A gummy smile refers to excessive upper lip elevation during smiling or laughing, exposing more than 2mm of maxillary gingival tissue. While not a disease, a gummy smile can significantly affect facial aesthetics and social confidence — many people consciously suppress their smile, cover their mouth, or avoid social situations where they might laugh openly. The causes of gummy smile are multifactorial: (1) Hyperactive upper lip elevators — the levator labii superioris and levator labii superioris alaeque nasi contract excessively during smiling, over-elevating the upper lip. (2) Maxillary protrusion — excessive anterior maxillary development positions the gums forward, exposing them even with normal lip elevation. (3) Short upper lip — insufficient lip length (normal approximately 20-24mm), exposing more teeth at rest and more gum when smiling. (4) Gingival hypertrophy — excessive gum tissue growth covering too much tooth surface, making exposed gum appear more prominent. The most common and most suitable type for Botox treatment is the hyperactive elevator type — accounting for approximately 60-70% of gummy smiles. Rappoel Dermatology near Gangnam Station, Seoul, uses Korea’s Coretox botulinum toxin — precise injection into the upper lip elevators for safe and effective muscle relaxation, restoring a natural smile.
Technical Principles of Coretox Gummy Smile Treatment
- Botox relaxes upper lip elevators: Coretox is botulinum toxin type A — when injected into the levator labii superioris and levator labii superioris alaeque nasi, it blocks acetylcholine release at the neuromuscular junction, moderately relaxing the overactive elevators. With muscle relaxation, upper lip elevation amplitude decreases during smiling — clinical data shows 3-5mm average reduction in gum exposure at 1-2 weeks
- Coretox Korean-origin high-purity advantage: Coretox is 150kDa high-purity toxin with unnecessary complex proteins removed, reducing antibody formation and resistance risk. Facial expression muscle treatment requires precise dose control — the high-purity formula’s smaller diffusion range enables precise relaxation control, avoiding over-relaxation causing lip droop
- Fast onset (2-3 days): Coretox clinical data shows average onset of 2-3 days — upper lip elevators begin relaxing at 3-5 days, optimal results at 1-2 weeks. Patients typically notice smile improvement within one week
- Precise diffusion control: Gummy smile injection points are adjacent to the nasal ala and upper lip — excessive diffusion would affect the orbicularis oris, causing smile stiffness or mouth corner asymmetry. Coretox’s smaller diffusion range makes it safer for precise facial injection
- Preservative-free hypoallergenic formulation: Coretox contains no animal-derived proteins or human serum albumin — reducing allergic reaction risk
Treatment Strategies for Different Gummy Smile Types
- Hyperactive elevator type (most common): Excessive upper lip elevation during smiling, gum exposure over 4mm, but normal lip position at rest. Strategy: inject Coretox into the levator labii superioris and levator labii superioris alaeque nasi — 2 points per side, 2-3 units per point, bilateral total 8-12 units. This type responds best to Botox
- Maxillary protrusion type: Excessive anterior maxillary development with forward gum position. Strategy: Botox can partially improve (relaxing elevators to reduce elevation), but the skeletal issue requires orthognathic surgery for definitive correction. Recommend trying Botox first to assess improvement — if satisfactory after gum reduction, continue maintenance; if not, consider surgery
- Short upper lip type: Upper lip length under 20mm. Strategy: After Botox relaxes the elevators, lip elevation amplitude decreases, visually making the lip appear longer. Can combine with HA lip filler to increase lip volume and visual length — Botox + HA lip filler is an effective combination for short-lip gummy smile
- Mixed type: Simultaneous hyperactive elevators + short lip + mild maxillary protrusion. Strategy: First inject Botox to improve muscle over-elevation (8-12 units), assess at 2 weeks. If significant gum show remains, combine with HA lip filler. Do not simultaneously do orthognathic surgery and Botox — assess non-surgical results first
- Mild gummy type: Gum exposure 2-4mm, only prominent during full laughter. Strategy: Low-dose Coretox injection (bilateral total 6-8 units) suffices — no need for high doses, avoiding over-relaxation causing lip droop or smile stiffness
Rappoel Gummy Smile Botox Injection Treatment Protocol
- Gummy smile assessment and plan design (10 min): Patient smiles naturally and broadly → photograph and measure gum exposure and lip elevation amplitude → assess upper lip length → determine gummy smile type (muscular/skeletal/short-lip/mixed) → establish injection plan (points, dosage)
- Disinfection preparation (5 min): Facial cleansing → povidone-iodine preparation of nasal ala sides and upper lip area → mark injection points (1cm lateral to nasal ala and above nasal ala)
- Precise injection (5-8 min): 32G ultra-fine needle → 2 injection points per side (lateral to nasal ala and above nasal ala) → 2-3 units Coretox per point → superficial injection (subcutaneous 2-3mm, into the superficial upper lip elevators) → gentle pressure after injection
- Immediate assessment and guidance (5 min): Patient smiles to observe upper lip elevation → post-care instructions (avoid pressing injection area, avoid lying flat for 4 hours, avoid strenuous exercise for 24 hours, avoid facial massage for 1 week) → 2-week follow-up
The entire gummy smile Coretox injection takes about 15-20 minutes, with onset at 3-5 days, optimal results at 1-2 weeks, lasting 3-4 months. Located 3 minutes from Gangnam Station Exit 10, with seamless English and Chinese consultation.
