If you feel that too much gum shows when you smile, the first question is not simply how many units of Botox or Xeomin you need.
It is why your gums are showing.
At LIPS NY by Rainforest Medical Aesthetics, we evaluate your upper lip at rest and during a full smile to determine whether excessive muscular elevation of the lip appears to be contributing to your concern.
When neuromodulator treatment is appropriate, the goal is to soften excessive upper-lip elevation while preserving a natural, expressive smile.
Botox or Xeomin: $9.50 per unit
10-unit minimum — $95 minimum treatment
A “gummy smile,” also called excessive gingival display, describes a smile in which more of the upper gum is visible than a person would like.
That matters because Botox or Xeomin does not correct every cause of a gummy smile.
Neuromodulator treatment is most relevant when upper-lip muscle activity is an important part of the problem.
In some people, these muscles produce a strong upward pull, exposing more gum as the smile becomes larger.
Botulinum toxin can temporarily reduce selected muscular activity. When excessive lip elevation is contributing to the gummy smile, carefully placed treatment may reduce how far the upper lip rises during a full smile.
The objective is to reduce excessive elevation while maintaining natural facial expression.
Your full smile
10-unit minimum — $95 minimum treatment
The number of units and placement are determined after evaluating your smile and treatment goals.
You do not need to decide whether you want Botox or Xeomin before your appointment.
Both are botulinum toxin type A products that reduce muscle activity, but they are distinct prescription products with product-specific potency units.
At LIPS NY, both are currently priced at $9.50 per unit.
Your provider will discuss which product is being considered and the treatment plan before injection.
GUMMY SMILE TREATMENT
The primary concern is:
Treatment is directed toward excessive upper-lip elevation when muscular activity is contributing to the gum show.
LIP FLIP
The primary concern is:
A lip flip is designed to create subtle eversion of the upper lip without adding filler volume.
One patient can have elements of both concerns.
That does not mean the treatments are automatically identical.
We evaluate the smile first.
If your primary goal is fuller lips, lip filler addresses a different concern.
Gummy-smile treatment changes muscular movement. Lip filler changes volume and structure.
And it cannot correct every anatomical reason for excessive gum display.
If your smile suggests that another anatomical factor is dominant, neuromodulator treatment may produce only limited improvement or may not be the most appropriate approach.
We would rather explain that before treatment than promise a result the treatment cannot create.
The result should therefore be evaluated after the toxin has had appropriate time to take effect rather than immediately after treatment.
The effect is temporary.
That is the goal.
The muscles that elevate your upper lip are part of normal smiling and facial expression.
Treatment should therefore be conservative enough to reduce excessive movement without intentionally eliminating your ability to smile naturally.
Asymmetry is a possible concern whenever a treatment intentionally changes facial muscle activity.
The upper lip may already move differently from side to side before treatment. Dose, placement, anatomy, and diffusion can also influence the result.
That is why we assess your smile before injection and consider existing asymmetry as part of the treatment plan.
Botox and Xeomin are FDA-approved medications. Treating a gummy smile is an off-label use.
The current FDA-approved cosmetic indications for Botox Cosmetic do not include gummy-smile treatment.
The current cosmetic labeling for Xeomin does not include gummy-smile treatment either.
Using an FDA-approved medication for an indication not included in its approved labeling is called off-label use.
Off-label prescribing is used throughout medicine. At LIPS NY, it means the treatment should follow an individualized evaluation, discussion of expected benefits and limitations, review of relevant risks, and informed consent.
Botulinum toxin has been studied for excessive gingival display, but the evidence base is smaller than that supporting the products’ FDA-approved cosmetic indications.
Botulinum toxin products also carry important prescribing warnings, including the potential for toxin effects to spread beyond the injection site.
Treatment around the mouth requires particular attention to anatomy because the muscles in this region contribute to smiling, speaking, eating, drinking, and lip control.
Do not try to hide the gum show.
We need to see the expression that actually concerns you.
LIPS NY is the lip-focused destination of Rainforest Medical Aesthetics in East Meadow, Nassau County, New York.
We evaluate the lips and smile in motion to help distinguish concerns involving excessive gingival display, upper-lip movement, lip visibility, and lip volume.
1757 Front St
East Meadow, NY 11554
516-900-7772
Botox or Xeomin — $9.50/unit
If too much gum shows when you smile, you do not need to know which muscle is responsible. You do not need to know how many units you need. And you do not need to decide whether it is a gummy smile, a lip-flip issue, or something else.
