Softening a Gummy Smile with Anti-Wrinkle Injections: How It Works

A smile is one of the first things people notice about you, and for most of us it happens without a second thought. But if your top lip lifts higher than you would like when you grin, revealing a broad band of gum above the teeth, that reflex can start to feel like something you manage rather than enjoy. It is one of the most common concerns we see at Wellface, and one of the most satisfying to treat, because the fix is quick, precise and completely non-surgical.

In a recent clinic reel, one of our doctors walked through a treatment with a patient who has lovely full lips but felt her smile showed a little too much gum. As she put it on camera, when the patient gives a big, genuine smile, the lip travels up too far. A few carefully placed anti-wrinkle injections around the base of the nose relax the muscle that pulls the lip skyward, so the same happy smile shows more tooth and less gum. Here is how the treatment works, who it suits, and what to expect if you are thinking about it.

What actually causes a gummy smile

A gummy smile, known clinically as excessive gingival display, simply means that more of the gum tissue is visible than most people feel comfortable with when smiling. There is no strict medical threshold, but as a rough guide, showing around two to three millimetres of gum is considered within the normal range. Beyond about three to four millimetres, many people start to feel self-conscious.

The important thing to understand is that a gummy smile can have several different causes, and they do not all respond to the same treatment. In some cases the upper lip is simply very mobile, meaning the muscles that raise it are strong and pull it higher than average. In others the issue relates to the teeth themselves, the way the gums sit, the length of the upper lip, or the position of the jaw. Sometimes it is a combination.

The muscle at the heart of the most treatable type is a small one with a long name: the levator labii superioris alaeque nasi, often shortened to the LLSAN. It runs down each side of the nose and attaches near the upper lip and nostril, and its job is to lift the lip and flare the nostril. When this muscle is overactive, it hauls the top lip up too far during a full smile and exposes the gum line. That is exactly the pattern our doctor identified in the reel, and it is precisely the type that anti-wrinkle injections address so well.

Why it matters which type you have

This is where an experienced, doctor-led assessment earns its place. Anti-wrinkle injections work beautifully for a gummy smile driven by a hyperactive lip, because you are relaxing the muscle that is doing the pulling. If the excess gum display is mostly down to the teeth or gum anatomy, a dental or orthodontic approach is more appropriate, and injections alone would not deliver the result you want. Many people have a bit of both, and part of the consultation is working out how much of the display is muscular and therefore treatable in the clinic.

How anti-wrinkle injections treat it

Anti-wrinkle injections use botulinum toxin, a purified protein that temporarily reduces the signal from nerve to muscle. When a small, precise dose is placed into an overactive muscle, that muscle relaxes and moves less. It is the same principle we use to soften frown lines or crow's feet, applied here to the muscles that lift the upper lip.

For a gummy smile, the toxin is placed at the base of the nose, where the LLSAN muscle sits close to the surface. In the reel, our doctor described injecting on either side to relax the lip elevators, plus a point in the centre. That central placement is a nice detail of good technique: relaxing the side muscles softens the lip lift, while a small dose in the middle helps support the nasal tip so it does not turn downward when you smile. The aim is a balanced, natural result, not a lip that cannot move.

The effect is subtle by design. You keep your full range of expression and your smile still reaches your eyes. What changes is how high the top lip climbs at the peak of a big grin. Instead of riding up to expose a strip of gum, it settles a couple of millimetres lower, so the smile reveals more teeth and looks more even.

The appointment itself

The whole thing is quick. After a proper consultation and a look at your smile in motion, which is why our doctor kept asking the patient for bigger and more genuine smiles, the actual injections take only a few minutes. The needles used are very fine. Most people describe the sensation as a brief sting or pinch at each point rather than anything painful, and no anaesthetic is usually needed.

There is nothing to recover from in the practical sense. You can drive yourself home and return to work the same day. We do ask you to follow a few simple aftercare steps in the hours afterwards, which we will come to below.

When you will see results and how long they last

Anti-wrinkle injections are not instant. The protein needs a little time to take effect on the muscle, so you will usually notice the first changes within a few days, with the full result settling by around two weeks. That is why our doctor told the patient she would show the outcome in a couple of weeks rather than on the day. It is worth being patient here. Judging the result too early can be misleading, because the muscle has not fully relaxed yet.