Frequently Asked Questions
Will gummy smile Botox affect speaking and eating?
At correct dosage, speaking and eating are not affected. Rappoel injects the upper lip elevators (levator labii superioris and levator labii superioris alaeque nasi), not the orbicularis oris (the muscle controlling lip closure). After injection, upper lip elevation amplitude moderately decreases, but lip closure, speech articulation, and eating function are completely unaffected. Mild upper lip weakness during smiling may be felt for 2-7 days — this is a normal effect, not a side effect. Precautions: (1) First treatment starts with lower dose (bilateral total 8-10 units), adjusted after assessing response. (2) Avoid injecting the orbicularis oris — if diffusion reaches it, mouth corner asymmetry or leakage may occur. (3) Rappoel uses Coretox’s small diffusion range to precisely inject the upper lip elevators without affecting surrounding muscle function.
How long do gummy smile Botox results last? How often should I get it?
Gummy smile Botox typically lasts 3-4 months — the upper lip elevators are facial expression muscles with frequent daily activity (speaking, expressions, smiling), so neuromuscular junction regeneration is relatively fast. Rappoel recommends: injection every 3-4 months for maintenance. With regular treatment, some patients find baseline elevator tone gradually decreases, allowing extension to 4-5 month intervals. Regarding resistance: long-term repeated injections may produce neutralizing antibodies — incidence approximately 1-5%. Coretox’s high-purity formulation theoretically reduces antibody risk. Minimum 3-month intervals recommended with lowest effective dose.
Will gummy smile Botox cause facial paralysis or stiff smile?
No — the key is dose control and precise injection. Rappoel’s safety strategy: (1) Low dose — bilateral total 8-12 units, a reasonable dose for gummy smile improvement without over-relaxation. (2) Precise injection of upper lip elevators — not injecting the orbicularis oris or other facial expression muscles, preserving natural smile function. (3) Coretox’s small diffusion range — reduces risk of spreading to surrounding muscles. (4) First treatment starts low, with 2-week follow-up and micro-adjustment if needed. If smile stiffness occurs (usually from excessive dose or diffusion to surrounding muscles), it typically resolves naturally within 2-4 weeks — as Botox effects are reversible. Rappoel has never had facial paralysis or severe smile stiffness cases.
What other treatments are available for gummy smile besides Botox?
Treatment options depend on type and severity: (1) Botox injection — ideal for hyperactive elevator type, non-invasive, 3-day onset, lasts 3-4 months. The first-line non-surgical option. (2) HA lip filler — for short upper lip type, increases lip volume and visual length to camouflage gums. Can combine with Botox. (3) Gingivectomy — for gingival hypertrophy type, removes excess gum tissue. Requires periodontist evaluation. (4) Orthognathic surgery — for maxillary protrusion type, definitively corrects through maxillary setback. Invasive with long recovery. (5) Lip repositioning surgery — surgically detaches upper lip elevators for permanent lip lengthening. Carries surgical scarring and irreversibility risks. Rappoel recommends: try Botox first — fast, safe, reversible, no recovery. If satisfactory, continue maintenance; if insufficient, consider other options.
How does Coretox differ from other botulinum toxins for gummy smile?
Key differences between Coretox and other brands: (1) Purity — Coretox is 150kDa high-purity toxin with complex proteins removed; Botox is 900kDa complex. (2) Onset speed — Coretox averages 2-3 days; others typically 5-7 days. Gummy smile patients usually want rapid smile improvement, making Coretox advantageous. (3) Diffusion range — Coretox has smaller diffusion, safer for precise facial injection (reduced risk of spreading to orbicularis oris causing smile stiffness). (4) Formulation — Coretox contains no animal-derived proteins or albumin, lower allergy risk. Facial skin is thin and sensitive, making hypoallergenic formulation particularly important. Both last similarly (3-4 months). Rappoel selects based on patient needs — Coretox recommended for those wanting fast results, precise control, or experiencing diminished effect from other brands.
Gummy smile holding back your confidence? Rappoel Coretox gummy smile treatment — natural smile in 3 days!
📍 77, Seocho-daero, Seocho-gu, Seoul, South Korea
🕐 Mon–Fri 10:00–19:00 · Sat 10:00–17:00
💬 WeChat Main: rappoelkr | WeChat Backup: rappoelkr2 | LINE: rappoelkr
Scan to connect with us
WeChat (Main)
WeChat (Backup)
LINE