Letibotulinum Toxin for Gummy Smile Correction: Synergistic Aesthetic Benefits Revealed by Advanced Imaging

Giordano Vespasiani*, Federica Trovato*, Simone Michelini, Antonio Di Guardo, Lorenzo Califano, Stefania Guida and Giovanni Pellacani

Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, University of Rome, "Sapienza", Rome, Italy Department of Dermatology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy

^*Correspondance to: Giordano Vespasiani 

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Abstract:

Gummy smile (GS) is an aesthetic condition characterized by excessive exposure of the upper gingiva during smiling. It occurs approximately twice as often in females as in males. Botulinum toxin injection into the levator labii superioris alaeque nasi muscle, near the nasal ala, is considered the gold standard for minimally invasive GS correction. Targeted neuromodulation in this area may also affect adjacent muscle groups, leading to broader aesthetic improvements. A total of 4 units (4U) of LetibotulinumtoxinA were administered. Clinical imaging and surface analysis were performed using the CANFIELD Visia® CR5 system and PRIMOS software. In the present case, correction of GS using a low dose of botulinum toxin resulted in complete resolution of gingival display and visible improvement in nasolabial folds, bunny lines, and lateral canthal lines. These findings suggest a synergistic aesthetic effect beyond the primary treatment area, supporting the continued exploration of botulinum toxin as a valuable tool in facial aesthetics.

Keywords:

Botulinum toxin; Gummy smile; Nasolabial folds

Cite the Article:

Vespasiani G, Trovato F, Michelini S, Di Guardo A, Califano L, Guida S, et al. Letibotulinum Toxin for Gummy Smile Correction: Synergistic Aesthetic Benefits Revealed by Advanced Imaging. Ann Clin Case Rep. 2025; 10: 2773..