Once the effect has settled, a gummy smile treatment typically lasts somewhere in the region of three to four months, sometimes a little longer. The muscles around the mouth are among the busiest in the face, working every time you talk, eat and smile, so results in this area can wear off slightly faster than in, say, the forehead. Most patients choose to top up two or three times a year to maintain the look. As with all anti-wrinkle treatments, results tend to become more predictable and sometimes longer-lasting with regular, well-spaced sessions.

Is it right for you?

The ideal candidate is someone whose gummy smile is caused by an overactive upper lip, who is in good general health and has realistic expectations about a temporary, refinement-level change. If you find yourself instinctively holding back your smile in photographs or covering your mouth when you laugh, and the extra gum shows mainly because your lip lifts high, this is very likely to help.

There are a few situations where we would pause or recommend a different route. Anti-wrinkle injections are not suitable during pregnancy or breastfeeding, or for people with certain neuromuscular conditions. If your gum display is mostly a dental or skeletal matter, we will be honest about that and point you toward the right kind of care rather than a treatment that will not achieve your goal. This candour is central to how our doctors work. The most flattering result comes from matching the right treatment to the right cause.

How it compares to the alternatives

For a muscular gummy smile, injections are the least invasive option available, with no cutting, no stitches and no downtime. The trade-off is that the result is temporary and needs maintaining. Surgical and dental approaches, such as gum contouring, lip repositioning or orthodontic work, can offer more permanent change but involve a bigger commitment, more recovery, and are only appropriate when the underlying cause is anatomical. For many people, a short course of injections is a simple, low-risk way to see whether they love the softer smile before considering anything more involved. Often, they simply carry on with occasional top-ups and never need to.

Aftercare for the best result

Aftercare for a gummy smile treatment mirrors our general advice for anti-wrinkle injections. In the first several hours, try to stay upright and avoid lying flat, and skip anything that rubs or presses on the treated area. That means no facials, massages or make-up removal directly over the site for the rest of the day. It is also sensible to avoid strenuous exercise, hot environments like saunas and steam rooms, and alcohol for around twenty-four hours, as these can increase the risk of bruising.

You should feel completely normal straight away, so there is no need to clear your diary. A little redness or a small bump at each injection point is common and usually settles within an hour or so. If we have asked you to gently activate the muscle, we will show you exactly what to do. Otherwise, the toxin does its work quietly over the following days, and you simply carry on as usual while the result develops.

Common questions about gummy smile treatment

Will my smile look frozen or fake?

No. The dose used is small and targeted at the specific muscle pulling the lip too high. You keep your natural expressions, and the change is a subtle lowering of how far the top lip lifts. A good result should have friends telling you that you look well rather than asking what you have had done.

Does it hurt?

Very little. The needles are fine and the injections take only a few minutes. Most people report a quick pinch or sting at each point and nothing more. No numbing cream is usually required.

How many sessions will I need?

The treatment itself is a single, quick appointment. We then review the result at around two weeks to check we have achieved the right balance, and a small adjustment can be made if needed. After that, it is a matter of returning for a top-up when the effect begins to fade, typically every few months.

Can it be combined with lip treatments?

Yes. Because the concern here is about how high the lip rises rather than its shape or volume, a gummy smile treatment often sits comfortably alongside other work such as lip filler or skin treatments. In the reel, the patient already had full lips, and the injections were purely about softening the lift. During your consultation we will map out a plan that suits your whole face rather than treating one feature in isolation.

What if injections are not enough on their own?

If your assessment shows that part of your gum display is dental or skeletal rather than muscular, injections will improve the muscular component but may not fully resolve the concern. We will be clear about what is realistic and, where appropriate, suggest combining approaches so you get the outcome you are hoping for.

See what a softer smile could look like for you

A gummy smile is one of those concerns that feels bigger to the person living with it than it does to anyone else, and it responds remarkably well to a treatment that takes minutes and needs no recovery. The key is a proper assessment: watching your smile in motion, working out what is driving the gum display, and placing a small, precise dose exactly where it counts.

If you have ever caught yourself softening a grin in photos, our doctors at Wellface would be glad to take a look. You can book a consultation at our clinics in Cobham, Esher or Wimbledon, where we will talk through your smile, explain what is achievable and, if it is right for you, plan a treatment tailored to your face. Come and have the conversation, and let us show you what your happiest smile could look like.