Prof Ghassan Abu-Sittah MBchB, FRCS(Plast)
A wonderful smile is a critical feature of beauty to which society gives a great importance. A smile is key to our socialization and attraction. A person’s smile can express a sense of happiness, sensuality, success, affection and courtesy. It can also show confidence and kindness. Unfortunately for the 15-20% of young adults who have a Gummy Smile, it is a source of insecurity. The concept of a nice smile basically depends on the entity of three anatomic components: gum, teeth, and lips. A Gummy Smile, or a High Lip Line, is when the lip rests high on the gums when we smile and a disproportionate amount of gum tissue is shown leaving people self-conscious about smiling in public or even worse in photographs. In 2022 a research article published in Plastic Surgery’s most prestigious journal (Plastic and Reconstructive Surgery Journal) highlighted what patients presenting with a “gummy smile”
have long been telling us for a long time, “Botox is an effective treatment that lasts for 2–3 months, with almost complete relapse at 4 months.” [i] It is therefore not surprising that patients are increasingly looking for more permanent solutions.
The surgical Lip Repositioning procedure has been shown to produce long-term patient satisfaction with permanent results. [ii] It offers a permanent solution to the Gummy Smile. With many patients seek this surgery after having a series of Botox injection treatments that only last for a few months.
The procedure usually takes about 45 minutes to complete is performed under local anaesthetic. Two minor incisions are just below where the gums meet the upper lip and a small band of gum tissue is removed. A strip of the muscles that elevate the lip is excised so as to prevent the recurrence of the Gummy Smile. This adjusts the level the lip rises to when smiling or laughing. The lip is then sutured to achieve the final position.
The procedure is safe and has minimum side effects. Reports in the literature have shown minimal post-operative bruising, discomfort and swelling. Recovery takes 3 to 4 days. During that time, there is typically moderate pain and swelling, which is manageable with over the counter pain medications. Patients typically can go back to work after 4 days, but will need to avoid strenuous exercise or activity for about 2 weeks. After the first 4 weeks of healing, there will be some minor settling over the first 6 months in which the lip may rise about an additional millimeter when smiling. After 6 months the results of lip repositioning surgery last permanently. According to research published in 2019 patients who had this procedure were still happy with the results 2 years after the surgery.
