There's a specific kind of self-consciousness that comes with a gummy smile. You're not unhappy with your teeth. You're not unhappy with your lips. It's just that when you laugh — really laugh — more gum shows than you'd like, and somewhere along the way you started pulling your smile back slightly to manage it. If that sounds familiar, you're not alone, and the good news is that there's a straightforward, low-commitment fix that Sterling VA patients are quietly discovering in growing numbers.
Botox for a gummy smile is one of the most underrated treatments we offer at Physician Artistry. It takes a few minutes, requires almost no recovery, and when done with the right clinical hand, the results look completely natural — just a softer, more balanced smile that still reads as entirely yours.
What Actually Causes a Gummy Smile?
A gummy smile — technically called excessive gingival display — happens when the upper lip rises too high when you smile, exposing more of the gum tissue above your teeth than most people find aesthetically comfortable. For most patients, this comes down to overactive elevator muscles, specifically the levator labii superioris alaeque nasi (LLSAN), which is responsible for pulling the upper lip upward when you smile.
It's not a dental problem. It's not a lip problem. It's a muscle activity problem — and that's exactly what neurotoxin treatment is designed to address. A small, precise amount of Botox placed into the hyperactive muscle reduces how far the upper lip lifts during a smile. The muscle still works. You still smile naturally. You just don't expose as much gum tissue in the process.
This is a treatment where placement accuracy matters enormously. Too much product, or product placed even a few millimeters in the wrong direction, can flatten the lip's natural movement or create asymmetry. This is not a treatment to have done casually. It requires someone with a genuine understanding of facial anatomy and muscle behavior — which is exactly the kind of oversight Dr. Thomas brings to every treatment plan at Physician Artistry.
Who Is a Good Candidate for Gummy Smile Botox?
Most patients who are bothered by their gummy smile are excellent candidates, but a proper consultation helps confirm that Botox is the right solution for your specific anatomy. The treatment works best when the gummy smile is caused primarily by upper lip hyperactivity rather than by skeletal structure or the position of the teeth and gums themselves.
During your consultation, we'll look at how much gum tissue is visible when you smile at rest versus when you smile fully, assess the range of motion of your upper lip, and determine the ideal injection points and dose for your anatomy. Patients with milder cases often need only a very small amount — sometimes as little as 2 to 4 units per side — while patients with more pronounced cases may need slightly more to achieve the balance they're looking for.
Good candidates tend to be people who:
- Show more than 3 to 4 millimeters of gum tissue when smiling
- Have normal dental and skeletal structure
- Want a subtle, natural-looking correction without surgery
- Are comfortable with a treatment that requires maintenance every three to four months
Patients who have had previous dental work, jaw surgery, or significant lip augmentation may need a modified approach, and we'll discuss all of that openly during your visit.
What Does the Treatment Feel Like?
Quick is the word most patients use. The injection itself takes less than five minutes. Most patients describe the sensation as a small pinch — nothing that requires numbing cream, though we can offer it if you'd prefer. You'll be in and out of the office without any meaningful disruption to your day.
There's no real downtime. Some patients notice mild tenderness or tiny injection marks at the treatment site for an hour or two, but these resolve quickly. You can return to work, social commitments, or any normal activity immediately. We do recommend avoiding intense exercise for the remainder of the day and not rubbing or pressing on the treatment area, but those are minor precautions.
What Do Gummy Smile Botox Before and After Results Look Like?
The results from botox for gummy smile before and after comparisons tend to surprise patients in the best way. The change isn't dramatic in the way that surgery might be — it's more like your smile finally looks the way it always felt to you on the inside. The gum tissue that used to dominate your smile recedes into the background, and your teeth and lips take center stage instead.
Most patients start noticing results within three to five days as the neurotoxin begins to take effect, with full results visible by the two-week mark. The upper lip doesn't look stiff or frozen — it still moves naturally, still expresses emotion, still looks like you. It simply doesn't travel quite as far upward when you smile broadly. The effect is subtle enough that many patients find their friends and family notice something is different without being able to articulate exactly what changed.
