rate
What is the success rate? Is there always success in the treatment?
I do not want a botox treatment, because it is temporary.
What is your opinion on Lip Lowering Surgery? Do you use it?

A: In answer to your questions:

1,2 and 4 are always done in Gummy Smile Surgery. A premaxillary implant is rarely used unless one has a premaxillary deficiency.
A Gummy Smile surgery can be done on anyone with a gummy smile. Seeing pictures of your face and seeing it at rest and smile is the examination that is needed.
Most of the swelling will ben gone in 7 to 10 days after the procedure.
There is always going to be some permanent improvement, it is just question of how much. I have never performed a revision on such surgery to date.
Lip Lowering Surgery is the same as a vestibuloplasty. It is part of every Gummy Smile Surgery

Dr. Barry Eppley
Indianapolis, Indiana