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2026.11.12
Botox as an Option for Treating a Gummy Smile | A Dentist Explains Dosage, Costs, and Tips for Avoiding Complications
He is a specialist in the treatment of gummy smiles, one of the most sensitive areas of esthetic dentistry. He practices, lectures, researches, and writes articles in Japan and abroad. He is the only Japanese dentist who is certified as an implant specialist in both the U.S. and Europe. He uses a multifaceted approach, including surgical treatment, orthodontics, and Botox injections, to address all concerns about the mouth. He is a dentist who can help patients achieve their “desired smile.
"Gummy Smile Botox" is a procedure that adjusts the function of the upper lip muscles to reduce the amount of gum visible when you smile. The injection volume and placement are determined after assessing the movement of the upper lip and other factors.
"How many units of Botox are needed for a gummy smile?" "I'm worried my mouth might look unnatural or that the procedure might go wrong."
When considering Botox injections, many people are likely concerned not only about the effectiveness but also about the dosage and cost.
In fact, even for the same type of gummy smile, the required injection volume and the most appropriate method can vary.
A dentist from BIANCA CLINIC will discuss the specific treatment plans, risks, and costs associated with Botox injections.
Why is Botox an option for treating a gummy smile?
Botox injections for a "gummy smile" are a treatment option to consider when the upper lip lifts significantly when you smile, making your gums more visible.
By temporarily relaxing the muscles, this procedure adjusts the lift of the upper lip. Another key feature is that it does not require an incision and can be performed quickly.
However, Botox acts on the muscles. It does not change the position of the gums or the bone structure itself.
Therefore, it’s not just the amount of gum tissue visible that matters—it’s also important to identify the underlying cause of a gummy smile.
Where is Botox injected for a gummy smile? How many units are needed?
With Botox injections, both the injection site and the dosage affect the final result.
The injection targets the muscle that lifts the upper lip
Injections to correct a gummy smile primarily target the muscles known as the “levator labii superioris” and the “levator labii superioris alaeque nasi.”
Most of you are probably wondering, “Where is that?” It might help if you picture the area around the nasolabial folds.
At Bianca Clinic, we recommend injections at a total of four sites—two on each side—targeting these muscles.
The key here is to observe the movement of the upper lip when you smile. Just because you inject in the same spot doesn’t mean everyone will experience the same results.
What is the recommended dosage in units?
At Bianca Clinic, the recommended dosage for Botox to treat a gummy smile is a total of 4 units.
However, this does not mean that 4 units is the right amount for everyone.
A review of 13 clinical trials published in 2024 also found that the injection site and dosage varied depending on the symptoms, and multiple methods were being evaluated [1].
Therefore, it is important to determine the actual injection volume after assessing factors such as the movement of the upper lip and the amount of gum exposure.
What Are the Risks and Drawbacks of Botox for a Gummy Smile?
Although Botox injections are a procedure that does not involve incisions, the results may not always meet your expectations.
The mouth area, in particular, is a part of the body that moves frequently in daily life—whether during conversation, while eating, or when smiling. It’s important to strike a balance between minimizing gum exposure and maintaining natural facial expressions.
Your smile looks unnatural or there is a discrepancy between the left and right sides
If you suppress the activity of the muscles that lift the upper lip too much, your lips may not lift enough when you smile, which can make your facial expression look unnatural.
Furthermore, if there is a difference in how the muscles on the left and right sides are affected, the smile may become asymmetrical. The literature also reports cases where the strength of the lips weakens, leading to difficulty moving the mouth [2].
To avoid such changes, it is important to administer the injection in a way that aligns with the muscle's natural movement.
I'm not seeing the results I expected
There may also be cases where people say, “I got Botox, but it didn’t really hide my gums.”
This is because, in cases where the position of the gums or the bone structure—in addition to the movement of the upper lip—play a role, Botox alone may not be sufficient to achieve adequate improvement.
Even if you feel the effects are weak, you should not repeatedly administer additional injections on your own; instead, you should first determine the cause and assess your condition after the procedure.
How Can You Reduce the Risk of a Botched "Gummy Smile" Botox Treatment?
During your consultation, be sure to specifically mention any areas of concern regarding your natural smile and how much you’d like to reduce the amount of gum showing.
If you have had Botox injections in the past, information about the results and any discomfort you experienced at that time is also important.
It is also important to receive a thorough explanation from your doctor regarding the reasons for choosing the injection site and the number of units, as well as what changes you can expect in your smile after the procedure. Understanding this information and making an informed decision are key to minimizing the risk of complications.
When do the effects of Botox for a gummy smile start? How many treatments are needed?
With Botox for a gummy smile, you may begin to notice a difference a few days to about a week after the procedure.
