08:38am Monday 09 December 2019

A Better Smile with OnabotulinumtoxinA


New York, NY – In recent years, the rate of minimally invasive aesthetic surgery has risen dramatically, with onabotulinumtoxinA (Botox, formerly called botulinum toxin type A) cosmetic treatments ranking as the most commonly performed nonsurgical aesthetic procedure in the United States. In an off-label study on the application of onabotulinumtoxinA for treatment of excessive gingival display, or “gummy smile,” researchers found that this injectable offered an effective, minimally invasive, and safe alternative to surgery, yielding a significant improvement in smile aesthetics with high patient satisfaction. The complete findings are presented in the article, “OnabotulinumtoxinA for the Treatment of a ‘Gummy Smile’,” appearing in the March issue of the Aesthetic Surgery Journal.

“Approximately 14% of women and 7% of men have excessive gingival exposure upon smiling,” said lead author Jessica Suber, MD. “We are excited to present our findings, showing not only that study participants had significant improvements in their smile aesthetics, but also that the vast majority indicated high satisfaction levels and interest in repeat treatments.”

Study participants (n=14) had a minimum of 2 mm of gingival exposure above the central incisors upon smiling naturally, a trait often considered aesthetically unappealing. All patients were initially classified as having a “cuspid smile,” where elevator muscles raise the upper lip—like a window shade—to expose the upper teeth and gingival scaffold, contributing to a “gummy smile.” OnabotulinumtoxinA was bilaterally injected into participants’ lip elevator muscles at three sites. Two weeks after treatment, all patients showed a significant decrease in gingival show, with an average reduction of 85 percent over the central incisors and 83 percent over the canines. In addition, all but one patient was highly satisfied with the post-treatment smile.

“The smile is such a meaningful facial expression, and it is very important for the overall aesthetics of our patients. It will be interesting to see how popular the use of onabotulinumtoxinA evolves in this area,” said Foad Nahai, MD, Editor-in-Chief of Aesthetic Surgery Journal.

According to the American Society for Aesthetic Plastic Surgery (ASAPS), there were over 3.7 million cosmetic procedures performed in the US using onabotulinumtoxinA in 2013.


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.






About ASJ


The Aesthetic Surgery Journal is the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS) and is the most widely read clinical journal in the field of cosmetic surgery, with subscribers in more than 60 countries.




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Gloria Gasaatura
Public Relations Assistant
o American Society for Aesthetic Plastic Surgery (ASAPS) – surgery.org
o Aesthetic Surgery Education & Research Foundation (ASERF) – aserf.org
o Society of Plastic Surgical Skin Care Specialists (SPSSCS) – spsscs.org

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