Botulinum Toxin (Botox™) Treatment for Gummy Smiles

Overview

Some people feel that when they smile they show too much of their gums, or that their gums are simply too prominent when they smile – this is often referred to as a ‘gummy smile’. Gummy Smile is a phenomenon that when some people smile, their upper lip elevates too far above their upper teeth, exposing gums and producing an unattractive smile. One of the causes is a hyperactive muscle which elevates the upper lip. Occasionally, the gummy smile is also aggravated by a thin upper lip that further contributes to the problem by exposing the upper gum even more. Fortunately, gummy smile can be simply and effectively corrected with Botulinum toxin (commonly known as Botox) injections to reduce the activity of the muscle that elevates the upper lip.

A small amount of Botulinum toxin will be injected at both sides of the junction of nostril and nose to mouth fold to weaken the muscles.

Botulinum toxin, often referred to as Botox®  is a naturally occurring protein produced by the bacterium Clostridium Botulinum. The toxin blocks the transition of chemical messages sent from the nerve to cause the muscle to contract. Without these messages, the muscle stays in a resting state until the ‘messengers’ recover.

Licensed brands of botulinum toxin A include,’ Botox®, Azzalure®, Bocouture®, Xeomin®, and Dysport®. All botulinum toxins are prescription only medicines (POM) and can only be prescribed by doctors, dentists, prescribing nurses and pharmacists with a prescribing qualification, following a face to face assessment and consultation with the qualified prescriber. This MUST be with a doctor, nurse prescriber, dentist or a prescribing pharmacist.

  • After treatment it is expected that you will start to see an improvement within 2 or 3 days  when the elevation of the upper lip will gradually become less and less. The full result will be achieved 2 weeks after the treatment.
  • The full result may be judged at 2-3 weeks. You may be invited to attend a review appointment at 2-3 weeks where the success of the treatment may be assessed and adjustments to your personal treatment plan made, if necessary.
  • You will be advised to keep the target muscles active for a few hours and to avoid extremes of heat or cold, vigorous exercise, lying down or leaning over for 4-6 hours.
  • This recovery takes approximately 8 to 12 weeks on average.
  • Results tend to last 3-4 months Movement will begin recovering from 8 weeks Frequent treatment at intervals of less than 3 months is NOT recommended.

Your practitioner will take a detailed medical history and an assessment of your needs and expectations to ensure this is an appropriate treatment for you. Botulinum Toxin (commonly referred to as Botox) is a prescription only medicine. This means that you MUST have a face to face consultation with a licensed prescriber to assess whether you are suitable for treatment. *This MUST be with a doctor, nurse prescriber, dentist or a prescribing pharmacist.

  • Except in exceptional circumstances this is not a treatment recommended for those under 25 or over 65.
  • For best results skin should be in good condition and the target lines not too furrowed. Your practitioner will assess your suitability and advise.
  • Botulinum toxin cannot be given to pregnant or breast feeding women.
  • Not suitable for patients with certain neurological disorders.
  • Not suitable if you are currently taking certain medicines.
  • If you have previously experienced adverse reactions to any botulinum toxin treatment.

With any injectable treatment;

  • Treatment is not recommended if you are suffering from any skin infection in or near the treatment area or are unwell in any way (even a cold).
  • If you are taking any medicines which affect bleeding, such as aspirin or warfarin.
  • If you are currently or have recently completed a course of Roacutane (acne treatment) in the last 18 months.
  • If you are pregnant or breastfeeding.

Caution

  • If you are planning to attend a special event when a bruise, should it occur, would be unacceptable to you.
  • If you are planning to attend an important event and any adverse event described would be unacceptable to you, discuss with your clinician in advance of having treatment.
  • Some over the counter medicines and supplements can also affect bleeding (make you more prone to bruising) as can alcohol- which should be avoided the day before and after treatment.
  • Vigorous exercise, sun exposure, sun beds, sauna should be avoided for 48 hours, or as advised by your clinician, after treatment.

If you are at all concerned about symptoms you were not expecting or not happy with, please contact the practitioner for advice. If necessary an appointment will be made for you to be seen. 

All treatments carry a degree of risk. All risks and complications will be discussed with you at consultation and prior to any treatment being agreed. Botulinum Toxin should be administered by a healthcare professional with specialist training. Side effects include, but are not limited to;

  • Bruising
  • Swelling at injection sites
  • Redness at injection sites
  • Asymmetry of expression
  • Drooping of the brow, or eyelid
  • Headache or a sensation of ‘tightness’ or ‘heaviness’

Adverse events are uncommon, usually occur within a few days of treatment and are expected to be temporary, usually resolving spontaneously within weeks. Your practitioner will provide aftercare advice designed to minimise risk and promote speedy recovery from any expected side effects.

A very fine needle is used and generally this treatment is not painful and can be well tolerated with no anaesthetic. Ice may be helpful in numbing the skin for nervous patients as well as reducing the risk of a bruise.

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