The aesthetic concern affecting smile confidence
Gummy smile — visible excessive gum tissue above the upper teeth when smiling — affects approximately 10–14% of adults globally. The condition isn\'t medically significant but commonly affects smile confidence, with patients reporting hesitation to smile widely or in photos. Causes are diverse, ranging from hyperactive lip elevation muscles to actual excessive gum tissue or short tooth crowns. Effective treatment requires diagnosing the specific cause.
Korean dental and cosmetic surgery has refined treatment options across the gummy smile severity spectrum. From quick 30-minute Botox treatments to comprehensive surgical correction, the Korean 2026 landscape offers approaches matched to specific patient anatomy and budget.
Diagnosing the underlying cause
Hyperactive upper lip elevator muscle
The most common cause:
- Levator labii superioris elevates upper lip excessively when smiling
- Reveals more gum than necessary for full smile
- Botox-responsive condition
- Often combined with other features
Excessive gum tissue (gingival hyperplasia)
Genuine excess of gum tissue:
- Tooth crowns appear short
- Gum tissue extends low over teeth
- Requires gum tissue reduction
- Surgical or laser treatment needed
Vertical maxillary excess
Underlying jaw bone structure too tall:
- Upper jaw bone projects downward more than ideal
- Causes both gummy smile and lip incompetence
- Requires orthognathic surgery (LeFort I osteotomy)
- Major surgery, most invasive option
Short upper lip
Upper lip too short to cover gums:
- Anatomically short philtrum and upper lip
- Bullhorn lip lift can worsen this
- Less common cause
- Limited treatment options beyond accepting
Delayed passive eruption
Gum tissue didn\'t recede properly during development:
- Crown lengthening surgery indicated
- Removes excess gum revealing more tooth
- Specific dental procedure
Treatment options by cause
Botox for hyperactive lip muscle
The least invasive approach:
- Botox injected into elevator labii superioris alaeque nasi muscle
- Reduces upward lip movement when smiling
- Results visible 3–7 days post-injection
- Effect lasts 3–4 months
- Cost: ₩200,000–500,000 per session
- Best for: hyperactive muscle as primary cause
Lip lowering surgery
Adjusts upper lip position:
- Incision inside upper lip
- Lip repositioned downward to cover more gum
- Result lasting but not always permanent
- Cost: ₩1,500,000–3,500,000
- Best for: muscle-related gummy smile
Gum contouring (gingivectomy)
For excess gum tissue:
- Laser or scalpel removal of excess gum
- Reshaping gum line for aesthetic proportions
- Quick procedure (30–60 minutes)
- Cost: ₩800,000–2,500,000
- Permanent result
Crown lengthening
More extensive gum tissue removal with bone work:
- Removes both gum tissue and small amount of bone
- Exposes more of the actual tooth crown
- Best for delayed passive eruption
- Cost: ₩1,500,000–4,500,000
- Permanent result
Veneers for short crown appearance
Cosmetic dental treatment:
- Veneers extend tooth length aesthetically
- Combined with gum contouring often
- Most expensive option but addresses multiple concerns
- Cost: ₩600,000–1,500,000 per tooth
Orthognathic surgery (LeFort I osteotomy)
For vertical maxillary excess:
- Repositioning upper jaw bone
- Major surgery requiring general anesthesia
- 2–4 weeks recovery
- Cost: ₩15,000,000–30,000,000
- Reserves for severe cases
The Korean comprehensive approach
Korean clinics often combine treatments for optimal results:
Common combination: Botox + Veneers
- Botox reduces excessive lip movement
- Veneers extend tooth length
- Together creating ideal smile aesthetics
- Less invasive than orthognathic surgery
- Combined cost: ₩2,500,000–8,000,000
Botox + gum contouring
- Botox addresses muscle component
- Gum contouring addresses tissue component
- Conservative invasive combination
- Long-lasting result
Smile Lipt (Korean specialty procedure)
Korean-developed combination procedure:
- Lip lift + gum management
- Specifically addresses gummy smile presentation
- Single procedure approach
- Cost: ₩3,000,000–6,500,000
The Botox treatment in detail
Target muscles
- Levator labii superioris alaeque nasi (LLSAN) — main target
- Levator labii superioris (LLS) — secondary target
- Zygomaticus muscles — sometimes addressed
Dosing
- Typical dose: 4–10 units per side
- Variable based on muscle activity
