Lip Repositioning Surgery
What is Lip Repositioning Surgery?

A fantastic smile always makes a great impression. But for people suffering from the common and treatable condition of Excessive Gingival Display (EGD), or a ‘’gummy smile’’, laughing and smiling are often sources of social anxiety and discomfort. People with a gummy smile have a larger than usual amount of visible gum tissue when they smile or laugh. Nowadays it is becoming more common for dental patients to say their gummy smile makes them feel self-conscious in social situations. A gummy smile can be caused by smaller than typical teeth, excessive gum tissue, a closely connected upper lip and gums, or hyperactive “elevator” lip muscles. Between 10% to 25% of all adults experience EGD of varying severity. Though today, you do not have to suffer from social anxiety associated with this condition. Your periodontist can perform a simple procedure that allows your upper lip to rest lower down over your gums — giving you the perfect smile you always wanted. In order for Lip Repositioning surgery to be effective long term, your periodontist will conduct a meticulous dental examination and discuss alternative options as well as combination with other treatments, including gingivectomy, aesthetic crown lengthening, restorative tooth procedures, and injections.

Lip Repositioning Surgery (LPS) is an innovative procedure that reduces the appearance of a gummy smile and requires modification of soft tissue only. The procedure diminishes the hyperactive upward pull of the “elevator” (upper) lip muscles, which allows for how much of the gum surface is visible when you smile. LPS can be used alone, or in a combination with other techniques and has minimal risk and side effects. LPS is also effective in reducing “lip incompetence or strain”, an inability to maintain a relaxed, closed mouth. Sufferers of this condition have tension in their face when they try to close their lips, and as a result, they experience altered facial development and jaw function as well as swallowing disturbances, tooth eruption and alignment issues.

What to Expect

Dr. Bonacci will first complete a clinical exam to determine if you’re a good candidate for the procedure. He will then use a local anesthetic on the gums and make two tiny incisions under the lip, just below the spot where your gums meet your upper lip. Then he will carefully remove a tiny strip of gum tissue and attach your upper lip to a lower position, which will decrease how far your lip rises when you smile. The procedure will take into account the specific proportions of your face, as well as your desired outcome. The severity of the condition will determine how much gum tissue needs to be removed to readjust your lip position. The procedure takes less than an hour to be performed. It will take around two weeks to heal, and during that time, you should minimize laughing and smiling to avoid stretching your stitches, which could cause the lip to heal incorrectly. Mild swelling and tightness are normal for around two weeks, and you can manage any discomfort with over-the-counter pain medications. Patients can usually return to their normal routine after 4 days, but you should avoid strenuous activities for around 2 weeks.

How Is LPS Different from Other Procedures?

People with a mild gummy smile can have a positive outcome with a gingivectomy, aesthetic crown lengthening, or injections such as Botox or Dermal fillers. Some patients first try lip injections and then later opt for a more permanent remedy. Injections can result in an asymmetrical smile if they are not done properly. Positive changes from injections generally only last for several months. Extensive research shows that Lip Repositioning Surgery is overall a relatively permanent and effective treatment for a gummy smile. Recent studies show that LPS results in improvements for longer periods of time then for injections and dermal fillers.

A Gingivectomy procedure, which involves mild sculpting of the gums, is the routine option for people having minimal extra gum tissue, rather than those who have a hyperactive upper lip or small teeth.

Aesthetic Crown Lengthening, which is a procedure involving trimming away of extra gum tissue and possibly very minimal reshaping of the bone below the required gum to be trimmed, can be utilized in mild to moderate cases.

Should I Consider Seeing a residency trained and Board Certified Periodontist?

When general dentists have patients with more complex dental issues, they will usually refer them to a specialist such as a periodontist. Periodontists, while being dentists with comprehensive overall dental knowledge, also have formal specialist residency training and knowledge in the treatment of the gums and the bones that support the teeth. Lip Repositioning Surgery should be performed by a Board Certified periodontist that specializes in these advanced as well as aesthetic dental procedures.

Would you like to discuss your options regarding Lip Repositioning Surgery?

Dr. Bonacci to address all of your specific questions and concerns as well as to help ensure a healthy mouth, teeth and gums for a lifetime.

Call us today to schedule a consult with Dr. Bonacci!