Bunny lines and a gummy smile share more than facial real estate. They both come from overactive muscles around the midface, and they often show up together when someone laughs or grins. Addressing one without respecting the other can lead to an odd balance, the kind where the nose barely creases but the upper lip still lifts too high, or the smile looks softer but the nose scrunches like an accordion. Thoughtful combination Botox treatments can smooth both, preserve expression, and avoid that slightly “flattened” look that patients try to sidestep.
I have seen a full range of preferences in clinic, from actors who need animation with micro-adjustments to bride‑to‑be clients who want the tiniest change to how much gum shows in photos. The common thread: small, precise doses in the right planes. With neurotoxin injections, less is almost always more in the midface. The art sits in millimeters and units, and the plan should reflect the way you actually smile.
What we mean by bunny lines and a gummy smile
Bunny lines are the short diagonal creases that appear high on the sides of the nose when you smile or laugh hard. They are produced by the transverse fibers of the nasalis and often by contributions from levator labii superioris alaeque nasi. If you see those fine etchings only when you grin, they are dynamic lines. If they linger at rest, time has etched them into the skin and they need a softer hand, sometimes with additional skin therapies.
A gummy smile shows more of the upper gums than you want when smiling. There are several patterns. Some people lift the central lip too high due to a strong levator labii superioris complex. Others flare the nostrils, pull the lip corners hard, or roll the lip inward. Occasionally, the gums look prominent because the upper lip is naturally short or the maxilla projects forward. Each pattern calls for a different map of injections and a different dose. This is why cookie‑cutter placement rarely satisfies.
Why blend treatments
Treating bunny lines alone can shift the midface dynamics. If you soften the nasalis but ignore a strong levator labii superioris alaeque nasi, the smile may lift even higher in the center and look off. Likewise, addressing a gummy smile without quieting nose scrunching can leave those nasal creases as the new focal point. Combination Botox treatments create equilibrium across the nose and upper lip, so the expression still reads like you but the small distractions fade.
Patients also appreciate a single appointment for both concerns, one plan, one set of aftercare instructions, and one follow‑up. When timed correctly, results develop together over 3 to 7 days, peak by 2 weeks, and wear off in step over 8 to 12 weeks, sometimes longer.
Anatomy that matters for precision
Midface neurotoxin work sits near function you do not want to blunt. Two examples explain the tightrope:
- The levator labii superioris alaeque nasi helps elevate the upper lip and can over‑retract, revealing gum. Dosing here softens the lift. Too much weakens smile strength or narrows the nasal airway for a few weeks, which mouth‑breathers feel most. The nasalis compresses the nasal bridge and contributes to bunny lines. Over‑treating this muscle risks a slightly heavy upper lip look or odd wrinkling patterns migrating elsewhere as the face compensates.
Add in the orbicularis oris at the vermilion border, which is relevant for a Botox lip flip, and the zygomatic elevators for smile width, and you understand why mapping injections at rest and in motion is essential. A good injector watches you talk and laugh, marks points as you move, and may ask for a series of smiles: polite, broad, and exaggerated. Those little differences change the plan.
Dosing ranges and placement, from practical experience
Every brand of botulinum toxin type A behaves a little differently and has its own unit scale. Below are practical ranges that commonly work with onabotulinumtoxinA, with adjustments for other brands as needed. The numbers are typical starting points, not prescriptions.
Bunny lines botox tends to be light. Most patients do well with 2 to 4 units per side, placed as two small blebs along the lateral nasal bridge, slightly above where the crease appears when you smile. The needle angle is shallow, the depth intradermal to very superficial subdermal, and the spacing about 1 to 1.5 cm apart aimed at the nasalis. If the lines extend higher, an additional micro‑drop may be placed, but restraint is key. First‑time patients should lean low, then titrate.
Gummy smile botox dosing depends on pattern:
- Central gum show from overactive levators often responds to 1 to 2 units per side at the levator labii superioris alaeque nasi insertion, just lateral to the nasal ala. The angle is shallow, the depth superficial, and placement slightly lateral avoids heavy nasal effects. Lateral gum show near the canines may benefit from a small dose into levator labii superioris proper, again 1 to 2 units per side, positioned lower and more lateral. If the corners pull too high, a micro dose into zygomaticus minor or at the overlap of the levators can help. This is advanced work and should be minimized to avoid a flat smile. For a full lip flip botox effect, micro‑doses of 0.5 to 1 unit in 4 points around the upper vermilion border can help the red of the lip evert slightly. This pairs well with gummy smile treatment when the lip tends to curl inward as you grin. It is optional and not always necessary.
When combining bunny lines botox with gummy smile botox, the total midface dose is often under 10 units in first‑timers. You can always add a touch at the two‑week botox follow up, but you cannot remove it. That philosophy, plus precise placement, is the backbone of natural looking botox in this region.
