Botox, Dysport or Xeomin can be used to decrease the lip movement to lessen a gummy smile. Some patients show excessive amount of teeth or gum when at rest or especially smiling. These patients usually have an increased downward growth of their upper jaw called vertical maxillary excess. The permanent treatment for this is to have an Oral & Maxillofacial surgeon move the upper jaw upwards to shorten the jaw which results in less tooth and gum show. This may not be practical for all patients and a quick and easy treatment is using neuromodulators in the smiling muscles to decrease their activity. The patient shown below had a single injection of Botox on each side of the nostril. She is shown before and 2 weeks after injection. The effect lasts about 3 months.