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Gummy Smile

Gummy Smile

A gummy smile is a smile in which a larger-than-typical band of the upper gum is visible above the teeth, known clinically as excessive gingival display. It is an entirely natural variation in how the muscles, lip, teeth, and jaw work together, and it is not a problem in itself — but some people would prefer a smile in which less gum is shown. Carefully placed micro-doses of muscle-relaxing injections, and in selected cases very small amounts of soft hyaluronic acid filler, can soften the upward pull on the upper lip and gently lower how the lip rests when you smile — without changing how you speak or restricting your expression.

Medically reviewed by Dr Bhavin Garara, GMC 7155707 · Last reviewed: 15 June 2026

On this page
What it is

What Is a Gummy Smile?

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A typical smile reveals the full length of the upper teeth and, often, a small band of gum tissue above them — usually around two millimetres or so at the centre. When three to four millimetres or more of gum is visible during a relaxed natural smile, the smile is described clinically as a gummy smile, or excessive gingival display.

For some people the increased gum show is part of how their face has always animated, and they think nothing of it. For others — particularly where the pattern feels new, asymmetric, or pronounced — it can affect how comfortable they feel smiling in photos or in conversation. There is no obligation to treat a gummy smile; it is a choice, and only some patterns and causes respond well to the non-surgical treatments we offer.

Dr Bhavin Garara’s approach to a gummy smile is conservative and pattern-led. The aim is to soften the specific muscle activity that is producing your particular gum show — not to immobilise the smile or alter your face. A well-judged treatment should leave your smile fully expressive, just with a little less gum on view.

Side by side

Patterns of Gummy Smile

Working out which muscles are driving your gum show is the central step in deciding which treatments are likely to help. There are three broad patterns.

Anterior gummy smile

Most of the gum show is in the centre of the upper lip — above the front teeth. This is usually driven by a small but powerful muscle called the levator labii superioris alaeque nasi, which pulls the centre of the upper lip straight upwards alongside the nose.

Posterior gummy smile

Most of the gum show is towards the back of the mouth — over the canines and back teeth. This is usually driven by the zygomaticus major and zygomaticus minor, which pull the corners of the mouth up and outwards.

Mixed or asymmetric gummy smile

A combination of the above, sometimes with one side showing more gum than the other. This often involves the depressor septi nasi and other small elevators acting together.

A clinical assessment of which pattern you have shapes both whether a non-surgical treatment is likely to help and where injections would be placed.

What causes it

What Causes a Gummy Smile?

There are several reasons a smile can show more gum than the patient would like. They often combine.

  1. 1

    Hyperactive upper-lip elevator muscles

    The most common reason is simply that the muscles which lift the upper lip are stronger or more active than average. When you smile, they pull the lip higher than the underlying gum line, revealing more gum. This is the pattern most responsive to muscle-relaxing injections.

  2. 2

    A naturally short upper lip

    If the distance between the base of your nose and the bottom of your upper lip is shorter than average, even normal muscle activity will expose more gum. A short upper lip can be partly addressed by treatments that allow the lip to gently evert (showing more vermilion downward, less gum upward).

  3. 3

    Dental and skeletal factors

    Some patterns are dental rather than muscular. Altered passive eruption is a condition in which the gum tissue does not recede normally as the teeth erupt, leaving more gum visible. Maxillary excess is a skeletal pattern in which the upper jawbone has grown longer than average, so the teeth and gums sit lower in the face. These causes sit outside aesthetic medicine and are best assessed by a dental specialist or, in some cases, an oral and maxillofacial surgeon.

    Some of the causes named above are dental or skeletal conditions. This page is general information, not a diagnosis. If your gummy smile may have a dental or skeletal component, Dr Garara will explain that at consultation and direct you to the right specialist — only some gummy-smile patterns respond to the non-surgical treatments we offer.

  4. 4

    Combinations

    In practice, many gummy smiles are a combination — for example, a slightly short upper lip and somewhat hyperactive elevator muscles. The clinical assessment determines what mix of factors is at play and which, if any, the non-surgical options here are likely to address well.

