Watch as Nicola Lowrey PA-C administers both Botox and Filler on this Gummy Smile Treatment.
Excess gingival show, aka a “Gummy Smile”.
To treat this condition appropriately you need to understand the multiple anatomical and muscular variations at play.
I have seen an emerging pattern in my practice in many cases that I have treated:
* a negative anteromedial vector
* a class 2 malocclusion
This results in a hyperactive LLSAN when elevating the upper lip on smiling and hypertonicity of the mentalis as it has to work hard to keep the lower mandible elevated to close the mouth.
For the most natural outcome, all issues must be addressed both structurally and functionally.
In this case filler was added to the:
* Piriform fossa
* Chin
* Lips
And Botox was used on the:
* LLSAN
* Mentalis
* Orbicularis Oris
(Be cautious in using Botox only for the chin when there is retrognathia. The patient will find it quite challenging to close their mouth. The structure of the chin must be supported first.)
When the entire perioral area is considered in cases like this, the results can be life changing.
Llsan Botox: Decrease the over activity of the muscle
Orbicularis Oris Botox: For resting upper lip balance
Mentalis Botox: To relax chin dimpling
Lip Filler: Volume to the upper lip decrease gummy show
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