Years of smiling with your lips closed and a hand that covers your mouth when you laugh. Gummy smile treatment in Marylebone relaxes the lip muscles so you can laugh freely again.
You have spent years smiling with your lips pressed together, and every group photo shows the same careful half smile. When something is really funny, your hand drifts up to cover your mouth before you laugh. Gummy smile treatment with anti-wrinkle injections at Dr Joney De Souza Clinic in Marylebone lets the full smile out again.
| Performed by | Appointment | Downtime | Results |
|---|---|---|---|
| Dr Joney De Souza or Dr Mattia Parducci | About 15 minutes | None, straight back to your day | Begin in three to five days, settle at two weeks |
The idea is simple. In most gummy smiles the teeth and gums are perfectly normal, and the upper lip is simply lifted a little too high by its own muscles. Relax those muscles by a carefully judged amount, and the lip comes to rest a few millimetres lower whenever you smile. Your teeth are then framed by soft pink lip instead of gum.
The change is larger than most people expect. In one group of 30 patients, the band of gum showing above the front teeth averaged 5.2 mm before treatment and 0.09 mm two weeks after small injections into the lip elevator muscles. Dr Joney De Souza or Dr Mattia Parducci performs every treatment, and the appointment itself takes about ten minutes.
Your teeth are then framed by soft pink lip instead of gum.
Most people show a sliver of gum when they laugh, and a small amount reads as youthful and warm. A 1984 survey of 454 smiles in the Journal of Prosthetic Dentistry found that an average open smile shows roughly the full length of the upper front teeth. A smile starts to feel gummy when the pink band above them becomes the first thing you notice.
The most common cause is muscular, and it is the kind this treatment is made for. The muscles that raise the upper lip are especially strong or active, so every laugh hitches the lip higher than average. Your teeth may be a perfectly normal length, yet the lip curtain lifts clear of them and the gum line takes centre stage.
Gum show also differs in where it appears. A 2010 paper in the Journal of the American Academy of Dermatology sorted gummy smiles into four types. Anterior smiles show gum above the front teeth and posterior smiles above the back teeth, while mixed smiles do both and asymmetric smiles lift higher on one side. Each type involves a slightly different set of muscles, so each needs its own injection pattern.
That paper treated 16 patients with a technique matched to their type and reported an average improvement in gum display of about 75 percent. The lesson for your appointment is that the doctor watches where your gum appears before choosing a single injection point. A smile that lifts higher on the left is treated differently from one that lifts evenly.
Several small muscles lift the upper lip, and they meet in a tight cluster beside the nose. The longest, with the memorable name levator labii superioris alaeque nasi, runs down the side of the nose and flares the nostril as well as raising the lip. Its neighbours pull the lip upwards and slightly outwards towards the cheek.
When you laugh, these lip elevators contract together and draw the centre and sides of the upper lip towards the cheeks. In a gummy smile they travel a little further than usual. You can sometimes feel them yourself by resting a fingertip beside each nostril and smiling broadly in front of a mirror.
Only a very small dose is needed at that meeting point. Ease the pull of the elevators by a fraction and the lip rises less far. It still curves and moves freely. You keep the warmth of a full smile, and the gum line simply sits further out of view behind the lip.
Gentler smiles that show gum only during a big laugh receive an even more conservative dose. Everyday expressions stay entirely natural. The trimming shows at the moments that matter most to you, the open laugh at dinner and the group photograph at a wedding.
Because the elevators also flare the nostrils slightly, some people notice a small bonus. The sides of the nose look a touch calmer in a broad smile, and the upper lip curves more gently over the teeth. The overall effect is a smile that looks easy and unforced from the front and in profile.
You are first asked to smile naturally, then laugh, then relax. Baseline photographs are taken of each expression, because the gum line can look quite different in a posed smile and a real one. Those pictures become the benchmark for judging the change at your review two weeks later.
The treatment uses a few tiny injections beside the nose on each side. They sit high in the fold where the cheek meets the upper lip. The needle is very fine, and most people feel a quick, sharp prick that passes immediately. No anaesthetic is needed, and the whole sequence is over in a few minutes.
It is wise to avoid alcohol for a day or so beforehand. Afterwards there is no downtime, and you can return to work, lunch or a meeting near Oxford Circus straight away. For a few hours you keep your hands off the area and avoid strenuous exercise, so the product stays where it was placed.
Both doctors favour a conservative first dose for this area. The upper lip is central to speech and expression, and a modest first treatment shows exactly how your muscles respond. A small top-up at review is easy, and it keeps the smile looking like yours rather than held back.
Any faint pink marks beside the nose usually fade before you have reached the street. You can wear lipstick that evening as normal, and eating and drinking feel exactly the same. Nothing about the lip looks swollen or different at rest, which surprises people who expected to feel self-conscious on the way home.
For the first few days you will see little change. Then, between day three and day five, the upper lip begins to rise a little less when you laugh. People often notice it first in a mirror mid-conversation. The smile suddenly shows teeth framed neatly by the lip instead of a ribbon of gum.
At around two weeks you return for a review. Your smile is compared with the baseline photographs taken on the first visit, and a top-up is added only if needed. In most faces the smile now looks balanced and relaxed, with the softer line that people had been hoping for.