- Korean injectors often use lower doses for natural-appearing result
The procedure
- Smile assessment with photo documentation
- Marking of injection points (above upper lip, near nose base)
- Topical numbing if desired
- Quick injection at 2–3 points per side
- Procedure time: 10–15 minutes
- Same-day return to normal activities
Results timeline
Botox approach
- Day 3–5: subtle reduction in lip elevation
- Day 7–14: full effect visible
- Weeks 2–10: maintained result
- Week 10–16: gradual return of muscle function
- Repeat treatment needed every 3–4 months
Surgical approach
- Day 1–7: significant swelling, restricted activity
- Weeks 2–4: visible improvement
- Months 2–6: final shape settling
- Result permanent or long-lasting
Cost summary in Korea (2026)
| Treatment | Cost | Duration | Invasiveness |
|---|---|---|---|
| Botox | ₩200,000–500,000 | 3–4 months | Minimal |
| Lip lowering surgery | ₩1,500,000–3,500,000 | Long-lasting | Moderate |
| Gum contouring | ₩800,000–2,500,000 | Permanent | Minor |
| Crown lengthening | ₩1,500,000–4,500,000 | Permanent | Moderate |
| Veneers | ₩600,000–1,500,000/tooth | 10–15 years | Moderate |
| Orthognathic surgery | ₩15,000,000–30,000,000 | Permanent | Major |
Treatment selection logic
Try Botox first if
- Mild-to-moderate gummy smile
- Primarily hyperactive lip muscle cause
- Want to evaluate result before commitment
- Limited budget
- Avoiding surgical procedures
Consider gum contouring if
- Excess gum tissue obvious
- Botox attempt insufficient
- Want permanent solution
- Tooth crowns appear short
Consider veneers if
- Combined gum and tooth length concerns
- Cosmetic smile makeover already planned
- Budget allows comprehensive dental work
Consider orthognathic if
- Severe vertical maxillary excess
- Significant functional issues alongside aesthetics
- Lip incompetence present
- Major facial restructuring desired anyway
Combined Korean specialty: gum contouring + Botox
Korean dental-aesthetic clinics offer combined protocols:
- Gum contouring permanently addresses tissue
- Botox addresses muscle component
- Both procedures done in same visit or close succession
- Comprehensive result without orthognathic surgery
- Cost: ₩1,500,000–4,000,000 combined
Recovery considerations
Botox
No recovery time. Avoid massaging area for 24 hours. Avoid lying down for 4 hours.
Gum contouring
- Soft food diet for 1 week
- Salt water rinses after meals
- Minor sensitivity for 5–7 days
- Full healing at 2–4 weeks
Crown lengthening
- Soft food diet for 1–2 weeks
- Sutures may need removal at 1 week
- Sensitivity for 2–3 weeks
- Final aesthetic at 2–3 months
Side effects and risks
Botox
- Asymmetric smile if doses unequal
- "Frozen" upper lip appearance if overdone
- Difficulty pronouncing certain words temporarily
- Bruising at injection sites
Gum contouring
- Gum recession (potential cosmetic concern)
- Tooth sensitivity
- Asymmetric healing
- Need for revision
Crown lengthening
- Permanent tooth sensitivity
- Bone removal complications (rare)
- Asymmetric result
Who is a good candidate?
- Self-conscious about gummy smile
- Specific identified cause
- Realistic about treatment options
- Adequate dental health for procedures
- Acceptance of permanent change (for surgical options)
- Budget appropriate to chosen treatment
Wrong candidates
- Mild gummy smile within normal range
- Active periodontal disease
- Tooth decay requiring treatment first
- Unrealistic expectations
- Pregnancy or breastfeeding (Botox contraindicated)
Honest framing
Korean gummy smile treatment offers comprehensive options matched to specific patient anatomy and budget. Botox provides excellent first-line treatment for muscle-related causes — try this before considering more invasive procedures. Gum contouring delivers permanent solution for excess tissue cases. Combined approaches often produce optimal results. Orthognathic surgery is reserved for severe vertical maxillary excess cases. Choose Korean clinics with experience in your specific gummy smile cause — dental and cosmetic surgery practices have different specialties. The 2026 Korean landscape offers accessible treatment for this common cosmetic concern at significantly lower cost than Western alternatives. For most patients, Botox trial followed by combined gum contouring + Botox if needed produces excellent results without major surgery.