Understanding Botox Treatment for Gummy Smile in Singapore

Yoneda Narumi
Dec 29, 2025
6 min read

What Is a Gummy Smile?

A gummy smile, medically termed excessive gingival display, occurs when a significant portion of the gum tissue becomes visible above the upper teeth when smiling. This aesthetic concern affects individuals differently, with some people showing 3-4 millimetres or more of gum tissue during a full smile.

The visibility of gum tissue varies naturally among individuals. While there is no universal medical standard for what constitutes "excessive" gingival display, many people seek treatment when they feel self-conscious about the appearance of their smile. Understanding the underlying causes can help determine appropriate treatment approaches.What Is a Gummy Smile?

Common Causes of Excessive Gingival Display

The development of a gummy smile typically results from anatomical and functional factors. The upper lip's position and movement during smiling play a central role in how much gum tissue becomes visible.

Anatomical Factors

Several structural characteristics may contribute to excessive gingival display. A hyperactive upper lip elevator muscle can cause the lip to rise higher than typical during smiling, revealing more gum tissue. The natural length and thickness of the upper lip also influence how much gingiva shows when a person smiles. Additionally, the vertical positioning of the maxilla (upper jaw) and the eruption pattern of the teeth can affect the gum-to-tooth ratio visible during facial expressions.

Muscular Factors

The levator labii superioris alaeque nasi muscle, along with other muscles controlling upper lip movement, can exhibit heightened activity in some individuals. This increased muscular contraction pulls the upper lip further upward during smiling, exposing more of the gum tissue than the person may desire.

Treatment Approaches for Gummy Smile

Multiple treatment options exist for addressing excessive gingival display, each with distinct mechanisms, invasiveness levels, and considerations. The selection of an appropriate approach depends on the underlying anatomical cause, the degree of gingival display, patient preferences, and clinical assessment.

Botulinum Toxin Type A for Gummy Smile: An Overview

Botulinum toxin type A injections represent one approach to managing excessive gingival display caused by hyperactive lip elevator muscles. This treatment is considered an off-label use of botulinum toxin products, as it falls outside the primary indications approved by the Health Sciences Authority (HSA) in Singapore.

Mechanism of Action

Botulinum toxin type A temporarily inhibits the release of acetylcholine at the neuromuscular junction. When injected into the muscles responsible for elevating the upper lip, the toxin reduces the strength of muscle contraction. This temporary reduction in muscular activity limits how high the upper lip rises during smiling, potentially decreasing the amount of visible gum tissue.

The effects develop gradually over several days following injection, typically becoming noticeable within 3-7 days and reaching maximum effect within 2 weeks. The duration of effect varies among individuals but generally lasts between 3 to 6 months, after which muscle activity gradually returns to baseline levels.

Clinical Considerations

The use of botulinum toxin for gummy smile management requires precise anatomical knowledge and injection technique. Treatment outcomes depend on multiple factors including injection site accuracy, dosage, individual anatomy, and the degree of muscle hyperactivity present.

It is important to understand that this represents a temporary intervention that requires repeated treatments to maintain results. Some individuals may experience satisfactory aesthetic outcomes, while others may find the effect insufficient for their concerns. Results vary significantly among patients due to differences in facial anatomy, muscle strength, and tissue characteristics.

The Treatment Process

Initial Consultation

A comprehensive consultation with a qualified medical professional is essential before proceeding with any aesthetic treatment. During this assessment, the practitioner evaluates facial anatomy, discusses aesthetic concerns, reviews medical history, and determines whether botulinum toxin injection is appropriate for the individual's specific situation.

The consultation should include discussion of realistic expectations, as treatment outcomes vary among individuals. Alternative treatment options should also be presented to enable informed decision-making.

Injection Procedure

The injection procedure itself is relatively brief, typically completed within 15-30 minutes. The treatment involves the following general steps:

The practitioner identifies the specific muscles contributing to excessive lip elevation through anatomical assessment and may ask the patient to smile to observe muscle movement. The injection sites are marked based on individual facial anatomy. Small amounts of botulinum toxin are injected into the targeted muscles using fine needles. The number of injection points and the dosage used vary depending on individual anatomical factors and clinical judgment.

Post-Treatment Period

Following the injection procedure, patients can typically resume normal daily activities with minimal restrictions. However, certain precautions may be recommended during the initial hours after treatment. The practitioner will provide specific post-treatment instructions, which commonly include avoiding vigorous exercise for 24 hours and refraining from lying flat for several hours after injection.

The treatment effects develop progressively over the following days and weeks. Patients should not expect immediate results, as the neuromuscular effects of botulinum toxin require time to manifest fully.

