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Surgical or medical correction of a gummy smile

Dr Vincent Masson, plastic surgeon Paris

We say that a person has a gummy smile when we can see all of their teeth and part of their gums when they smile.

In the most extreme cases, almost all of the gum is visible.

Considered unsightly according to certain criteria, a correction procedure is always worth considering.

What are the causes of a gummy smile?

  1. Hyperactivity of the upper lip levator muscle.
  2. hyperdevelopment of the gums.
  3. Tooth position abnormalities.
  4. A malformation of the shape and position of the mandible (lower jaw).

Different techniques exist to correct a gummy smile, which is also known as an excessive gingival display.

1: Botulinum Toxin or Botox injections

There are several products currently available: Vistabel, Dysport and Azzalure. The aim is to relax one of the muscles located on the side of the nose, the levator muscle of the upper lip. Two or three injections are administered on the sides of the nose. It is not particularly painful and does not leave any visible mark except, occasionally, a few bruises which last for 24 hours at the location of the injections. Botulinum toxin injections are given in the office and there is no need to be hospitalized. The result is visible in 2 to 15 days and will last for between four and six months. There are two complications that may arise from this treatment: the actual lack of any results at all in some cases or, on the other hand, a too great a result with an excessive sagging of the lip downwards. This is a transitory side effect however and, on average, disappears within three weeks. The average price for the injections is 450 euros which are carried out by a cosmetic surgeon or a doctor specialized in aesthetic medicine.

2: Lip plasties or lip lifts

The principle is to perform an upper lip plasty (upper lip lift, lip lifting or lip lift) in order to modify its placement. This is a cosmetic surgery technique usually performed under general anesthesia although a simple local anesthetic can sometimes be enough. Day hospitalization is required in the clinic. The lip is swollen for 10 days postoperatively, so time off work needs to be planned. The procedure is carried out by a cosmetic surgeon.

3: Gingivoplasty or gingivectomy

Performed by a specialized dental surgeon, the gums can be reshaped to make them less visible if they are enlarged or badly positioned.

4: Orthognathic jaw surgery

This is a procedure carried out by a maxillofacial surgeon, the aim is normally to impact the maxillary bone in order to reduce its height (maxillary impaction osteotomy). This is done in the operating room under general anesthesia and postoperative discomfort can be quite severe for the first few days.


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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