Why Did My Gummy Smile Procedure Not Work?
Q: Dr. Eppley, I had a gummy smile procedure done about 3 years ago. I have attached a link so you can see what type of procedure the doctor did. Given that the soft tissue procedure did not work, I am thinking that I need the bone surgery instead. How long is the maxillary impaction osteotomy recovery time and would it require braces after?
A: In looking at the link, I would never have expected that type of ‘gummy smile’ procedure to have ever worked in your case. It was only a very limited anterior maxillary vestibuloplasty procedure. It may work for someone with a small gummy smile problem (maybe 1 or 2mms) but it is a fundamentally flawed procedure. There may have been some temporary restriction of upper lip movement but that would stretch out and relapse back into the full gummy smile in a matter of weeks or a month or two at best.
Maxillary impaction surgery requires orthodontic braces to be in place before (to be used during surgery to help make the bite fit) and then remain in place after surgery to do any adjustment and fitting in of the bite should it be off a little bit. Recovery from such surgery is defined largely by how long does the swelling last until you lok normal. The jaws are not wired together after this kind of surgery so isolated maxillary surgery is quicker to recover from than other types of jaw surgeries. I would say it would take about 3 weeks until you look pretty normal again, although the final bits of swelling takes several months to fully go away.
Give the very limited soft tissue procedure you had done and the more significant commitment of maxillary surgery, a more thorough soft tissue procedure for your gummy smile may be worth considering. One which includes superior labialis muscle release, aV-Y mucosal lip advancement and a more extensive vestibuloplasty procedure.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.