What Is The Best Way To Fix My Gummy Smile?
Q: Dr. Eppley, I have a gummy smile. I would like to see what options are out there to correct this issue. I have attached pictures of me smiling and not smiling for you to see how much gummy smile I have.
A: Thank you for sending your pictures. The first thing I can say is that you are not a candidate for any bone surgery (maxillary impaction) for your gummy smile (thank heavens) as one has to have lip incompetence at rest…which you do not. Therefore, any effort for improvement in your gummy smile has to be directed towards soft tissue management. While there are internal soft tissue lengthening procedures which will have long-term benefits, your long upper lip (skin between your nose and upper lip) poses some concerns. One has to be careful that you don’t fix the gummy smile but then also lengthen the upper lip. (may not be a good trade-off) The good news is that there is a test before doing the procedure to see how the result of the surgery might work. That is Botox. A few units of Botox (generally 2 – 4 units per side) on each side of the nose will simulate the effects of a muscle release and mucosal lengthening. if you like the result of the Botox injections, you can just continue with the Botox (much less units and cost than the typical injection sessions done in the forehead which are usually 20 to 30 units) or then proceed for the surgery.
Dr. Barry Eppley