How Can I Get A Better Result After My First Gummy Smile Surgery?

Q: Dr. Eppley, About nine months ago, I underwent a standard lip repositioning surgery for my gummy smile.  The procedure appears to have relapsed — I suspect due to the strength and hypermobility of my smile muscles.  I’m hoping to schedule a consultation with you to discuss treatment options along the lines of what’s discussed on your web page: intraoral levator myotomy combined with a V-Y mucosal advancement/vestibuloplasty.  This approach seems like it would address the root issue of overactive muscles.

A: In my experience with gummy smile surgery, we usually see very little if any relapse. Since I don’t know the exact technique you previously had done it is hard to say whether a second gummy smile surgery would be more effective. Usually when you shorten the vestibule that is a permanent change, which is the primary technique in gummy smile surgery. Release of some of the levator muscles is an adjunct procedure that I incorporate into the technique based on what I’ve learned by doing Botox injections into these muscles.

Dr. Barry Eppley

Plastic Surgeon