Potential Risks and Side Effects

As with any medical procedure, botulinum toxin injections carry potential risks and side effects that should be understood before treatment. While many individuals tolerate the procedure well, adverse effects can occur.

Common Side Effects

Mild and temporary side effects may include:

Discomfort or tenderness at injection sites
Minor bruising or swelling
Temporary asymmetry in lip movement
Difficulty with certain facial expressions during the effect period

These effects typically resolve spontaneously within days to weeks.

Considerations and Contraindications

Botulinum toxin treatment may not be suitable for everyone. Individuals with certain medical conditions, neuromuscular disorders, or allergies to botulinum toxin products should not receive this treatment. Pregnant or breastfeeding women are generally advised against elective botulinum toxin procedures due to insufficient safety data in these populations.

A thorough medical history review during consultation helps identify any contraindications or factors that might increase treatment risks.

Realistic Expectations and Limitations

Setting realistic expectations is crucial when considering any aesthetic treatment. Botulinum toxin injection for gummy smile represents one management option with specific characteristics and limitations.

What Treatment Can and Cannot Achieve

Botulinum toxin may reduce the visibility of gum tissue during smiling by limiting upper lip elevation in appropriate candidates. However, this treatment:

Does not permanently alter facial anatomy
Requires repeated sessions to maintain effects
May not completely eliminate gingival display
Works primarily for cases caused by muscle hyperactivity
May have limited effectiveness if skeletal or dental factors predominate

Individual responses vary considerably. Some people may achieve aesthetic outcomes they find satisfactory, while others may experience minimal change or require alternative treatment approaches.

Importance of Professional Assessment

Only qualified medical professionals can assess whether an individual is a suitable candidate for this treatment approach. Factors such as the primary cause of excessive gingival display, degree of muscle hyperactivity, overall facial anatomy, and patient goals all influence treatment appropriateness and likely outcomes.

Alternative and Complementary Approaches

For individuals whose gummy smile results primarily from skeletal positioning, tooth eruption patterns, or other non-muscular factors, alternative treatment modalities may be more appropriate.

Orthodontic treatment can address certain cases where tooth positioning contributes to excessive gingival display. Surgical approaches, such as lip repositioning or orthognathic surgery, may be considered for cases with significant anatomical contributions. Gingivectomy procedures can modify gum tissue contours in selected cases.

Each approach has distinct indications, benefits, limitations, and risk profiles. Comprehensive evaluation by qualified professionals, potentially including consultation with multiple specialists (dermatologists, plastic surgeons, orthodontists, or oral surgeons), can help determine the most appropriate treatment strategy for individual circumstances.

Finding Qualified Providers in Singapore

When seeking treatment for aesthetic concerns, it is essential to consult with appropriately qualified and registered healthcare professionals. In Singapore, medical aesthetic procedures should be performed by doctors registered with the Singapore Medical Council.

Potential patients should verify practitioner credentials, inquire about specific experience with the treatment being considered, and ensure they receive comprehensive information about risks, benefits, alternatives, and realistic outcomes during consultation.

Cost Considerations

The cost of botulinum toxin treatment for gummy smile varies depending on factors such as the amount of product required, the complexity of treatment, and the specific clinic. In Singapore, prices typically reflect the need for specialized expertise and quality medical care.

Since this is considered an aesthetic procedure, it is generally not covered by health insurance plans. Patients should discuss all costs transparently during consultation, including potential costs of follow-up treatments needed to maintain results.

Conclusion

Excessive gingival display when smiling is a common aesthetic concern with multiple potential treatment approaches. Botulinum toxin type A injection represents one option for managing gummy smile caused by hyperactive lip elevator muscles, offering a minimally invasive, temporary intervention.

However, this treatment is not suitable for everyone, involves certain risks, and produces variable results among individuals. Comprehensive evaluation by qualified medical professionals is essential to determine appropriate treatment strategies based on individual anatomical factors and aesthetic goals.

Anyone considering treatment for gummy smile should engage in thorough consultation with registered healthcare providers, discuss all available options, understand potential risks and limitations, and form realistic expectations about possible outcomes.

Note: This article is for educational purposes only and does not constitute medical advice. Individual treatment plans should be developed in consultation with qualified healthcare professionals. Treatment outcomes vary from person to person, and no guarantee of results is intended or implied. All professional treatments mentioned should be performed by licensed medical practitioners in Singapore, using HSA-approved or otherwise MOH-approved products, devices, and techniques, as applicable.

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Botox Treatment at KINS Clinic