Dr Bhavin Garara
Dr Bhavin Garara, MBBS, BMedSci, PGDip
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Dr Garara's approach

How Dr Bhavin Garara Treats Gummy Smile

A gummy smile treatment is anatomically demanding because the muscles around the upper lip and nose are small, closely overlapping, and central to how the face animates. Over-treating this area can lead to a stiff or elongated upper lip that hinders natural expression, affects speech, or looks unnatural at rest.

At the clinics in London, Dr Garara carries out a careful dynamic assessment at consultation — asking you to smile at varying intensities and observing which muscles are contributing to your specific pattern of gum show. He also assesses the length and shape of your upper lip at rest, the proportions of your smile to the rest of your face, and whether the cause appears to be muscular, dental, or a combination.

From there, he designs a plan that uses carefully targeted micro-doses of muscle-relaxing injections in the specific muscles driving your particular pattern, and — in selected cases — adds a very small amount of soft hyaluronic acid filler to support the upper lip. The aim throughout is to soften, not freeze: your smile should still look like your smile.

  • Anatomy-led assessmentTreatment plans built around your unique facial structure and movement.
  • Personalised planCombinations chosen for your skin, goals, and lifestyle — not a one-size-fits-all protocol.
  • Natural resultsA refreshed, well-rested version of you — never a frozen or over-treated look.

Features

Treatment Options for Gummy Smile

Pattern-led micro-dose muscle-relaxing injections, with selective upper-lip support and onward referral where the cause is dental or skeletal.

Prescription muscle-relaxing injections

Prescription muscle-relaxing injections

Pattern-led micro-doses placed in the specific elevator muscles driving your gum show. Off-licence use; conservative dosing matters.

Hyaluronic acid filler for upper-lip support (selective)

Hyaluronic acid filler for upper-lip support (selective)

Where the upper lip is short or curls inward when smiling, a very small amount of soft HA can support how the lip behaves during a smile. Often combined with muscle-relaxing injections.

Treatments outside our scope

Treatments outside our scope

Where the cause is dental (altered passive eruption) or skeletal (maxillary excess), Dr Garara refers to a dental specialist or oral and maxillofacial surgeon.

Non-surgical treatment of a gummy smile is most effective when the cause is muscular hyperactivity, or where a short upper lip can be supported with very small amounts of filler. Dental or skeletal causes are referred onwards.

Prescription muscle-relaxing injections

  • Best for: Gummy smile driven by hyperactive upper-lip elevator muscles
  • Downtime: None to minimal — brief pinpoint redness
  • Lasts: Around 3–4 months

For gummy smiles driven primarily by hyperactivity of the upper-lip elevator muscles, micro-doses of prescription muscle-relaxing injections placed in the specific muscles driving your pattern can soften the upward pull, allowing the upper lip to rest a little lower when you smile and reducing how much gum is shown.

Prescription muscle-relaxing injections work by temporarily reducing the activity of specific muscles, so the skin above them stops folding with each movement. The active ingredient is botulinum toxin type A, a purified protein delivered in very small, precisely placed doses. These are prescription-only medicines in the UK, which means they can only be prescribed and administered by a qualified medical prescriber following a face-to-face consultation. Whether this treatment is suitable for you, and what specific product or dose would be used, is something Dr Garara will discuss with you at consultation. It is not suitable for everyone.

This use of botulinum toxin is what’s known as “off-licence” — established, lawful practice in qualified medical hands, but not specifically licensed by UK regulators for this particular indication. Dr Garara will explain this fully at consultation, including why he considers it appropriate for your case, and will obtain your informed consent before any treatment.

Dosing here is particularly conservative. Too much, or treatment placed in the wrong muscle for your pattern, can lead to a stiff or elongated upper lip, an asymmetric smile, or — in rare cases — difficulty with speech or drinking from a straw for the duration of the effect. This is a question of careful technique and pattern-led placement.

Hyaluronic acid filler for upper-lip support (selective)

  • Best for: Gummy smile partly driven by a short or inward-curling upper lip
  • Downtime: 1–3 days of possible swelling or bruising
  • Lasts: Around 6–12 months in this area

Where the gummy smile is partly driven by a short or thin upper lip that curls inwards when you smile, a very small amount of soft hyaluronic acid (HA) filler placed in the upper lip can give the lip enough structure to remain in a slightly lower position during a smile, partly covering the gum line. This is used very selectively — not to add volume to the lip, but to support how it behaves during animation. It is often combined with muscle-relaxing injections rather than used alone.

