[Comparative efficacy of Botox and surgical lip repositioning in the correction of gummy smile].

Background: A smile plays an important role in determining a person's initial impression.

Objective: This study aims to evaluate the effectiveness of both injection botulinum toxin type A (botox) and surgical lip repositioning in the correction of the gummy smile due to hyperactive upper lip according to the resulting smile and the patients' satisfaction.

Material And Methods: The study consisted of 24 patients: 12 received the BTX-A (botulinum toxin type-A) injection and the remaining 12 underwent the surgical procedure (lip repositioning). The patients rated their satisfaction according to their gingival display that was defined as the difference between the lower margin of the upper lip and the superior margin of the right incisor, and patients were followed at 2 weeks, 2 months, and 6 months. Post injection and post-surgery with changes documented by photographs. Both groups answered a questionnaire addressing the overall appearance and they were asked to rate the improvement of their smile according to a 5-point aesthetic scale.

Results: The patients rated the effects of BTX-A as highly favorable if we take into consideration that BTX-A had a temporary effect while the surgical procedure (lip repositioning) had a relapse likelihood of more than 80% because the lip reverted back to its original position with almost complete relapse after 6 months and not to mention the risks affiliated with the surgical procedures.

Conclusion: BTX-A injection exhibits better results than those of surgery and had given safer and more satisfactory results and achieved the required cosmetic patient requirement than lip repositioning.