Gummy Smile (Gingivectomy)

A gummy smile is when a person smiles and the upper lip rises well above the teeth, exposing too much of the gum. There are numerous causes of a gummy smile and there are numerous procedures described to improve this appearance as well.

Anti-wrinkle injections, which are placed into the lip can bring the lip down by a one or two millimetres by weakening the lip elevators.

Dermal fillers can also be used to correct the lip by a few millimetres by pushing down the lip.

Surgical options to reduce a gummy smile

• The mucosal resection option restricts the amount that the lip moves up by restricting the upper buccal sulcus. This is achieved by shortening the amount of mucosa in the upper buccal  sulcus. This can be achieved by excising a portion of mucose in the upper lip and then suturing it up again essentially shortening the excision of the upper lip.

• Depending on the cause of the gummy smile, orthognathic surgery or surgery to the upper and lower jaws can be performed to make the height and the prominence of the pre-maxilla less, hence improving the smile. This operation is a large and extensive operation and is performed by some plastic surgeons and some maxillofacial surgeons. This often involves orthodontic treatment as well as the surgery.

• Crown lengthening operations to increase the height of the teeth can be performed if the teeth appear too short. This is often performed by periodontists under local anaesthetics in the office.

I perform the most advanced surgical options and the mucosal shortening of the flap. This procedure involves an incision between the gum and the upper lip. I am also able to adjust the anterior nasal spine and caudal nasal septum at this time if these are too prominent thus gaining some lip length.

The operation can be performed under local anaesthetic, assisted local or a general anaesthetic and is usually performed as a day only procedure. The resultant scar is hidden well within the gum upper lip crease inside the mouth and is a relatively small and simple operation with good and lasting results.

A final few words

Gummy smiles can be an embarrassment at any age and once fixed, have a good and lasting effect. Sometimes for the very first time and their self-esteem soars. As a quick and simple procedure, this operation gives good results that last a lifetime. Regaining ones smile makes ones self esteem soar.