Gummy Smile Treatment: 3 Real Options, One Right Answer for Your Case

Botulinum toxin for gummy smile works by reducing the activity of the levator labii superioris, the muscle responsible for lifting the upper lip when you smile. When this muscle contracts too forcefully or has too much range of movement, it pulls the lip up higher than average, revealing more gum tissue than most people consider aesthetically ideal.

An injection of a small, carefully calculated dose of botulinum toxin into this muscle temporarily reduces its pull, so the lip does not rise as high during a smile.

The effect is visible within three to five days and lasts approximately four to six months. The procedure itself takes about ten minutes and requires no anesthesia and no recovery time.

For many of my patients who are not ready to commit to a permanent surgical procedure, or who want to see what their smile could look like with less gum showing before deciding on surgery, this is the ideal starting point.

I use it frequently as a diagnostic tool as much as a treatment: if a patient is happy with how their smile looks after botulinum toxin, it tells us a great deal about what a permanent result should look like and confirms that the hyperactive lip is the primary issue.

The limitation is that it is temporary. Patients who choose botulinum toxin as their long-term solution need to return every four to six months to maintain the result. Over time, some patients choose to transition to a permanent option once they are confident in what the corrected smile looks and feels like.

The injection also works best when lip hypermobility is the dominant cause of the gummy smile. When excess gum tissue is the primary issue, botulinum toxin reduces the visual impact of the gummy smile but does not address the gum itself, so the improvement is less dramatic.

Crown Lengthening: The Most Common Permanent Solution

Crown lengthening is the procedure I recommend most often for gummy smiles caused by excess gum tissue covering the tooth crowns. It is a periodontal procedure, meaning it is performed on the gums and the underlying bone, and its goal is to expose more of the natural tooth structure by removing the excess gum that is covering it.

The procedure involves numbing the area with local anesthesia, then carefully sculpting the gum line to the ideal position. In many cases, a small amount of underlying bone also needs to be recontoured to ensure the gum line stays stable in its new position. If we only remove gum tissue without addressing the bone, the gum can migrate back over time.

The healing period is typically three to five days of mild discomfort and some swelling, after which patients return to normal activity. Full healing and the final aesthetic result take about three months, at which point we can evaluate whether any further work is needed.

Crown lengthening is also the foundation for many smile design cases. When a patient wants porcelain veneers but their teeth look short because gum is covering part of the crown, we first perform crown lengthening to reveal the full tooth length, allow the area to heal, and then proceed with the veneers. Combining the two procedures gives results that look proportionate and natural, because we are working with the correct tooth dimensions from the start.

Lip Repositioning Surgery for Gummy Smile

Lip repositioning surgery addresses gummy smiles caused by a hyperactive or short upper lip. In this procedure, we detach a strip of the mucosa (the tissue that connects the inner lip to the gum), remove a small segment, and reattach the lip at a lower position. The result is that the lip cannot rise as high as it did before, because the range of motion is now physically limited. The correction is permanent.

The procedure is done under local anesthesia in about forty-five minutes to an hour. There is some swelling in the first week, and patients are on a soft diet for a few days. The sutures dissolve on their own, and most patients feel comfortable returning to normal life within five to seven days. The final result is fully visible after two to three months, once the tissues have settled into their new position.

Lip repositioning is often the procedure I recommend when a patient has a normal amount of gum tissue (meaning crown lengthening would not help) but their lip rises too high when they smile. We sometimes combine it with crown lengthening when both factors are contributing to the gummy smile, which is more common than most people realize. A thorough clinical examination before committing to any procedure is essential to identify all the contributing factors in each individual case.

Coming to Clinica Viena from the United States for Gummy Smile Treatment

A significant portion of our gummy smile patients travel from the United States, Canada, and Europe specifically for this procedure. The reasons are straightforward: the cost of crown lengthening and lip repositioning surgery in the US is often three to five times what the same procedure costs in Medellin, and the quality of care at Clinica Viena is comparable to the best private clinics in any major US city.

Our team speaks English, our facility is modern, and our patient coordination team handles scheduling from the initial consultation through the follow-up visit.

For patients traveling for gummy smile treatment, the typical visit is three to seven days depending on the procedure. Botulinum toxin requires only one appointment and no recovery time, so patients can be treated and continue their trip. Crown lengthening and lip repositioning require a short healing period, so we recommend staying in Medellin for at least five days after the procedure.

We coordinate with patients in advance, hold a virtual consultation before their trip, and prepare a detailed treatment plan so that when they arrive, everything is already planned and the first appointment can be the procedure itself.

Medellin is also a genuinely pleasant city to spend a week in while recovering. The climate is mild, the food is excellent, and the city has transformed dramatically over the past decade into a destination that many of our patients describe as a surprise. Several of our patients have told us that the trip itself was worthwhile entirely apart from the dental treatment.

If you are considering treatment for a gummy smile and want to understand which option is right for your case, I am happy to review photos and give you an initial assessment. Every gummy smile has a specific anatomical explanation, and knowing that explanation is what makes the difference between a treatment that truly corrects the problem and one that only partially addresses it.

Come see us at Clinica Viena in Medellin, or reach out before your trip and we will start the conversation there.