Periodontal Plastic Surgery
Lip Repositioning
What Is Lip Repositioning Surgery?
For a substantial share of patients, a gummy smile has nothing to do with the gums. The teeth are the right length, the gum sits where it should, and the bone is at a normal level — the upper lip simply travels further than average when smiling, exposing tissue that would otherwise stay hidden. Lip repositioning surgery addresses that directly by limiting how far the lip can rise.
The muscles that elevate the upper lip pull against the inside of the lip where it meets the gum. Lip repositioning removes a narrow strip of the lining tissue in that vestibule and sutures the lip back at a slightly lower position. The muscles are unchanged and the lip moves normally — it simply reaches a shorter distance at full smile, so less gum shows.
It is worth being precise about why this matters, because the alternatives are not interchangeable. Removing gum tissue from a patient whose gum was never the problem gives longer, less natural-looking teeth and does not fix the display. Reshaping bone in the same patient is more invasive still, for the same wrong reason. When lip movement is the cause, lip repositioning is the procedure that treats it.
It is deliberately conservative — no bone is touched, no tooth structure is altered, and the tissue removed is entirely inside the lip where it is never visible. For appropriately selected patients it is one of the more elegant solutions in periodontal plastic surgery.
Who it’s for
- A gummy smile caused by a hypermobile upper lip that elevates excessively
- Excess gum display where the teeth are already a normal length
- Patients who want a conservative option that doesn’t involve bone surgery
- Those for whom gum contouring alone would not resolve the display
- A short upper lip contributing to how much gum shows
- Patients seeking a balanced smile while keeping natural facial expression
- Cases combined with gum contouring where more than one cause is present
What to expect
- 1
Diagnosing the cause
We measure how far your lip travels between rest and full smile, how long your teeth actually are, and where the gum and bone sit — the four causes of a gummy smile look identical to the patient and completely different on examination.
- 2
Assessing suitability
Lip repositioning works best where lip movement is the dominant factor. Where excess gum tissue or skeletal proportion is also involved, we say so and plan accordingly.
- 3
Planning the amount
The width of tissue to be removed is calculated from the correction needed. Judging this is what separates a natural result from an over-corrected, restricted-looking smile.
- 4
The procedure
Under local anesthesia, a measured strip of lining tissue is removed from inside the upper lip and the lip is sutured at its new position. Nothing is done to the gum, teeth, or bone.
- 5
Early healing
Sutures are typically removed after a week or two. Tightness and swelling of the upper lip are expected during this period.
- 6
Settling
The result is at its most restricted immediately after surgery and relaxes over the following weeks toward the intended position.
Recovery & aftercare
Expect tightness, swelling, and tenderness of the upper lip for the first several days — most patients describe the sensation as a lip that feels stiff rather than painful. Over-the-counter pain relief is usually enough.
Smiling widely, laughing hard, and stretching the lip are discouraged during early healing, since tension on the suture line is the main cause of the correction relapsing. Soft food, gentle cleaning, and no lip-stretching for the period we specify.
The smile looks over-corrected at first and relaxes over the following weeks, so judging the outcome early is misleading. Most people return to normal activities quickly; the definitive result is assessed after the tissue has fully settled.
Common questions
- How is this different from crown lengthening?
- They treat different causes of the same appearance. Crown lengthening reshapes gum and bone to expose more of a tooth that is genuinely covered. Lip repositioning limits a lip that lifts too far over teeth that are already the right length. Doing the wrong one leaves the problem unsolved and the teeth altered unnecessarily.
- Is the result permanent?
- Many patients enjoy a long-lasting result, but relapse is a recognized limitation of the procedure and it is more common with larger corrections. Lip muscles adapt over time and can gradually recover some elevation. Where it happens, the procedure can generally be revised. We discuss this candidly before you decide.
- Will my smile still look natural?
- That’s the aim, and it depends on not overdoing the correction. The lip continues to move normally — the muscles aren’t cut or paralyzed — it simply travels a shorter distance. Over-correction is what produces a restricted, unnatural smile, which is why the amount is measured rather than estimated.
- Is there a visible scar?
- No. The incision is entirely inside the upper lip, in the fold where the lip meets the gum. It is not visible in any expression.
- How does it compare with Botox for a gummy smile?
- Botulinum toxin weakens the elevating muscles temporarily and wears off in a few months, needing repeated treatment. Lip repositioning is a one-time surgical procedure with a much longer result. Botox is sometimes used first as a reversible trial of what the change would look like, which some patients find reassuring.
- Can it be combined with gum contouring?
- Yes, and often should be. Plenty of gummy smiles have more than one cause — a lip that lifts too far and gum tissue sitting lower than it should. Treating only one leaves an incomplete result, so the two procedures are frequently planned together.
- Am I a candidate if I have a very gummy smile?
- Possibly, but very large gum displays are where relapse is most likely and where a skeletal cause is more likely to be involved. In those cases orthodontic treatment or, occasionally, jaw surgery may be the more appropriate route. The evaluation is what determines this honestly.
- How long does the procedure take?
- The surgery itself is short — typically under an hour under local anesthesia — and you go home the same day. It is the healing and settling period, not the operation, that takes time.
Talk to a specialist about lip repositioning
Whether you’re a patient considering treatment or a dentist referring a case, we’ll evaluate, plan, and coordinate care from diagnosis through follow-up.
Sources
This information is provided for educational purposes and is not a substitute for a professional evaluation. Diagnosis and treatment should always be determined by a qualified dental professional based on your individual condition.