Gummy Smile

Anti-wrinkle injections (botulinum toxin) for gummy smile correction are generally well tolerated, but as with any injectable medical treatment, there are risks and possible side effects patients should be aware of before proceeding. This information is general in nature and your practitioner will discuss risks specific to your situation during consultation.

Common, temporary side effects

These are the most frequently reported effects and typically resolve on their own within days.

• Bruising, redness, or swelling at the injection sites.

• Mild pain or tenderness at the injection sites.

• Headache following treatment.

• A feeling of tightness or heaviness in the upper lip area.

Asymmetry and functional changes to the smile

Because the treatment targets specific muscles involved in lip elevation, there's a risk of uneven results or unwanted effects on lip function.

• Asymmetric smile, where one side of the lip lifts higher than the other if the toxin spreads unevenly or muscles respond differently between sides.

• Flattened or reduced smile, where the lip doesn't lift as much as desired, sometimes described as a less natural or less expressive smile.

• Difficulty with lip seal, which can affect drinking from a straw, whistling, or pronouncing certain sounds clearly.

• Drooling or difficulty controlling saliva, in cases where surrounding muscle function is affected.

• Difficulty eating or speaking, particularly in the days following treatment while the muscle is most affected.

These functional effects are usually temporary and resolve as the toxin wears off, generally within three to four months, but can be distressing while present.

Risk of toxin migration

Botulinum toxin can occasionally spread to nearby muscles beyond the intended treatment area. Depending on placement and individual anatomy, this can affect:

• The muscles around the mouth more broadly, affecting speech or expression.

• The lower face asymmetrically if injected too close to muscles controlling the lower lip.

This risk is reduced by accurate technique and thorough understanding of facial muscle anatomy, but cannot be entirely eliminated.

Less common risks

• Allergic reaction to the injected product, which can range from mild localised reaction to, rarely, a more significant systemic reaction.

• Infection at the injection site.

• Small bumps or lumps at injection sites, usually temporary.

• Ptosis (drooping) affecting nearby structures if the toxin migrates, though this is more commonly reported with upper face treatments such as forehead or brow injections than with lip-area treatment.

Rare but serious risks

• Botulinum toxin carries a rare risk of distant spread of toxin effect beyond the injection site, which can cause symptoms such as generalised muscle weakness, vision changes, difficulty swallowing, or difficulty breathing. This is rare but requires urgent medical attention if it occurs.

• Anaphylaxis or severe allergic reaction, though extremely rare.

Other considerations

Results are not permanent and will gradually wear off, generally over three to four months, after which gum display returns to its prior level. Repeat treatment is required to maintain results, and repeated treatment carries the cumulative risks above with each session.

Results vary between individuals. Some patients may not achieve the degree of change they hoped for, and there is no guarantee of a specific cosmetic outcome.

This treatment is not suitable for everyone. Your practitioner will ask about your medical history, including any neuromuscular conditions (such as myasthenia gravis), current medications, allergies, and previous reactions to botulinum toxin, as these may affect your suitability for treatment.

Treatment should not proceed if you are pregnant or breastfeeding, as safety in these circumstances has not been established.

If you experience any concerning symptoms following treatment, including difficulty breathing, swallowing, or significant weakness, you should seek medical attention promptly.