One thing worth noting: because the muscles involved in upper lip movement are small and the doses used are correspondingly modest, this treatment tends to wear off a bit faster than Botox placed in larger muscle groups like the forehead. Most patients return every three to four months to maintain their results. Some patients find that with consistent treatment over time, they can extend their intervals slightly as the muscle gradually learns a new baseline — though this varies by individual.
If you're curious about how neurotoxin longevity differs across treatment areas and what affects how long your results last, our post on how long Botox really lasts breaks this down clearly for Northern Virginia patients.
Can Gummy Smile Botox Be Combined With Other Treatments?
Yes — and for many patients, combining treatments in a single appointment creates the most cohesive, natural-looking outcome. Patients who are already coming in for forehead lines, crow's feet, or lip filler often add gummy smile treatment to the same visit with no additional recovery time.
Lip filler and gummy smile Botox are a particularly natural pairing. Lip filler adds gentle volume and definition to the lips themselves, while the Botox softens the upper lip's elevation when smiling. Together, they create a smile that looks fuller, more balanced, and more proportionate — without any one element looking overdone. Our blog post on combining lip filler and Botox in one appointment goes deeper on how to approach this combination thoughtfully.
Patients who are also interested in jawline refinement, brow positioning, or addressing other areas of facial balance may find that a broader treatment conversation is worthwhile. At Physician Artistry, we take a comprehensive view of the face rather than treating individual areas in isolation — because the most natural results come from understanding how everything works together. You can explore more about that philosophy in our guide to combining Botox and fillers for a full-face refresh.
How Is Physician Artistry Different for This Treatment?
The gummy smile injection site sits very close to muscles that control other aspects of lip movement. In the wrong hands, this treatment can flatten the natural curve of the upper lip, create uneven movement on one side, or leave the lip looking stiff in ways that read as unnatural. These aren't rare outcomes at practices where this is treated casually — they're the predictable result of imprecise technique.
What makes Physician Artistry different is that Dr. Thomas has spent over 30 years building the kind of anatomical understanding that makes precision possible. He doesn't approach the face with a standard formula — he approaches it with the curiosity and attention of a clinician who genuinely cares whether the result looks right on your face, with your anatomy, and your smile. Patients consistently describe results that "enhanced my features without ever looking overdone" — and that's not a coincidence. It's the product of a physician who takes the time to think before he injects.
Our patients also speak to something beyond the clinical skill: the way they're treated throughout the process. Everyone here is kind, attentive, and genuinely invested in how you feel about your results. You're not being moved through an assembly line. You're being seen.
If you want to understand more about what makes neurotoxin results look natural versus overdone, our guide to getting natural-looking Botox results is a good place to start.
What About Cost?
Gummy smile Botox is one of the more affordable treatments we offer, in part because the doses involved are modest. During your consultation, we'll give you a clear, honest picture of what to expect in terms of units and pricing — no surprises, no packages you didn't ask for. If you'd like a general sense of how neurotoxin pricing works at Physician Artistry, you're welcome to reach out ahead of your visit and we're happy to walk you through it.
Many patients find that bundling gummy smile treatment with another area they're already treating — like forehead lines or crow's feet — makes the overall visit feel extremely efficient and cost-effective. Our post on treating multiple areas with Botox in one appointment covers how to think about sequencing and prioritizing when you have more than one concern.
Ready to Talk About Your Smile?
If you've spent years feeling self-conscious about how much gum shows when you smile, it's worth knowing that the fix may be simpler than you think — and that the right provider can make the difference between results that look genuinely natural and results that look like you've had something done.
At Physician Artistry in Sterling, VA, we'd love to talk with you about whether botox for gummy smile is the right fit for your anatomy, your goals, and your lifestyle. A consultation is a conversation, not a commitment — and we think you'll leave with a much clearer picture of what's possible.
Come see what sterling virginia smiles can look like when they're treated with the warmth and clinical precision this kind of work deserves. Learn more about our Botox treatments or reach out directly to schedule your consultation with Dr. Thomas.
