How Can I Improve My Gummy Smile and Lip Incompetence?

Q: Dr. Eppley, I have a huge aesthetic issue with my excessive incisor display at rest. I do not have a gummy smile as the upper lip does not elevate when smiling much. However, at rest and while talking the front teeth show excessively which is rather unsightly. It is strenuous for me to keep my lips sealed as I need to strain my lower lip/chin.

I have had orthodontic treatment to straighten my teeth but nothing has been done with the jaw/lips and I am not sure what the issue is or what needs to be done to reduce the position of the lips/teeth when not smiling.

A:You do have vertical maxillary excess which is defined as excessive tooth show AT REST. Only double jaw surgery (Lefort I impaction and advancement, lower jaw to follow for occlusal alignment) with a sliding genioplasty advancement is going to improve that skeletal problem.

Dr. Barry Eppley

World-Renowned Plastic Surgeon