Gummy smile cases can originate from anatomical, skeletal, or muscular hyperactivity. If the problem stems from an overactive levator labii superioris muscle, which pulls the upper lip upwards, Botulinum Toxin (Botox) injections temporarily relax the muscle, preventing excessive upward movement of the lip. However, since the effect of Botox wears off within 4-6 months, surgical lip repositioning is preferred for patients seeking a more permanent aesthetic solution or those with suitable space in the inner lip mucosa. In this surgery, a small amount of tissue is removed from the mucosal strip on the inside of the upper lip, and the lip is sutured to the gum at a lower level. If the patient has both muscular hyperactivity and a mild skeletal discrepancy, combining these two methods provides the most stable, long-lasting, and least invasive aesthetic result.