A 2024 report summarizing the results of multiple studies indicated that the effects peaked 2 to 4 weeks after injection and lasted for approximately 12 to 24 weeks [1]. However, in actual clinical practice, variations in injection volume and individual differences must also be taken into account.
Based on my experience, I generally explain that the duration is typically around 3 to 6 months.
You can expect to see results even after just one session, but the effects are not permanent. If you wish to maintain the results, consider undergoing additional treatments at regular intervals.
Regarding how the effects manifest and how long they last,An article providing a detailed explanation of Botox injections for a gummy smilePlease also refer to this.
How much does Botox for a gummy smile cost?
The cost of Botox for a gummy smile varies depending on the product used, the number of units, and the procedure fee.
The prices for Botox injections at Bianca Clinic are as follows.
| formulation | Fee per unit |
|---|---|
| BOTOX VISTA | 900 yen |
| CORETOX | 900 yen |
| INNOTOX | 500 yen |
*A separate treatment fee of 25,500 yen per session applies. Prices are current as of November 2026.
Assuming 4 units are used, the cost of Botox injections for a gummy smile ranges from 27,500 to 29,100 yen. The actual cost varies depending on factors such as the injection volume, which is determined during the consultation.
Some people may be thinking, “I want to get treatment at the cheapest clinic possible.”
However, when comparing prices, it’s important to check not only the price per unit but also the total cost, including the service fee.
Even more important are the doctor’s technical skills and the thoroughness of their consultation. Do they check the movement of the upper lip and any asymmetry, and do they consider adjustments tailored to each individual’s condition rather than deciding on injection sites and dosage uniformly?
Another important factor in choosing a clinic is whether you can fully communicate your desired results and receive a clear explanation of the treatment plan that you find satisfactory.
What is BIANCA's stance on Botox for a gummy smile?
When I examine patients with a gummy smile, I focus not only on how much of the gums to cover, but also on how to refine their facial expression when they smile.
For example, even for people whose upper lip lifts significantly, the way it moves on the left and right sides isn't necessarily the same.
At Bianca Clinic, we determine the suitability of Botox injections by observing the movement of the upper lip and assessing the condition of the teeth and gums.
In addition, if the issue stems from the position of the gums or the bone structure, a different approach may be necessary. The key is not to make the injection itself the goal.
From a dentist’s perspective, we consider the overall balance of the mouth and face as we plan treatments designed to help patients achieve the smile they desire.
Frequently Asked Questions About Botox for a Gummy Smile
We’ll answer common questions about Botox injections for a gummy smile, including pain during the procedure, differences between formulations, and precautions to take when receiving repeat injections.
Q1. Does Botox for a gummy smile hurt?
Although we use a fine needle, you may feel a slight prick when the solution is injected. The degree of pain varies from person to person, and mild swelling or bruising may occur after the injection.
Q2. Are Botox injections for a gummy smile effective even if the product is made in South Korea?
Botulinum toxin products manufactured in South Korea also have the effect of suppressing muscle function.
At Bianca Clinic, we also carry Korean-made CORETOX and INNOTOX.
Q3. What should I look for in before-and-after photos of Botox treatments for a gummy smile?
Let's take a look not only at how much of the gums are showing, but also at the position of the upper lip and the overall balance of the smile.
It’s also important to confirm whether the treatment involves Botox alone or is being used in combination with other procedures.
Q4. Do the effects of Botox for a gummy smile last forever?
No, the effects of Botox injections are not permanent. Over time, muscle function returns to normal, and the amount of gum tissue visible will gradually return to what it was before the procedure.
Although the duration of the effects varies from person to person, it typically lasts about 3 to 6 months.
Q5. How many Botox injections are needed to treat a gummy smile?
You can expect results even after just one treatment. First, check the changes after the injection and decide whether additional treatments are necessary.
At Bianca Clinic, we generally wait at least three months after the previous injection before considering the next treatment, taking into account the movement of the upper lip and how long the effects have lasted.
When Choosing Botox for a Gummy Smile, Consider the Dosage and Suitability
Botox injections for a gummy smile are a procedure that allows you to adjust the movement of your upper lip without surgery.
However, a higher number of units does not necessarily mean better results; depending on the cause, sufficient results may not be achieved.
At BIANCA CLINIC, we prioritize a natural smile while assessing the movement of the upper lip and the condition of the gums to determine the most appropriate treatment method.
If you are looking for a clinic in Ginza, Tokyo, that offers treatment for a gummy smile, please contact us.
▶Details on Gummy Smile Treatment at Bianca Clinic in Tokyo
▶Costs and Formulations of Botox Injections for Gummy Smile Treatment
References
[2] Eid A, et al. Cosmetic Management of Gummy Smiles with Botulinum Toxin A: A Review. FACE. 2026
