Botulinum toxin type A injections helpful for long-term resolution of gummy smile

Repeated botulinum toxin type A (BT-A) injections have been used for various indications, with long-term benefits in reducing wrinkles and preventing dynamic wrinkles. The current body of knowledge is limited about the long-term results after repeated cosmetic BT injections. Still, a few studies indicate that the long-term effects are cumulative over the years.

In the manuscript, D. Hexsel, Hexsel Dermatologic Clinic, Porto Alegre, Brazil, and colleagues report the prolonged effects of botulinum toxin type A injections after repeated treatments for a gummy smile over a few years.

They discussed the effectiveness of repeated botulinum toxin type A injections for treating a gummy smile. They shared their observations of continuous improvement and, in some cases, permanent resolution of a gummy smile in several patients who received regular botulinum toxin type A injections for ten years. Many of these patients did not require further injections for a prolonged period.

"Botulinum toxin injections are a simple and elegant corrective treatment for a gummy smile," Ashish C. Bhatia MD, FAADAssociate Professor of Clinical Dermatology, Northwestern University, Illinois, USA, wrote in an accompanying editorial. He argued that the patients might not require further injections to maintain their correction maintenance over time. He explained, "This may be due to weakening of the muscle, ageing-related elongation of the upper cutaneous lip, or the habit of muscle flexion in that area being reset to not flex as intensely; most likely, it is a combination of these reasons."

"It is a good idea to let patients know that this may happen to them, and we monitor the need for additional injections at every visit. It's always exciting to see a long-term correction from treatments that otherwise require recurrent treatments," he concluded.

Reference:

Hexsel D, Hexsel CL, Mosena G, Dos Santos ACK, Fabris VC. The long-term resolution of gummy smile with repeated injections of botulinum toxins. J Eur Acad Dermatol Venereol. 2023 Apr 27. doi: 10.1111/jdv.19139. Epub ahead of print. PMID: 37102361.