Aesthetic Medicine

Gummy smile: balancing the smile without surgery.

When you show more gum than you would like when smiling, the cause is not always the teeth. Often it is the upper lip rising too far — and that is where botulinum toxin can help.

Helder Moreira · 19 October 2026 · 2 min de leitura

In short

Why it happens

A smile is considered gummy when several millimetres of gum show when smiling. Causes include short teeth or teeth partly covered by gum, excessive vertical growth of the upper jaw, a short upper lip or a lip that rises too far because of muscle overactivity — and they often combine¹.

From diagnosis to plan

Assessment

Looking at the smile, teeth and lip, at rest and in movement.

Cause

Identifying whether it is mainly muscular, dental or skeletal.

Plan

Botulinum toxin when there is a muscular component; referral to a dentist or surgeon when not.

Review

At 15 days, to fine-tune symmetry if needed.

What to expect from botulinum toxin

Very small doses are injected into the muscles that lift the upper lip. The result shows within a few days, peaks at around two weeks and lasts on average 3 to 6 months; studies show a clear reduction in visible gum, with mild, short-lived side effects^2,3. The aim is to soften the smile, never to “freeze” it.

Myths and facts

✕ Myth

“I won’t be able to smile.”

✓ Fact

The dose is tiny: you still smile, just with less gum showing³.

✕ Myth

“It works for every case.”

✓ Fact

No. If the cause is dental or skeletal, other approaches are more suitable¹.

For a gummy smile, botulinum toxin is an off-label use, outside the indications approved in the summary of product characteristics, decided by the doctor after an assessment and with informed consent⁴. Results vary from person to person.

At FACELAB

How we can help.

Botulinum toxin

Tailored doses to balance the smile, after a medical consultation.

Hyaluronic acid

For lips and contour, when it makes sense to combine.

A plan made for you.

Every face and every skin is different. Book an assessment: we review your case and design a personalised treatment plan with you, with realistic goals.

Written by

Helder Moreira

Physician accredited in Aesthetic Medicine · Portuguese Medical Association (Ordem dos Médicos) — licence no. 55532

Patient information

The procedures and treatments mentioned in this article require a prior individual medical assessment and, in some cases, a medical prescription. Indications, results and their duration vary from person to person and cannot be guaranteed. This article is for information only and does not replace a medical consultation.

For more information contact Facelab, Lda. on +351 961 023 229, by email at geral@facelab.pt, or visit www.facelab.pt.

FACELAB Albufeira — Rua do Estádio, Quinta da Bela Vista, Lote 2, 8200-127 Albufeira · ERS Registration Certificate: E172446 · Operating licence: 24619/2024
FACELAB Faro — Rua da PSP, n.º 22, 8000-408 Faro · ERS Registration Certificate: E180121 · Operating licence: 26536/2025

References

Mazzuco R, Hexsel D. Gummy smile and botulinum toxin: a new approach based on the gingival exposure area. J Am Acad Dermatol. 2010;63(6):1042–1051.
Nasr MW, Jabbour SF, Sidaoui JA, Haber RN, Kechichian EG. Botulinum toxin for the treatment of excessive gingival display: a systematic review. Aesthet Surg J. 2016;36(1):82–88.
Sundaram H, Signorini M, Liew S, et al. Global Aesthetics Consensus: Botulinum toxin type A — evidence-based review, emerging concepts, and consensus recommendations for aesthetic use, including updates on complications. Plast Reconstr Surg. 2016;137(3):518e–529e.
INFARMED, I.P. Resumo das Características do Medicamento (RCM) das toxinas botulínicas tipo A autorizadas em Portugal. Base de dados INFOMED.

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