Gummy Smile Botox: How Many Units, How Long It Lasts, And When It Is Not Enough
Written by Dr. Ashutosh A. Shah, M.B.B.S., M.S., M.Ch., D.N.B., Board Certified Plastic Surgeon, Elegance Clinic. Reg. no. [REG NO]. In practice since 2004.
Medically reviewed by Dr. Ashutosh A. Shah · Published 7 May 2026 · Last reviewed 13 October 2026
Gummy smile Botox uses a few units injected beside the nose into the muscle that lifts the upper lip, so the lip rises less and shows less gum when you smile. It works best when an overactive lip is the cause. The effect appears in a week, peaks at two weeks and usually lasts 3 to 4 months.
Does Botox for gummy smile work and how long does it last? Yes, when the upper lip is lifting too high, and the main effect usually lasts three to four months. This page is the practical guide to gummy smile botox: how much gum show counts, which causes it can fix, the units and injection point, how long it lasts and the side effects. For the full range of causes and alternatives, read What no one tells you about gum exposure correction.
How much gum show counts as a gummy smile?
More than about 3 to 4 mm of gum above the upper front teeth on a full smile is commonly treated as excessive gum display. A 2018 systematic review in Brazilian Oral Research used more than 3 mm as its definition. Below that, gum show is usually seen as normal.
- Measure on a full smile, not a polite one, because that is when the lip rises highest.
- Look at rest too. Our rule: if gum shows when your lips are relaxed, the cause is likely in the jaw or teeth, and Botox is not the main answer.
Which causes can Botox fix and which it cannot?
Botox fixes one cause: an upper lip that rises too far. It cannot change gum tissue, tooth length or jaw size. The cause table sorts excessive gum show when smiling by cause.
| Cause | How to tell | Does Botox help? | Better option |
|---|---|---|---|
| Hyperactive lip | Normal gum show at rest; the lip lifts high only on smiling | Yes. This is the main use | Botox; surgery to limit lip movement is rarely needed |
| Short upper lip | Teeth and some gum visible even with lips relaxed | Partly, if the lip also over-lifts | Assessment for lip or jaw procedures |
| Excess gum tissue | Teeth look short and square; gum covers part of each tooth | No | Gum contouring or crown lengthening |
| Long upper jaw | Long lower face; gum shows at rest and on smiling across the whole arch | No, or only slightly | Orthognathic (jaw) surgery |
Many people have more than one cause. A dentist checks the gum and teeth, and the face is assessed for lip and jaw. Gum contouring (gingivoplasty) is the usual answer when excess gum tissue is the cause.
How many units are used and where? Planning gummy smile treatment in Katargam
How many units of Botox for a gummy smile? Published doses are low, about 2 to 2.5 units per side. In the 2018 review, two of the three included studies used 2.5 units per side and one used just under 2 units. Our page on Gummy smile Botox gives the clinic's own range.
The injection goes into the "Yonsei point", described in a 2009 anatomy study in The Angle Orthodontist. It sits beside the nostril, about 1 cm out from the side of the nose, where three lip-lifting muscles meet.
- Smile assessment: gum show measured at rest and on a full smile, with photos.
- Marking: one point on each side, beside the nostril.
- Injection: a small dose on each side, taking a few minutes.
- Review at two weeks: gum show measured again; a small top-up only if needed.
If you are also thinking about the lip itself, see Upper lip Botox.
How long does the result last, and what does wearing off look like?
Usually 3 to 4 months for a clear effect. The review found the maximum effect at about two weeks, with gum display reduced by around 3 to 5 mm in the studies included. The effect was still present at 12 weeks, and one study projected a full return to baseline at around seven to eight months.
- Days 3 to 7: the lip starts to rise less.
- Week 2: full effect and review.
- Months 3 to 4: gum show slowly increases as movement returns.
- After that: the smile drifts back to how it was before, not worse.
So how long does gummy smile botox last for you? The answer depends on dose, product and how strongly your muscles move, which the first treatment shows.
What are the side effects and how are they avoided?
Most are mild and temporary. Gummy smile botox side effects usually come from too much dose or a point placed too far from the nose.
- Uneven smile, if one side relaxes more than the other.
- Flat or stiff smile, or an upper lip that looks longer.
- Lip droop, the lip sitting lower than intended.
- Bruising or tenderness at the injection points.
They are avoided by a low starting dose, careful marking beside the nostril, no rubbing on the day, and a two-week review. As a gummy smile treatment without surgery, Botox is reversible: any unwanted effect fades as the dose wears off.
Botox or surgery for gummy smile?
Botox first, if the lip is the cause and you are happy to repeat it. Surgery or dental treatment, if the cause is gum tissue or the jaw, because Botox cannot change those.
Next step
Take two photos at home, one at rest and one on a full smile, and bring them to the assessment. The cause decides whether Botox, gum treatment or another approach is the right first step.
This page is for education and is not a substitute for assessment. Botox for gummy smile is an off-label use. Unit ranges and durations are from published studies, and your dose is decided after examination. Please consult Dr. Ashutosh A. Shah about your own treatment.
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