How a combined appointment unfolds
A thorough botox consultation sets the tone. I ask what bothers you first when you look at a photo. If you point to the lines near the nose and the gum show together, I watch your smile in stages. I may place a mirror so you can see what I see. I mark lightly with a cosmetic pencil while you move. A quick consent confirms risks, benefits, expected course, and alternatives.
During the botox procedure itself, we cleanse, sometimes apply ice for comfort, and use a fine insulin needle. The injections feel like tiny pinches. Expect two to four points per side total when treating both concerns. There is very little bleeding, sometimes a pinpoint dot. The entire botox appointment usually takes 10 to 20 minutes.
Aftercare is simple. Do not rub the areas for the rest of the day. Avoid hot yoga or a strenuous workout for 24 hours. Makeup can go on after a few hours if the skin looks calm. Tiny bumps resolve within minutes to an hour. Bruising is uncommon but possible. Arnica gel can help if a small bruise appears.
What results look like, and when
Botox results start whispering by day 3 and speak clearly by day 7 to 14. Bunny lines soften first. The smile still reaches the eyes, but those short diagonal creases along the nose diminish. For gummy smile botox, you will notice the upper lip does not climb as high. A half tooth or a full tooth of coverage might be the goal instead of exposing the gum. The effect should not look stiff, and speech should feel normal. If you opted for a botox lip flip, the upper lip can look a touch fuller at rest for a few weeks, more like a subtle roll than a true increase in volume.
How long does botox last in the midface? Most people enjoy 8 to 12 weeks of reliable effect, sometimes stretching to 3 to 4 months, especially after a few treatment cycles. Small doses wear off faster. Some patients time their botox maintenance around events or align with full face botox visits for forehead botox, glabellar botox for 11 lines, and crows feet botox near the eyes. If you are new to botox treatments, starting with midface targets alone keeps variables low and lets you judge comfort and expression before adding more areas.
Safety notes unique to this area
Botox for bunny lines and gummy smile is safe in experienced hands, yet side effects do occur. The most common are small bruises, transient redness, or a tender spot for a day. Short‑lived headaches can happen. Very rarely, the smile can feel weaker than intended or asymmetrical. If an injection is too close to the nostril, mild nasal stuffiness may be reported. With lip flip botox, sipping from a straw can feel odd for a week, and whistling may be harder.
People with known neuromuscular disorders, certain allergies to components, or who are pregnant or breastfeeding should avoid botulinum toxin injections. If you have a history of mouth breathing or nasal valve collapse, tell your injector before treatment. Placement can be adjusted to protect airway comfort. For patients using botox for migraines or medical botox for other indications, coordinate timing to prevent overlapping sessions that complicate assessment.
The role of assessment photographs and video
Before and after photos are not vanity. They help tailor dose and placement. I like to capture straight‑on and three‑quarter views at rest, soft smile, and big smile. Video is even better for first‑timers. Watching how the lip lifts over a second or two reveals the muscle that starts the movement and the one that finishes it. That difference guides whether I favor the levator labii superioris alaeque nasi Medspa810 Sudbury Botox MA near the ala or move slightly lateral. It also shows whether bunny lines appear first or if they are a late scrunch. The sequence drives placement.
How combo treatments play with other facial areas
Midface balance depends on the forehead and eyes. If you already have forehead botox or botox for frown lines, your brow position is stable and the eyes look open. Adding crows feet injections softens lateral creases that may stand out more after midface botox because the center of the smile is calmer. The best botox results often come from that cohesive view. That said, one session does not need to include everything. Strategic staging, especially for first time botox patients, avoids surprises.
For patients with a strong masseter or square jaw, masseter botox for bruxism can slim the lower face over time, which sometimes makes a gummy smile more noticeable simply by contrast. If that is your face shape, consider planning gummy smile botox and masseter treatments together. In my experience, the dosing synergy is small but the aesthetic payoff is neat, a more relaxed bite and a softer smile line.
When to consider alternatives or complements
Neurotoxin is not a cure‑all. If a gummy smile comes from vertical maxillary excess, skeletal proportions limit how far botulinum toxin treatment can go. You might gain a few millimeters of lip descent, which can be cosmetically satisfying, but it will not change the base structure. For a thin upper lip at rest, a touch of hyaluronic acid filler, placed conservatively, builds shape that a botox lip flip alone cannot. For etched bunny lines at rest, light resurfacing with energy devices or microneedling can improve skin texture while botox for fine lines reduces motion that re‑etches them.
A good injector should discuss sequencing. Filler first if shape is the priority, then baby botox to quiet overactivity. Or the reverse, depending on your anatomy and timeline. There is no universal order, just a rationale.
