A gummy smile is a very common problem where on smiling, a large area of gum can be seen above the upper teeth. Sometimes gummy smiles are genetic and will run in a family.
Small injections with a very fine needle are used to relax the muscles to bring the upper lip down to resolve the excessive gum display.
How long it takes
Approximate treatment time is 20 minutes.
Return to work
Approximately 1 hour after treatment.
Recovery time
Approximately 24–72 hours after treatment.
How long it lasts
Approximately 3-4 months after treatment.
Consultation
A £50 no-refundable deposit is required and can be used toward either the face to face consultation OR the treatment on the day.
For this treatment, we must take into consideration the following:
Is there a genetic component? ie are there others in the family who have a gummy smile?
Has the patient had treatment before and were they happy every time?
Did the effect of the muscle relaxing injections last well?
Which area came back first?
How is the patient’s metabolism?
Do they exercise? Are they very muscular?
Do they have trouble putting on or losing weight?
How many mm of gum display would the patient like resolved?
Have they ever had any complications with muscle relaxing injections before, including difficulties with speaking, “the camel” ie the reverse of the gummy smile where there is too little tooth show during smile because of excessive treatment
Does the patient want a more natural appearance, or do they want the maximum effect possible?
Have they used or are they going to use filler in the lips?
Dr Natasha will examine the face and gummy smile. In particular, she will look at many features, such as:
How is the appearance at rest, ie with no smile?
How is the smile through the whole range of smiling, from the start of a smile to maximum smile?
Whether there is an asymmetry, measuring the length of the philtrum.
Choosing the dose of injection
Dr Natasha will assess the gummy smile and decide on the best dose after discussing their history and examining the patient. In particular, discussing with the patient how many mm of reduction of excessive gum display would the patient want. If there is an excess of 6 mm, then that level of treatment can cause a speech impediment.
If the patient has a history of poor longevity, or needing high doses or wanting maximum effect, then a higher dose may be suggested.
If a patient has a history of complications with muscle relaxing injections, if their budget is small or if they want a more subtle result, then a smaller dose might be chosen.
It is very important to assess the philtrum, as some patients may look older with treatment for a gummy smile, so may be unsuitable. Dr Natasha can discuss this with you after your consultation.
Pain relief during injections
A numbing cream may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect. Most patients do not bother with numbing cream because it takes so long to work and because the treatment isn’t very painful anyway. Ice is always used to decrease pain and to reduce the risk of bruising.
What happens during the treatment itself?
The face will be cleaned with alcohol and chlorhexidine. Ice will be applied to the area briefly before treatment. Dr Natasha may inject 3 sites. Then pressure with gauze will be applied. The procedure itself takes less than 5 minutes.
Possible side effects
In general, treatment of a gummy smile is very low-risk. However, headaches can occur in around 10% of new users and bruising occurs in a significant number of cases.
What to expect after the treatment
Due to the nature of this treatment, sometimes the effect is not immediate. Sometimes there can be bruising, redness or small lumps, which can look like mild acne and usually resolves quickly.
Most people could come during their lunch break during work and go back to work without their coworkers noticing anything. The effect will not start to occur for 2-8 days. The onset of action of treatment of one of the brands of anti-wrinkle injections is quicker than the others.
The maximum effect of the treatment will be at 4 weeks, so a review should be booked in at 4 weeks (only after the first treatment, for subsequent injections, a review appointment shouldn’t be required).
How long will the treatment last?
The answer to this is very individual and depends on the patient’s metabolism, the dose, the placement etc.
For the majority of patients, typically at 3-4 weeks, there is a maximum effect, at 8 weeks, movement starts to return, at 12 weeks, 50% of movement should be back, at 16 weeks 80% of movement should be back.
When should I have my next treatment?
Typically around 3-4 months, although some patients prefer to book another treatment at 8 weeks.
Post-procedure Advice
Do not smoke for at least 24-36 hours (smoking is not recommended post-procedure).
Avoid any alcohol consumption for 24 hours before treatment and 24 hours post-procedure.
Avoid any exercise for 24 hours post-procedure.
Avoid using any make-up or skincare products/spray tan/direct sunlight, sun exposure and do not use tanning beds.
Use a facial cleansing wipe to clean face, avoiding the treated area.
Avoid touching or massaging the injected area, unless absolutely necessary.
Use Arnica Cream (TM) after your treatment to help with any bruising or discomfort (if required).
Apply cool compresses to injected sites for five minutes up to four times a day if required.
Restrict facial movements where possible for up to 1-3 weeks post-procedure.
Try to keep the head elevated while sleeping for the first 48 hours post-procedure to help prevent swelling.
Sleep in an upright position, face-up, to help reduce any swelling (3-7 nights post-procedure).
Avoid any dental appointments, facial appointments and chemical treatments 4 weeks post-procedure.
Avoid excessive heat – swimming pools, sauna, steam rooms, hot showers for at least 48 hours post-procedure.
Paracetamol is advised to patients for post-procedure discomfort (Ibuprofen should be avoided).