The softening lasts around three to four months on the clinic’s experience, then fades gradually as the elevators regain their strength. The 2008 study saw the same gentle curve, with gum show creeping back slowly from the second week rather than returning overnight. Most people refresh the treatment about three times a year to keep the smile consistent.
Exercises and smile coaching cannot weaken one lip muscle selectively, and lip make-up has only a small effect on how much gum shows. That is why so many people feel such relief after treatment. For the first time in years they laugh freely in front of a camera, and the photographs prove it.
Anti-wrinkle injections lower the lip, but they do not add height to a thin one. If your upper lip is short or slim, there is simply less lip to cover the gum even when it lifts a normal amount. Lip fillers add that soft cushion of height, and some smiles do best with the two together.
Gum show can also come from the proportions of the teeth, the level of the gum tissue or the shape of the upper jaw. Those causes belong with a dentist or orthodontist, and the clinic will refer you free of charge. You can read more about every cause on our gummy smile concern page.
Every visit begins with Dr Joney De Souza (GMC 7008632), founder and Medical Director, or Dr Mattia Parducci (GMC 7635663) in person. They watch you smile and laugh and look at your teeth and lip together. From that they decide whether the cause is muscle, lip shape or dental proportion. Doctors perform this treatment at the clinic, never non-medical injectors.
Because this is a prescription-only treatment, a short set of questions comes before any injection. Are you pregnant or breastfeeding, and do you have a condition that affects your muscles or nerves? Which medicines do you take, and when were you last treated anywhere? You are also asked about any event coming up, so the timing lands well.
If the elevators are the cause, you can usually be treated the same day. The plan and its investment are set out at that same visit. Our anti-wrinkle injections page shows how the lip elevators sit alongside every other area the doctors treat.
Most people need a single treatment and the review, then a refresh every three to four months. The consultation gives the real answer for your smile, since muscle strength and lip length vary so much from one face to the next.
The clinic is in Marylebone, close to Harley Street. Patients walk over from Fitzrovia and Regent’s Park and travel in from right across central London. The appointment is short enough to fit into a lunch hour, and nothing about your face gives the visit away afterwards.
If you have spent years smiling with your lips closed, this is one of the gentlest anti-wrinkle injections in London to try. Patients have given the clinic a 4.9 rating across more than 270 Google reviews. Visit our anti-wrinkle injections page for the full list of areas, then come in and let us see you laugh.
Short clips filmed at Dr Joney De Souza Clinic in Marylebone, so you can see how anti-wrinkle injections is carried out before you book.
If you have been hiding your smile for years, Dr Joney De Souza or Dr Mattia Parducci will watch it move and tell you what a tiny dose can do. Speak to the team on 020 7043 0748, or send a WhatsApp about your gummy smile.
Gummy smiles have several possible causes, and people often arrive unsure which one applies to them. These answers cover the questions we hear most about the injections, the dose and how the smile changes.
In most cases it is the group of lip elevators beside the nose, led by the levator labii superioris alaeque nasi. These muscles pull the upper lip up when you smile. If they are especially strong, the lip rises higher than average and uncovers the gum above your front teeth.
Only a few tiny injections, usually one small point on each side of the nose where the lip elevators meet. Smiles that show gum above the back teeth or on one side only need a different pattern. A 2010 dermatology paper mapped those types in detail. Dr Joney De Souza or Dr Mattia Parducci decides after watching you laugh.
Not when the dose is conservative, which is how the clinic approaches this area. Your lip still curves and moves when you talk and laugh. It simply rises less, by around 5 mm on average in one 2008 study. The teeth then stay framed by the lip instead of sitting under a band of pink gum.
For a muscle-driven gummy smile, yes. Anti-wrinkle injections soften the lip elevators in about ten minutes with no downtime. Surgical and orthodontic routes are aimed at causes in the jaw or tooth proportion, which injections do not change. Seeing your smile in person makes clear which group you belong to.
A little, and in a flattering way. Relaxing the lip elevator muscles lets the upper lip drop slightly when you smile. It then covers more of the gum and shows more of its own soft pink edge. At rest your lip looks exactly as it did before, because those muscles only shorten the lip at the moment they pull upward.
It can when a thin upper lip is part of the reason the gum shows. Filler adds a little height to the lip, so there is more lip to cover the gum line during a smile. Some people do best with lip filler alone, others with injections to the elevators plus a touch of filler.
Yes, and it is a common request. For smiles that show gum only during a full laugh, the doctors use an even lighter dose. That keeps your everyday smile untouched while reducing the gum display in the open, joyful moments that end up in photographs.
No. The injections work only on the muscles that lift the upper lip, so tooth length, gum tissue and jaw shape stay exactly as they are. If those structures are behind your gum show, the clinic will refer you for a dental or orthodontic opinion, and that referral is free.
The softening builds gradually over one to two weeks, so you will not see the full effect straight away. Many people notice the first change in the second half of the first week. Your review at two weeks is the point at which the smile is judged against the baseline photos.
Most people come back about three times a year. The effect lasts around three to four months and fades gently, so you will see the gum show returning slowly rather than overnight. Keeping to a regular rhythm keeps your smile consistent through birthdays, holidays and every photograph in between.
