Treatment option include orthodontics, surgery, botulinum toxin A injections, and micro-autologous fat transplantation. Botox (BTX-A) has been successful in the treatment of gummy smiles, however the results are not permanent, they last for an average of 6 months. The material is injected into the hyperactive muscles of upper lip, which causes a reduction in the upward movement of lip thus resulting in a smile with a less exposure of gingiva. Botox is usually injected in the three lip elevator muscles that converge on the lateral side of the ala of the nose; the levator labii superioris (LLS), the levator labii superioris alaeque nasi muscle (LLSAN), and the zygomaticus minor (ZMi).
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