What Is The Best Procedure To Fix My Gummy Smile?

Q: Dr. Eppley, I would love to show less gum when I smile. I have tried Botox and it has slightly improved the amount of gum shown, however I would like a more permanent solution. I have had repositioning which involved sewing the lip down, and although it looked nice for a while, it appeared to stretch out and go back to normal. I am terribly afraid of the procedure which involves cutting the bone, so I’m hoping that a soft tissue correction will fix my smile.

A: Based on your pictures and the magnitude of your gummy smile, I would not be optimistic about any soft tissue procedure significantly improving your gummy smile. As you know, the best procedure for you is a maxillary impaction osteotomy. (vertical upper jaw shortening) Since I do not know exactly what soft tissue procedure you had done, I can not tell whether my soft tissue approach to the gummy smile will provide benefit to you. I am not sure what was exactly done in the ‘sewing the lip down’ procedure and whether it involved labii superioris muscle release and a mucosal v-y lip advancement. I would need to read the operative note from the procedure you had done to tell if a different soft tissue approach to your gummy smile would be more effective.

Dr. Barry Eppley

Indianapolis, Indiana