Gummy Smile Treatment in Marylebone, London
Excessive gum show on smiling is most often caused by a hyperactive upper-lip elevator muscle — a condition resolved with 4 to 6 units of anti-wrinkle treatment.
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A gummy smile — defined as more than 3mm of gum visible above the upper teeth when smiling fully — has several possible causes. The most common is hyperactive contraction of the levator labii superioris alaeque nasi muscle (the small muscle that pulls the upper lip sharply upward on smiling). Less commonly it is caused by short anatomical upper lip length, vertical maxillary excess (a dental/orthodontic issue), or excess gingival tissue (treated with gum contouring by a periodontist).
When the cause is the hyperactive muscle, a tiny dose of anti-wrinkle toxin (4 to 6 units total, placed very precisely at the nasal base) dramatically reduces the lift of the upper lip on smiling, revealing less gum without changing the smile character. Results are visible within 3 to 7 days, full at 2 weeks, and last approximately 3 to 4 months per treatment. For patients with maxillary-excess causes, surgical consultation is the appropriate referral — this is always assessed at consultation before treatment.
What drives this concern
- Hyperactive levator labii superioris alaeque nasi muscle (most common cause)
- Short upper-lip anatomy
- Vertical maxillary excess (orthodontic/surgical cause)
- Excess gingival tissue (periodontal cause)
- Combination of two or more causes in the same patient
Treatment options for gummy smile
Anti-Wrinkle Injections
From £250Primary treatment when the cause is hyperactive upper-lip elevator muscle. 4 to 6 units of botulinum toxin placed precisely at the nasal base. Results visible in 3 to 7 days, last 3 to 4 months.
See treatment detail →Dermal Fillers
From £350For patients with short upper-lip anatomy, a small amount of lip filler can lengthen and balance the lip, reducing relative gum visibility. Used when anti-wrinkle alone is insufficient.
See treatment detail →FAQ
Common
questions
How much gum show is "too much"?
Clinically, more than 3mm of gingival display above the upper central incisors during a full natural smile is considered a gummy smile. Aesthetically, the threshold varies by personal preference and cultural norms — some patients want treatment for 2mm of show, others are comfortable with 5mm. Dr Valentina will photograph you at rest and during natural smile at consultation to assess your baseline and agree a realistic target.
Will anti-wrinkle treatment for gummy smile change my smile character?
Correctly dosed treatment reduces how high your upper lip lifts on smiling but preserves the smile shape, corner-of-mouth animation, and character. Mild over-dosing can produce a flat or "tight" upper lip — avoided with conservative starting doses (4 units initially) and adjustment at the 2-week review. Most patients report their smile looks lighter and more balanced rather than different.
How long does the result last?
Results last approximately 3 to 4 months per treatment, similar to other anti-wrinkle indications. Because the dose is small and the target muscle is very specific, some patients extend the interval to 5 or 6 months after a year of consistent treatment as the muscle weakens from reduced use. Maintenance is typically every 4 months in the first year, 5 to 6 months thereafter.
How much does gummy smile treatment cost?
£250 for gummy smile anti-wrinkle treatment, including the 2-week review. If you also want complementary lip filler to lengthen the upper lip, a combined package of gummy smile toxin plus 0.5ml lip filler is £550. If the underlying cause is determined at consultation to be skeletal or gingival rather than muscular, Dr Valentina will refer you to an appropriate specialist rather than treat.
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Dr Valentina Aesthetics • 1 Orchard Street, London W1H 6HJ
Book a SessionAppointments typically available within 1–2 weeks