How Many Units of Botox Do You Need for a Gummy Smile?

Most patients need between 2 and 4 units of Botox per side, so around 4 to 8 units in total, to correct a gummy smile.

That might sound tiny compared to other Botox treatments, and it is. This is one of the smallest, most precise doses used anywhere in facial aesthetics. The difference between a beautifully balanced smile and one that looks slightly “off” often comes down to a single unit, placed in exactly the right spot.

Here is what actually determines your dose, what is really happening under the skin when you smile, and why this particular treatment rewards a practitioner’s precision more than almost any other.

There is a small muscle running alongside your nose, on each side, whose job is to lift your upper lip when you smile. In most people, it lifts the lip just enough to show teeth and a small amount of gum. In a gummy smile, this muscle is simply a little overactive, pulling the lip higher than it needs to and revealing more gum than most people find flattering.

Botox works by gently quietening this muscle down. A very small, carefully placed dose on each side softens how far the lip lifts, so you show more of your smile and less of your gums, without changing how natural your smile looks or feels. It is not about “freezing” anything. It is about turning the volume down on one small, slightly overenthusiastic muscle.

This is one of the only places on the face where a tiny difference in dose can visibly change the way someone smiles.

Too much product and the lip can lift unevenly, or the smile can look slightly incomplete on one side. Too little and the gum show barely changes at all. The margin for error here is genuinely smaller than almost anywhere else Botox is used on the face, which is exactly why this treatment rewards real experience and a careful, unhurried approach.

How strong your smile muscle is. Some people naturally have a more active pull in this muscle than others. Your practitioner assesses this by watching your full, natural smile at consultation, not just a polite half-smile.

Whether you are male or female. Men generally have larger, stronger facial muscles than women, including this one, which usually means a slightly higher dose is needed to achieve the same softening effect.

How much gum currently shows. A conventionally “ideal” smile shows very little upper gum, generally a couple of millimetres at most. If you are showing significantly more than that, you may need a dose toward the higher end of the range to see a meaningful change.

Whether your smile is symmetrical. Almost everyone has some natural asymmetry between the left and right side of their face. A good practitioner will often use a slightly different dose on each side rather than assuming both sides need exactly the same amount.

Whether lip filler is being used alongside Botox. Some patients get their best result from Botox alone. Others benefit from adding a touch of lip filler, which brings extra volume to the upper lip and can reduce visible gum further, sometimes meaning less Botox is needed overall.

With treatments like a smoother forehead or a slimmer jaw, starting conservative and topping up later is standard practice. Gummy smile correction rewards that same restraint from day one, but even more so.

A subtle, precisely placed dose that leaves your smile looking like your smile, just a little more balanced, will always be the better result than a heavier dose chasing a bigger change. The most skilled injectors in this particular treatment are often the ones who use the least product to get the most natural-looking result.

You will usually start noticing a difference within 3 to 5 days, with the full result visible by around two weeks, once the muscle has properly settled. Results typically last 3 to 4 months, after which the muscle gradually returns to its normal activity and the gum show slowly comes back. Most patients book a top-up before this fully happens, to keep their smile looking consistent.

For a full breakdown of what to expect in the days after treatment, read our gummy smile treatment recovery and aftercare guide.

Botox works brilliantly when an overactive muscle is the cause of your gummy smile. But sometimes the cause is different, a naturally shorter upper lip, or simply how your teeth and gums are proportioned, and in those cases lip filler, or a combination of both, tends to give a better and longer-lasting result.

Working out what is really driving your gummy smile is the whole point of a proper consultation, and it is what determines whether Botox, filler, or both will suit you best. Our guide on whether you are a good candidate for gummy smile treatment goes into this in more detail.

The figures above are a genuinely useful starting point, but the right dose for you depends on seeing your smile in person, at rest and in full motion, and understanding exactly how your muscles and anatomy behave.

At Dr Hass Clinic, Dr Hasaneen Al-Janabi assesses this properly before deciding on the precise dose and placement for each side, rather than reaching for a standard amount regardless of your individual face.