Hyaluronic acid filler is reversible — it can be dissolved using an enzyme called hyaluronidase. If you are considering correcting or reversing previous filler, or want to understand more about how filler can be safely removed, see our page on filler removal and dissolving.

See our page on filler removal and dissolving.

Treatments outside our scope

Where the cause is dental — for example altered passive eruption — the right treatment is gum-contouring (a periodontal procedure) carried out by a dental specialist. Where the cause is skeletal — maxillary excess — the relevant assessment is by an oral and maxillofacial surgeon, and definitive correction may involve orthodontic or surgical treatment. We will not pursue non-surgical treatments at our clinic if the underlying cause is one we cannot meaningfully address; in those cases Dr Garara will explain why and refer you to the appropriate specialist.

Considering treatment for a gummy smile?

Book a consultation with Dr Bhavin Garara to discuss whether a non-surgical approach is right for your specific pattern.

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Compare at a glance

Treatments at a Glance

Prescription muscle-relaxing injections (micro-dose)

Best suited for
Gummy smile driven by hyperactive upper-lip elevator muscles
Typical downtime
None to minimal — brief pinpoint redness
How long results last
Around 3–4 months
What it does
Softens the muscle activity so the lip lifts less, showing less gum

Hyaluronic acid filler in the upper lip (selective)

Best suited for
Gummy smile partly driven by a short or inward-curling upper lip
Typical downtime
1–3 days of possible swelling or bruising
How long results last
Around 6–12 months in this area
What it does
Supports the lip so it covers a little more of the gum line

Combined micro-dose injections + small upper-lip filler

Best suited for
Mixed-pattern gummy smile
Typical downtime
1–3 days of mild swelling
How long results last
As above, by component
What it does
Addresses both muscle and structural contributions together

Downtime and duration figures are typical averages only. Individual results vary considerably depending on your specific anatomy, the dose used, and how your body responds. Dr Garara will give you a more personalised picture at consultation.

Safety & risk

Is Gummy Smile Treatment Safe?

Gummy smile treatments are widely performed by experienced practitioners, but the area is anatomically demanding. The muscles that lift the upper lip are small, closely overlapping, and central to how the face animates, so placement matters. The perioral and upper-lip area is also supplied by branches of the facial artery, including the superior labial artery. Any injection here, particularly with dermal filler, carries a small but recognised risk of vascular complications, which in rare cases can include skin necrosis. In very rare cases, retrograde flow through the facial vascular network can affect more distant areas.

We share this not to alarm you, but because patients deserve full information to make a confident decision. It is also the reason this area should only be treated by an experienced medical practitioner who understands the anatomy, uses safe technique, and is equipped to manage complications immediately if they arise — including the immediate availability of hyaluronidase to reverse hyaluronic acid filler. Dr Garara is always happy to discuss the specific risks of any treatment, and the safety protocols he follows, in detail at your consultation.

A more common, less serious consideration with muscle-relaxing injections in this area is the risk of an over-corrected outcome — a stiff or elongated upper lip, mild speech changes for the duration of the effect, or asymmetry — if the dose is too high or if it is placed in the wrong muscle for your pattern. This is a question of careful, conservative, pattern-led dosing and is part of why a thorough assessment matters.

  • Qualified medical practitionerTreatment carried out by an experienced doctor with detailed anatomical training.
  • Reversal agents on handHyaluronidase and other complication-management tools are immediately available.
  • Full informed consentRisks, alternatives, and expected outcomes discussed in detail before any treatment.
Dr Bhavin Garara
Reviewed byDr Bhavin Garara

Frequently Asked Questions

Common questions about gummy smile treatment.

Read next

Related Concerns

Gummy smile is closely related to other lower-face concerns. You may also want to read about:

Ageing lipsBarcode lip linesSmile lines and foldsFiller removal and dissolving
← All face concerns

For an overview of all the facial concerns we treat, visit our Face treatments hub.

Next step

Ready to take the next step?

Book a consultation with Dr Bhavin Garara for a personalised assessment of your smile and treatment options.

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This page is for general information and does not constitute medical advice. All treatments require a personal consultation. Suitability, risks, and expected outcomes will be discussed with you in detail before any treatment is carried out.