The timing cadence that works
Plan your botox appointment 2 to 3 weeks before an event. That window covers peak effect and any small adjustment at a discreet botox touch up. If you visit a botox clinic regularly, you might align midface work with your quarterly wrinkle relaxer injections. People who metabolize quickly, such as heavy exercisers, may need slightly more frequent sessions or accept a softer peak to extend comfort. If budget is a driver, spacing visits and using the smallest effective dose is the way to keep affordable botox without sacrificing safety or look.
Cost expectations and value
How much is botox for bunny lines and gummy smile? Pricing varies by region, injector qualifications, and brand. Most practices charge per unit or per area. Bunny lines may take 4 to 8 units total. A gummy smile usually takes 2 to 6 units depending on pattern, more if a lip flip is added. You can estimate the cost by multiplying local per‑unit pricing by your anticipated range. Be cautious with aggressive botox deals or botox specials that push higher dose packages. The midface thrives on restraint, not volume.
Choose a botox provider who can explain their plan in plain language and who welcomes a conservative first session. A professional botox approach values natural movement and symmetry over chasing total stillness.
What to ask your injector
You will get better results when you know what to ask. Keep it short and specific.
- Which muscles are you targeting for my smile pattern, and why those points? What is the total dose, and how will you stage a touch up if needed? How will you avoid altering my nasal breathing or making my lip feel weak? What will my smile look like at day 3, day 7, and week 2, and what is the plan if I want a tiny bit more or a tiny bit less?
Those questions separate technique from guesswork. They also build trust. A skilled botox injector will not rush through them.
Managing expectations without losing expression
You should still look like yourself. The goal is to refine, not erase. When patients ask for no gum show at all, I demonstrate with fingers on the philtrum how a full block would look and feel, then we agree on a middle ground. This matters for communicators, teachers, performers, and anyone whose job relies on facial nuance. Subtle botox is not a euphemism for under‑treating. It is a philosophy that seeks a narrower target between unbothered lines and live expression.
If you have a history of asymmetry, like one side of the lip pulling higher, mention it. Dosing can be asymmetric by design. Sometimes 1 unit difference is what keeps your smile even. If you habitually scrunch your nose when you concentrate, teach yourself a new habit as the botox sets in. Behavioral tweaks extend results and keep fine line injections working smarter.
Recovery and life after the appointment
Downtime is minimal. You can return to work immediately, which is why many call this lunchtime botox. Makeup and skincare routines can continue, avoiding vigorous rubbing for a day. If you do facial workouts, pause them for 24 hours. Alcohol that evening can increase the chance of a small bruise, but it will not ruin the outcome.
As botox wears off, movement returns gradually. Most people prefer a maintenance rhythm rather than waiting until everything is fully back. Work with your botox specialist to time your next visit so you do not chase your tail with big swings in expression. If you are exploring preventative botox across the face, combine it intelligently with midface tune‑ups so you do not over‑treat any one area.
Edge cases and judgment calls
Two scenarios deserve special mention. First, the athlete or fitness instructor who teaches high‑intensity classes daily. Heat and circulation do not inactivate the toxin, but increased metabolism can shorten duration. I suggest the lower end of a typical dose initially to learn their kinetics, followed by a tiny boost at two weeks if needed. Second, the patient with a history of sinus issues. While botox cosmetic does not directly affect sinuses, small doses near the nasal ala can, in rare cases, change nasal valve feel. Place laterally, and be cautious with cumulative doses if the patient notices any airflow change.
Another call: combining midface botox with neck botox for platysma bands or a micro botox facial. Micro dosing across the lower face and neck can refine texture and reduce pore appearance, but it can also interplay with lip competence if not calibrated. Keep these treatments separate by a few weeks unless your injector has mapped the interaction many times.
A note on choosing your practice
Searches for botox near me will pull up pages of options. Credentials help, but the in‑room conversation and the injector’s portfolio, especially of smiles, tell you more. Look for before and after examples that show teeth and lips in motion, not just a posed still. Ask how often they treat gummy smiles and bunny lines specifically. A clinic that welcomes a short video of you smiling at the two‑week check is investing in your long‑term calibration.
In the end, the best botox for this area comes from reading your muscles and your personality. Some people grin big in every room they enter. Others smile softly and prefer minimal shifts. Both deserve a plan that protects identity.
Putting it together
Bunny lines and a gummy smile share muscle players and timing. Treating them together, with small balanced doses, produces a cleaner, more harmonious smile while preserving character. Start conservatively, review at two weeks, and keep notes on your personal dose history. Over a few cycles you will land on a formula that feels like you on a good day, every day.
If you are considering your first session, schedule a dedicated botox consultation rather than asking to bolt these areas onto a large full face botox plan. Bring photos of how you smile when you do not think about the camera. Describe what you like about your expression as well as what you would change. That combination of clarity and restraint is how you get professional botox results that look effortless, hold up in candid light, and age with you gracefully.